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Articles tagged with: HIV

May21

I want it NOW!

Tuesday, 21 May 2013 Written by // Michael Yoder Categories // Opinion Pieces, Michael Yoder

Michael Yoder says “We all live in a world that has become increasingly used to immediate gratification.” And that won’t work when building (HIV) community.

I want it NOW!

“Rome wasn’t built in a day.”

Proverb 

“Ten seconds?! Is there nothing faster?!!”

Homer Simpson

(noticing the time remaining on the microwave) 

I’ve been talking with a good friend in a situation not unlike mine in my work, and while there are differences both in the communities in which we live and in the “audience” we seek to engage, the similarities and frustrations are similar. 

We all live in a world that has become increasingly used to immediate gratification. We expect that everything happens at the click of a mouse and the speed of cable connections. I remember someone telling me in 1997 that 58kbs was as fast as an Internet connection could ever possibly be. 

He was incorrect. 

My friend and I were and are (he left his work) in the process of building community. But in a world where we want everything yesterday, community building is old-fashioned and impossibly slow. It is the snail mail to email and apps for finding the next trick via GPS: “Mr. Hot Stuff is 10 metres from your current location…” Building community doesn’t come with a users’ manual and tutorials. It is a process that involves developing trust and connections and fostering and engaging people in connecting with each other. Those things don’t come with a clear timeline or rules. 

Average Joe’s in Vancouver has been going since the late 1980s, early 1990s. It’s a way to connect poz guys with each other in community. I doubt that in the early days there was more than a handful of men showing up for coffee or pizza, but the persistence and interest in being connected to people was important enough that it has blossomed into a large group of men living with HIV and various permutations of the original that suit others’ interests. Those early days were also well before anything like the internet was a concept we could grasp and cell phones were a technology requiring a forklift. 

In University I studied Music History. One of the most stunning things that I learned was how slowly ideas evolve. Back then it would take 500 years for one concept to replace another. These days, we expect the next i-something or other to come along within 6 months, if not sooner. We are like the wretched, selfish little girl Veruca Salt in Willy Wonka: “I want it NOW!!” 

But that’s not how it works. And the unfortunate casualties in our ever growing need for immediate gratification include the delicate blooms of real in-person communities. Health Authorities and funding agencies have the same expectations for delivering up “community” as though it were some sort of Athena, sprung fully-formed from the head of Zeus. There is no nuance anymore. If it isn’t countable and statistically significant, we have failed. 

The program for which I work, Positively Connected, has a small number of HIV+ guys on the email list and a small but slowly growing number of men attending events. It took a year to get this many out and every now and then one more person gets added and perhaps one drops away. It’s a process that involves talking or writing and connecting and re-connecting and trying something and failing and trying something else. I can’t just Facebook it into existence. I can’t make something new happen like it’s been running for years. I can’t make little conservative Victoria be like metropolitan Vancouver. And yet, there is an unspoken belief that’s how it all happens. 

Facebook is interesting because it’s a faux community. In fact, the whole online world is a fabrication. This does not mean that I don’t feel connected to people and my “friends”, but it’s not the same as being with someone in a café across a table talking over coffee, or physically hugging them – oddly hugging a computer monitor isn’t that pleasant. The people on social media are real people, and we’re connected but we’re not connected. I can’t walk down the street to visit my friend in Toronto for a beer, or have breakfast with my friend in Malaysia. Social media is an amazing thing and a useful tool as well, and I’ve had conversations with people I never would have met otherwise, and it leaves a hole in me: I will never likely meet most of those people who are probably amazing creatures. Making friends used to take weeks or months; now it only takes the clicking of the “confirm” button, and being in a community means simply “liking” a page. 

For many poz folk I know that the online world may be the only connection they have to other poz people, and for that I say “Huzzah, Mark Zuckerberg et al!” People living with the stigma of HIV (and many in small and rural communities) need those connections online: they are vital to maintaining our mental health and sense of belonging. But it also points out how glacially “real life” communities form. The sad part of the online world is that it is replacing real life interaction: it’s quick, it’s easy and I can turn it off whenever I want. 

There’s a book called “A Very Private Life” by Michael Frayn written in 1968. In it he explores a world like the one we’re creating: everyone lives in little rooms with only a screen connecting us to the outside world. A young woman accidentally comes in contact with a man in London. She falls in love and must leave her cubicle to meet him. Are we moving toward this world – where we are shut away from each other and more comfortable with that distance? Or are we willing to step outside that which is immediate and known, stop texting and risk the search for a community of which we can’t be sure and where we can surely find belonging? 

There’s a big world out there and it’s full of uncertainty and surprise and fear and love. 

And there’s no app for that.

May21

No, HIV Is NOT about to be cured in three months

Tuesday, 21 May 2013 Written by // Guest Authors - Revolving Door Categories // Research, Health, International , Opinion Pieces, Revolving Door, Guest Authors

From TheBody.com, David Evans of Project Inform dissects the hype and urges caution in interpreting press reports telling us a cure is near.

No, HIV Is NOT about to be cured in three months

Contrary to some hysterically hyped headlines this past week, HIV is not on the verge of being cured in the next three months, nor have scientists found an effective vaccine.

The truth is that a hopeful compound to force HIV out of hiding is under study, and the results should be known in the near future. Unfortunately, however, even if researchers hit a home run with this drug, it won't likely be a cure by itself and we will still be waiting for the day that we have a vaccine or other types of immune therapy to help the body kill any remaining infected cells. 

Let's unpack the hype. Last week the London Daily Telegraph ran a story on this new compound, but claimed that a cure was just around the corner. The reporter apparently misquoted the researcher and overly hyped what he'd been told. The reporter has since toned down his piece and changed the headline due to pressure from a prominent activist in England and likely due in part to a piece the researchers themselves felt compelled to post to refute the article's claims. Unfortunately, the press outside of London grabbed hold and has been retreading the original uncorrected story since then.

Here is the real story. First, contrary to some reports there is no actual vaccine involved at this point. That's probably the most mystifying and frustrating thing. Instead, there is a class of drugs that helps cause HIV that is bound up inside the DNA of resting immune cells to begin reproducing. If we want to cure HIV, then that's the first thing we'll have to do -- to unmask the hidden HIV. The class of drugs is called HDAC inhibitors.

Thus far, there have been four studies of this class of drug. Two were conducted with a very weak form called valproic acid that ultimately had no effect. Two more recent studies were with a drug called vorinostat and showed at least transient increases in HIV RNA production from latent cells, indicating activity, but the effect was also somewhat weak and didn't have the ultimate effect we'd want to see, which is to reduce the amount of HIV DNA there. That would tell us that we are actually reducing the size of the HIV reservoir.

The researchers in Denmark are using a more potent HDAC inhibitor called panobinostat. All of us in the cure advocacy arena have good hopes about the drug, but it is a very, very long way from being a cure all by itself and the very small Phase I study being run by the Danish researchers has yet to publicly report any results. Panobinostat may turn out to be a potent way to kick start HIV replication, but we'll probably have to pair it with a vaccine in order to kill those latent cells that panobinostat has woken up. Unfortunately, we're quite a ways away from having such a vaccine.

It says something quite sad about the state of science journalism in general that articles like this make it out the door. The hype that never pans out ultimately makes people so skeptical about the kind of work Project Inform advocates for and reports on. It's also sadly the case that stories like this, where the reporter, or the researcher -- or both -- hypes a study and claims a cure is just around the corner are all too common. We'll do our best to set the record straight when these arise.

This article original appeared in TheBody.com here.

May20

Another voice for treatment as prevention

Monday, 20 May 2013 Written by // Bob Leahy - Editor Categories // As Prevention , Health, International , Treatment, Opinion Pieces

South Africa’s Brian Williams says there is no other way to end the epidemic.

Another voice for treatment as prevention

At last month’s International Treatment and Prevention Workshop  in Vancouver which I wrote about here, Dr. Brian Williams from South Africa particularly impressed. Williams is a distinguished researcher and advocate for  people living with HIV, and currently heads the South African Centre for Epidemiological Modelling and Analysis (SACEMA)/

Says Williams in the interview you can watch below “treatment as prevention is absolutely essential if we are to have any hope of getting an AIDS-free generation.   It is the only way we can do it.”

He’s right, of course.

Meanwhile, I’m frustrated. We increasingly hear horrified voices from TasP opponents talking about the  - shudder - “medicalization” of HIV prevention, as if fighting an epidemic with pharmaceutical help – the bread and butter of disease control – is inherently wrong,  Never mind that first and foremost it's good for the patient. And failed condoms strategies, the “rubberization” (my term) of HIV prevention in years gone by, hardly sound attractive or humanizing, yet alone effective. Certainly those old-school strategies, by themselves, hold no hope of ending the epidemic, which has become the number one thing I live for to see.

You?

May20

Women talking about being HIV-positive

Monday, 20 May 2013 Written by // Guest Authors - Revolving Door Categories // Arts and Entertainment, Movies, Women, Living with HIV, Population Specific , Revolving Door, Guest Authors

Two young women born with HIV make a video about the advances in treatment, having babies and where they are today.

Women talking about being HIV-positive

FromConnected Health Solutions, Inc.  

While recent advances in the treatment of HIV have opened up new possibilities for families, stereotypes and misconceptions still abound.

According to the Centers for Disease Control, an HIV positive mother who is not being treated for her HIV during pregnancy, labor, or delivery has a 25% chance (1 in 4) of passing the virus to her baby. However, women with HIV who take antiretroviral medication during pregnancy as recommended can reduce the risk of transmitting HIV to their babies to less than 1% .

In this new adolescent-made public service announcement, two women with HIV discuss their feelings towards the mothers who transmitted the virus to them and how advancements in treatment changes their future fantasies.

"I wish I could have been one of those babies...[but] I'm going to be the best mom in the world." says one young woman. "For so long I had hateful feelings towards her...my destiny was chosen for me" says the other, but by the end of the film she expresses that "as a positive female, knowing that if I have a kid, that they're not going to be positive gives me hope."

These women also explore the stigma of being an HIV+ woman. "With the dating, comes the disclosure, comes the fear of rejection," says one of the women. The other woman mirrors these fears, "I feel like I won't have a future as far as finding love, starting a family." They both wanted to make this video as part of a competition held by "Youth, the Arts, HIV&AIDS Network" (YAHAnet), which instructed the adolescent contestants to create a "webisode" that addressed HIV and gender stereotypes.

"I am HIV positive. I'm healthy, I'm living, and I'm still going; If you are positive, stay positive," says one of the women who decided to show her face on camera. Though the other was inspired by her friend's bravery, she remained anonymous but took the next step of sharing her voice. The film can be seen below.

YAHAnet recently announced that the film was the winner of the 19-24 year old category.

About: Connected Health Solutions, Inc. is a consultancy for nonprofits, service organizations, and educational institutions. Their premier product, MyMediaLife, is series of group-level workshops that engage with at-risk target populations to explore and problem-solve social issues and find their voice through digital media. The resulting campaigns are highly polished public-service announcements that attempt to inform and change behaviors, norms, and attitudes.

May19

The first anal condom begins clinical trial in Boston

Sunday, 19 May 2013 Written by // Guest Authors - Revolving Door Categories // Health, Sexual Health, Revolving Door, Guest Authors

Insert and play. New fangled condoms in development place the bottom on top.

The first anal condom begins clinical trial in Boston

ORIGAMI Condoms, based in Los Angeles, CA, has been in development of the world’s next generation of condoms. The company’s unique silicone condom designs include the first condom designed and clinically tested for anal intercourse, the ORIGAMI Anal Condom. A Phase 1 Clinical Trial is underway in collaboration with researchers at The Fenway Institute of Boston. 

Surprising to most consumers, especially to gay men, no condom has ever been safety tested for anal sex usage, nor has it been reviewed or approved for such by the FDA.

The near universal dissatisfaction with the old, rolled latex condom has marked the history of condom use since its creation, and consumers are eager for more pleasurable, less compromising options. Things that are worn need to be design-specific to human anatomy. Hats are designed to wear on the head, shoes designed for feet, and likewise a condom for anal sex needs to be designed for compatibility with the rectum. The designers at ORIGAMI Condoms believe that the time for a new idea is long overdue.

The rolled latex condom has not had a significant structural design change since it was first marketed around 1918. 

The ORIGAMI Anal Condom is the first design initiative to propose a condom specifically for anal sex. It is an inserted condom that is internally fitted into the rectum for receptive anal intercourse. This means the ‘top’ partner needs no condom. The innovation reduces potential irritation for the receptive partner and simultaneously optimizes sensation for the penetrating partner. It is intended to be easily inserted with one finger and it could be put in place hours before intercourse. This new idea eliminates the distraction with intimacy that is often associated with unrolling a male condom onto the penis.  

The condom industry, now dominated by four major players, has not successfully leveraged new technologies for typical product design evolution. Condoms are still made the same way with the same type of dip molding equipment they started with following the industrial revolution. The issue is that men have never liked this form of protection but there was never an alternate choice available, until now. A paradigm shift from 'protection' to 'pleasure' will take some time, although the ORIGAMI Condom people are quite advanced with their developments. 

The Bill & Melinda Gates Foundation noted that “Origami Condoms provides an excellent example of a private enterprise focused on new condom design to promote consistent use by emphasizing the sexual experience. The idea of a condom that men [and women] would prefer to no condom is a revolutionary idea, but we know more today about sexual function than at any time in the past, and advances in relevant disciplines such as neuroscience, vascular biology, urology, reproductive biology, materials science, and other fields can contribute to new and unconventional approaches.” 

"What if we could develop a condom that would provide all the benefit of our current versions, without the drawbacks? Even better, what if we could develop one that was preferred to no condom? The idea of a condom that men would prefer to no condom is a revolutionary idea, but we know more today about sexual function than at any time in the past, and advances in relevant disciplines such as neuroscience, vascular biology, urology, reproductive biology, materials science, and other fields can contribute to new and unconventional approaches." 

The US clinical trial for the ORIGAMI Anal Condom was funded by the National Institutes of Health. The new type of condom is expected to reach the market following FDA review sometime in mid-2015. 

The Bill & Melinda Gates Foundation has decided to launch a competition for the eagerly anticipated, next generation of condoms. The winner of their $100,000 Grand Challenges Explorations may redefine how people all over the world will have sex in the very near future. The Gates Foundation is also offering the winners of this design challenge the opportunity for a subsequent, Phase II award of $1,000,000 to complete their product development and bring it to

May18

Infectiousness

Saturday, 18 May 2013 Categories // Gay Men, Research, Health, International , Sexual Health, Population Specific , Revolving Door, Guest Authors

Aidsmap.com reports about 10% of gay men taking antiretroviral treatment have low levels of HIV detectable in their semen, according to new research. Whether or not this level of HIV in semen is associated with transmission is unknown.

Infectiousness

PositiveLite.com editor's note: we have published this article even though it does not meet our standards for accuracy - see our note below.

From aidsmap.com

About 10% of gay men taking antiretroviral treatment have low levels of HIV detectable in their semen, according to new research. 

In the study, a low but detectable viral load (between 50 and 500 copies/ml) was associated with the presence of HIV in semen.

There is currently a lot of discussion about the effect of HIV treatment on infectiousness and the use of HIV treatment as prevention. Research conducted in heterosexual couples has shown that antiretroviral therapy that reduces viral load in the blood to undetectable levels (below 50 copies/ml) reduces the risk of sexual transmission by 96%. (PositiveLite.com editor's note: the research to which this refers - HPTN 052  - measured the impact of early treatment, not undetectable viiral load, two entirely different concepts..  We have questioned aidsmap.com about the accuracy of their statement.  UPDATE May 20: we have since heard from aidsmap who have admitted their statement is incorrect; they will be issuing a clarification.)

But there have been rare case reports of HIV transmissions in the presence of an undetectable viral load.

Untreated bacterial sexually transmitted infections (STIs) such as chlamydia and gonorrhoea may cause viral load to increase in genital fluids, even if a person is taking effective antiretroviral treatment.

Doctors in the United States wanted to see if infection with human herpes viruses also had an impact on viral load in genital fluids.

They monitored blood and semen samples taken from 114 gay men. All were taking HIV treatment and had a blood viral load below 500 copies/ml (88% had a viral load below 50 copies/ml).

HIV was detected in the semen of 10% of the men. The average viral load in semen was low – 126 copies/ml. Whether or not this level of HIV in semen is associated with transmission is unknown.

Detection of HIV in semen was associated with the presence of two viruses of the herpes family – high semen levels of CMV (cytomegalovirus) and detectable EBV (Epstein Barr virus) in semen.

“The association between isolated HIV shedding and high-level CMV replication and EBV replication in the genital tract suggests that the presence of these viruses could play a role in HIV transmission…these findings have important implications for the development of strategies to reduce HIV transmission,” comment the researchers.

They also found that 36% of study participants with a detectable viral load were shedding HIV in semen compared to 6% of participants with an undetectable viral load.

A urethral bacterial STI was diagnosed in 4% of men, but these untreated infections were not associated with the presence of HIV in semen.

For more detailed information on HIV transmission, visit our online resource HIV transmission and testing.

This article originally appeared in aidsmap news, May 2013. Read the full article here.

 

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