This recent article by Sean Hosein first appeared on the CATIE website here.

Une version française est disponible ici.

It has been 32 years since AIDS was first recognized and 30 years since the cause—a virus we now call HIV—was first isolated. In that time enormous advances have been made: There are tests that can detect HIV and treatment (commonly called ART or HAART) has transformed HIV into a chronic illness. Furthermore, the power of ART is so profound that a young HIV-positive adult who begins treatment shortly after diagnosis today, who takes his/her medicines every day exactly as directed and who has no or limited co-existing health conditions is expected to live for several decades.

Although ART has helped to transform HIV into a chronic illness—particularly in high-income countries such as Canada, Australia and the U.S. and regions such as Western Europe—there are still issues. This treatment must be taken at least once a day, every day, for the rest of a person’s life. Such high levels of adherence may be difficult to sustain for many years. Furthermore, medicines to treat HIV, particularly the newest and most tolerable drugs, are relatively expensive. As the vast majority of HIV-positive people live in low- and middle-income countries, some researchers have wondered whether it is possible to provide care and treatment for all HIV-positive people in those places. At present, not every HIV-positive person in those countries can access care and treatment. Thus, a cure would be very desirable for many reasons.

Know your co-receptors

HIV needs at least two receptors to enter and infect a cell. The first receptor is CD4+, which is found on many immune system cells. HIV usually then needs one of two other co-receptors, either CCR5 or CXCR4.

Some strains of HIV prefer to use CCR5, others CXCR4, and still others use both co-receptors.

Back to the cure

Since the late 1980s, researchers have attempted to cure HIV infection. However, in the first two decades of the AIDS epidemic, such efforts were largely dangerous and unsuccessful.

Then, in 2008, a major development occurred. Doctors in Berlin appeared to have cured an HIV-positive man, who was suffering from leukemia, of both cancer and HIV. The “Berlin patient” had been taking ART for several years prior to his cancer treatment and received chemotherapy, radiation and transplants of stem cells. What was unique in this case was that the donor of the stem cells had a rare mutation (called a delta-32 mutation by researchers) that resulted in his cells having no CCR5 co-receptors. This made the cells somewhat resistant to HIV infection. After intensive chemotherapy and radiation, ART was withheld and the stem cells were transplanted and took hold in his bone marrow, helping to create his new immune system. However, the man’s new immune system attacked parts of his body, a complication called GvHD (graft vs. host disease), and doctors had to prescribe a mix of powerful immune-suppressing drugs to manage this complication. His cancer returned and he had to undergo intensive chemotherapy again as well as another stem cell transplant.

The Berlin patient survived all of these interventions and recurrent cancer. He has not needed to resume ART and sophisticated tests have revealed that either he has no HIV or he has extremely low levels of this virus deep within his body from time to time.

Why the cure?

Researchers are divided about why the Berlin patient was apparently cured. Research teams have proposed different possible reasons for his apparent cure, as follows:

• the intensive bouts of chemotherapy and radiation
• the bone marrow transplant from a donor with a delta-32 mutation
• the intensive stimulation of his immune system arising from GvHD
• the use of transplant medicines, which dampen inflammation and reduce HIV’s ability to infect cells

It is likely that more than one of these factors played a role in his recovery from HIV.

Excitement

The apparent cure of the Berlin patient has excited the imaginations of many researchers and doctors around the world. Clinical trials are underway, mostly in the U.S and Western Europe, assessing different methods for attempting to cure HIV infection. Eventually some of these trials will occur in Canada.

Caution needed

Some of the attempts at a cure, such as genetic therapy, have been relatively safe. However, in attempting to replicate the success of the Berlin patient, other HIV-positive people have died. This is not surprising, as intense chemotherapy and radiation with or without transplant drugs are very debilitating.

Researchers at Harvard University have attempted a variation of the protocol used with the Berlin patient. Although two HIV-positive patients with cancer have volunteered for this experiment and have survived for several years, they remain weak, both physically and immunologically. A major difference between these patients and the Berlin patient is that they have not stopped taking ART. Due to their poor state of health, their doctors have been reluctant to withhold ART, so it is not yet clear if they have been cured.

These experiments with stem cell transplants and chemotherapy and subsequent transplant drugs are dangerous and will not be done on a large scale because among HIV-negative cancer patients such procedures carry a death rate of about 15%. No one is certain about the death rate for HIV-positive people, but it is likely to be at least as high.

Much caution with intense monitoring and hospitalizations will be needed for attempts at a cure. This will particularly be the case as researchers use multiple methods on the same person to attempt a cure.

Still, researchers should be praised for showing imagination and embracing cure research. Such encouragement is necessary because many of the complex ways that HIV interacts with the immune system are not fully understood. Therefore, much research on monkeys infected with SIV (simian immunodeficiency virus), mice transplanted with human immune systems, and HIV-positive people will be needed to gain such an understanding.

The journey toward a cure will not be easy and many challenges lie ahead. Some of the challenges are known, others may only become known as experiments proceed. As with any great scientific endeavour, there will be setbacks. This means that research funding agencies and the public need to be patient. The initial wave of cure research experiments over the next five years should be viewed as exploratory and their results preliminary. This research will seek to answer important scientific questions that can then be used to build a foundation as researchers work toward a cure.

To assist researchers in developing new ideas for cure research, Canada’s premier scientific agency, the Canadian Institutes for Health Research (CIHR), will be seeking proposals from research teams across the country. These proposals will be reviewed by scientists and the most promising proposal(s) funded for five years.

Resources

Hints of a cure—the future of stem cell transplants and HIV – CATIE News

Gene therapy for HIV—outcomes from a recent experiment – CATIE News

Attempts at a cure – TreatmentUpdate

—Sean R. Hosein

REFERENCES:

 1. Kent SJ, Reece JC, Petravic J, et al. The search for an HIV cure: tackling latent infection. Lancet Infectious Diseases. 2013; in press.

 2. Katlama C, Deeks SG, Autran B, et al. Barriers to a cure for HIV: new ways to target and eradicate HIV-1 reservoirs. Lancet. 2013; in press.

 3. Samson M, Libert F, Doranz BJ, et al. Resistance to HIV-1 infection in Caucasian individuals bearing mutant alleles of the CCR-5 chemokine receptor gene. Nature. 1996 Aug 22;382(6593):722-5.

 4. Moore JP, Kitchen SG, Pugach P, et al. The CCR5 and CXCR4 co-receptors—central to understanding the transmission and pathogenesis of human immunodeficiency virus type 1 infection. AIDS Research and Human Retroviruses. 2004 Jan;20(1):111-26.

 5. Huzicka I. Could bone marrow transplantation cure AIDS? Medical Hypotheses. 1999 Mar;52(3):247-57.

 6. Hütter G, Nowak D, Mossner M, et al. Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. New England Journal of Medicine. 2009 Feb 12;360(7):692-8.

 7. Allers K, Hütter G, Hofmann J, et al. Evidence for the cure of HIV infection by CCR5 Δ32/Δ32 stem cell transplantation. Blood. 2011 Mar 10;117(10):2791-9.

 8. Gorry PR, Zhang C, Wu S, et al. Persistence of dual-tropic HIV-1 in an individual homozygous for the CCR5 Delta 32 allele. Lancet. 2002 May 25;359(9320):1832-4.

 9. Soussain C, Ricard D, Fike JR, et al. CNS complications of radiotherapy and chemotherapy. Lancet. 2009 Nov 7;374(9701):1639-51.

 10. Krishnan A and Forman SJ. Hematopoietic stem cell transplantation for AIDS-related malignancies. Current Opinion in Oncology. 2010 Sep;22(5):456-60.

 11. Deeks SG and McCune JM. Can HIV be cured with stem cell therapy? Nature Biotechnology. 2010 Aug;28(8):807-10.

 12. DiGiusto DL, Krishnan A, Li L, et al. RNA-based gene therapy for HIV with lentiviral vector-modified CD34(+) cells in patients undergoing transplantation for AIDS-related lymphoma. Science Translational Medicine. 2010 Jun 16;2(36):36ra43.

 13. Hütter G and Thiel E. Allogeneic transplantation of CCR5-deficient progenitor cells in a patient with HIV infection: an update after 3 years and the search for patient no. 2. AIDS; 2011 Jan 14;25(2):273-4.

 14. Sauce D, Larsen M, Fastenackels S, et al. HIV disease progression despite suppression of viral replication is associated with exhaustion of lymphopoiesis. Blood. 2011 May 12;117(19):5142-51.

 15. Hunt PW, Landay AL, Sinclair E, et al. A low T regulatory cell response may contribute to both viral control and generalized immune activation in HIV controllers. PLoS One. 2011 Jan 31;6(1):e15924.

 16. Deeks SG. HIV infection, inflammation, immunosenescence, and aging. Annual Review of Medicine. 2011 Feb 18;62:141-55.

 17. Hatano H, Delwart EL, Norris PJ, et al. Evidence of persistent low-level viremia in long-term HAART-suppressed, HIV-infected individuals. AIDS. 2010 Oct 23;24(16):2535-9.

 18. Sigal A, Kim JT, Balazs AB, et al. Cell-to-cell spread of HIV permits ongoing replication despite antiretroviral therapy. Nature. 2011 Aug 17;477(7362):95-8.

 19. Mitsuyasu R, Lalezari J, Deeks S, et al. Adoptive transfer of zinc finger nuclease CCR5 modified autologous CD4 T-cells (SB-728-T) to aviremic HIV-infected subjects with suboptimal CD4 counts (200 to 500 cells/mm3). In: Program and abstracts of the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy, 17-20 September 2011, Chicago, Ill. Abstract HI-375.

 20. Henrich TJ, Sciaranghella G, Li JZ, et al. Long-term reduction in peripheral blood HIV-1 reservoirs following reduced-intensity conditioning allogeneic stem cell transplantation in two HIV-positive individuals. In: Program and abstracts of the XIX International AIDS Conference, 22-27 July 2012, Washington, DC. Abstract THAA0101.

 21. Deeks S, Drosten C, Picker L, et al. Roadblocks to translational challenges on viral pathogenesis. Nature Medicine. 2013 Jan;19(1):30-4.

 22. Towards an HIV cure: a global scientific strategy. International AIDS Society Scientific Working Group on HIV Cure. Nature Reviews Immunology. 2012 Jul 20;12(8):607-14

 23. Deeks SG, Barré-Sinoussi F. Public health: Towards a cure for HIV. Nature. 2012 Jul 18;487(7407):293-4.

 24. Pasternak AO, de Bruin M, Jurriaans S, et al. Modest nonadherence to antiretroviral therapy promotes residual HIV-1 replication in the absence of virological rebound in plasma. Journal of Infectious Diseases. 2012 Nov;206(9):1443-52.

 25. Bangsberg DR, Haberer JE. Lifetime HIV antiretroviral therapy adherence intervention: Timing is Everything: comment on "Managed problem solving for antiretroviral therapy adherence". JAMA Internal Medicine. 2013 Feb 25;173(4):306-7.

Vaccine Alert issued by Toronto Public Health.

Invasive Meningococcal C Outbreak among Men Who Have Sex with Men (MSM) in New York City: Recommendations for Travel

April 18, 2013: An ongoing outbreak of invasive meningococcal disease serogroup C has been occurring among men who have sex with men in New York City. Since 2010, there have been 22 cases reported: one in 2010, four in 2011, 13 in 2012 and four in 2013. Seven men have died, including three of the last five cases. The age range of cases is 21 to 59 years, and 50% have been Black, 27% White, and 18% Hispanic (any race). Twelve cases were HIV-infected, of which five have died. Cases of meningitis have also been reported in MSM in California.

The New York City Department of Health is recommending meningococcal vaccine to the following New York City residents:

• All HIV-infected MSM
• MSM, regardless of HIV status, who regularly have close or intimate contact with other men met either through an online website, digital application (“app”), or at a bar or party 

The Public Health Agency of Canada (PHAC) is not aware of any cases among Canadians related to this outbreak. Toronto Public Health has also not seen any cases related to this outbreak. Please call Toronto Public Health if you think you have a suspect or confirmed case of meningococcal disease to TPH's surveillance unit at 416-392-7411 during work hours (8:30am to 4:30pm, Monday to Friday) or at 3-1-1 after hours.

The National Advisory Committee on Immunization (NACI) recommends use of the quadrivalent meningococcal conjugate vaccine (Men ACYW-135 – Menactra or Menveo) to travelers where the risk of meningococcal transmission is high. NACI also says vaccination should be considered for individuals with HIV.

Toronto Public Health recommends physicians offer meningococcal conjugate ACYW-135 vaccine to MSM who are planning to travel to New York City and who are either HIV-infected or who may have close or intimate contact with other men met either through an online website, digital application (“app”), or at a bar or party in New York City. Note that this vaccine is not publicly funded for this group.

More information:

Toronto Public Health Immunization Information Centre:

416-392-1250 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

New York City Department of Health alerts. 

Canadian Immunization Guide on meningococcal vaccines.

Writing my last blog post was very difficult for me. It was a very emotional topic and I found it a mental battle to keep my thoughts and feelings in check.  Like many women, the events made me incredibly angry that, even today, we have to argue that women have the right not to be raped. It is so preposterous that we even need to discuss these issues anymore. It is disheartening.  And yet, when I finished that post, I knew my next blog post would be about hope.

You may recall an earlier post on International Women’s Day where I pondered the absence of men in events to do with women’s rights and women’s health. My musings turned out to foreshadow what would be dismal participation by men in our otherwise successful International Women’s Day events. No men showed up to a film screening on the history of Canadian feminism at the public library. No men showed up to the lecture on HIV campaigns and their (mis)representation of women by a professor of Sociology on campus.  Two men (ACG’s Executive Director and a member of our Board of Directors) showed up at our HIV & Pregnancy forum for medical & social service workers - two men, that is, out of 65 participants. And at our Women on the Bridge event, the small number of men in attendance seemed to have an organizational or political affiliation. It reinforced my feelings that somehow we are in this alone.

And so it was with some spark of hope that I began to see men respond to the issues around violence against women and rape culture as news of Steubenville infiltrated the media. There was word from Patrick Stewart. And George Takei. And Henry Rollins.

And then, of course, there were the women. The social media response to the rape culture problem has been amazing. Finally, we are seeing healthy, powerful messages broadcast through media (especially social media). For instance, the message that no woman – regardless of what she wears, what she drinks, or what she says, deserves to be raped. The message that victim blaming is not an appropriate response to rape. The message that we need to, finally, teach boys not to rape. These messages have been loud and clear – in countless campaigns, public service announcements, blog posts, you-tube videos, protests, memes and graphics. It truly gives me hope to see so much concerted effort towards this issue, and much of it youth-oriented, powerful, fresh - even fun.

But nothing has given me as much hope as the open letter by Melissa Harris-Perry.

It immediately re-shifted my focus. As a global community we have been discussing the problems with rape culture - as we should be.  But as much as we need to discuss these problems, there is something that is very good here. The young woman who was raped (and I say “young woman” because I suspect any identity of “girlhood” is gone now) had the bravery to come forward and the tenacity to persist through the god-awful trial. What she has endured will no doubt complicate her life with trauma. It will undoubtedly complicate her relationship with the world, with her body, with her relationships. But I hope she can someday see herself as someone who stood up for the rights of women worldwide. 

When women push towards their rights, they are often punished – socially, if not legally, physically, financially.  The social media smearing and shaming and the CNN coverage were evidence of this. But by going through with the trial and enduring all of it, this young woman helped to address some very serious issues and bring these issues to light.

The boys’ sentence, however mild, was still enforced, and this is a very good thing. I believe it was Emile Durkheim who theorized that the law is not a tool to enforce justice, but a tool used to solidify and reaffirm the existing moral code of a society. Using this theoretical framework, we can imagine that the boys’ sentence helps to reinforce a moral code which says women do not deserve to be raped - no matter what.

Because this young woman persevered, these issues became the catalyst to get a lot of people raising concerns about rape culture and finding new, interesting, colourful ways to change these cultural attitudes. Because of her, many new people are speaking about these issues and discussing them in different ways. It is not because of the rape itself that these positive things are happening, for rapes happen all the time. It is because she made the choice to proceed with the trial and use her voice, if only by being honest, to make a stand for women’s rights over their bodies and their lives.

Sometimes women activists don’t even realize that what they are doing is powerful and perhaps this is the case for this young woman. I hope then, that someday she can reshape her identity. Not as “slut” as so many have called her and not as “victim” either. I hope she can reshape her identity to acknowledge her strength, and her power.

From Rosa Parks, “Quiet Strength:”

I did not get on the bus to get arrested; I got on the bus to go home...  I had no idea that history was being made. I was just tired of giving in. Somehow I felt that what I did was right by standing up to that bus driver. I did not think about the consequences. I knew that I could have been lynched, manhandled, or beaten when the police came. I chose not to move. When I made that decision, I knew that I had the strength of my ancestors with me.

Saturday, April 13, 2013 – At the Canadian Association of HIV/AIDS Researchers conference in Vancouver AIDS ACTION NOW! led people living with HIV, researchers, and doctors to stand in solidarity and call for members of the Canadian HIV research community to stop acting as paid expert witnesses on the side of Crown prosecutors in HIV non-disclosure trials. 

Over 50 demonstrators stood behind a sign that said: “HIV is not a crime. AIDS Profiteering is” during Dr. Robert Remis’ (below, left) abstract presentation. Dr. Remis is a prominent epidemiologist who is responsible for Ontario’s provincial epidemic surveillance, and is also a paid expert witness for the Crown in many HIV non-disclosure trials.

AIDS activists have been increasingly angered at the perceived conflict of interest practiced by this scientist and that he financially benefits off the lives of people who are prosecuted in relation to HIV non-disclosure. In one case, Remis’ testimony in the pre-trial led to charges being increased from assault to aggravated assault. Remis is also a member of the Canadian Association of HIV/AIDS Researchers and was an abstract reviewer for the conference’s Epidemiology and Public Health Sciences track.

Jessica Whitbread of AIDS ACTION NOW! stated, “We are calling on HIV scientists and doctors to take a moral stand and stop perpetrating HIV stigma against those of us living with HIV. If we are to end stigma and HIV criminalization we need to act in our own movement first.”

The protest was silent and strong with members leaving their seats in the front row to come and join the demonstration. One member of the audience who joined the demonstration stated, “When I looked back I saw a dense wall of fierce women activists and it gave me the chills to know how powerful they were. Then I got up and joined them.” Another member of the protest said: “We need to stand for something or else we will compromise for anything.”

Demonstrators handed out a flyer that said:

Dear Doctor,

It’s your duty to actively oppose the criminalization of people living with HIV.

Use your title and platform to promote science, reason, and social justice. Speak out against the further marginalization of populations you serve and study.

Criminalization perpetuates stigmatizing misinformation, fear, and hatred. Testifying in support of prosecution appeases oppression. You know that this miscarriage of justice contradicts science and public health so retaliate.

Strongly advocate for universal access to HIV education, testing, and treatment, and say NO to the criminal prosecution of people living with HIV!

Sincerely,

Integrity

The short answer is, we didn’t win. But that’s misleading. There is so much more to the story.

On Friday April 5, as I whipped into the parking lot and dashed into the office, my heart was beating. It was our last chance to get the final votes.  I hadn’t slept much the night before, and thanks to a persistent cold, my throat was raw and I could barely speak.  I lit up my computer to send out last minute pleas for help through email, Facebook and Twitter, reminding anyone who cared (and probably some who did not) that we had only hours – and then minutes – left to win Canada’s Worst Charity Website.

I have been told that many of our supporters anxiously refreshed their browsers over and over again, waiting to see the final tally. What they didn’t know is that the company who hosted the contest, rTraction, was monitoring votes and would strip the final numbers of any that looked illegitimate.  We wouldn’t know the final tally until an hour later.

Both myself and Wayne have written previous posts on why this contest is important to us. We want to make our HIV prevention and support services more accessible online.  We do this work within the confines of certain barriers – including the fact that stigma, isolation (both social and geographical) make face-to-face conversations about HIV, AIDS and STIs difficult. For many hard-to-reach populations, including those who live in rural areas and those who fear stigma, discrimination or racism, a website is often a primary access point to information. For us, this was about bridging barriers.

Shortly after 1:00, our Executive Director, Tom, went into his office to answer the telephone and I knew right away the news wasn’t good.  From his office, he gave me a thumbs down.

I didn’t understand then, why he sounded so chipper. “We’re thrilled,” I heard him say a few minutes later.

When Tom gathered all the staff together for an announcement, he told us what I already suspected – we didn’t win first place. But rTraction had been so impressed with our enthusiasm and hard work, they decided to offer us a second prize that was nearly as great – a website makeover worth $15,000!

We are truly thrilled to accept this prize. The development will take place in 2014. I really look forward to having a user-friendly, responsive, and professional website.

Beyond that though, this process has been really enlightening. It’s been incredibly moving to see the kind of community involvement we’ve received. I say involvement, because it’s gone beyond the simple act of voting. Our supporters took a major role promoting the contest by sharing, tweeting, emailing, blogging, Facebooking – and plain old talking about the contest.  They designed memes. They gave free advice. One physicist friend actually wrote a computer program to help monitor and analyze the voting trends. And this support wasn’t only found in the Guelph community (although the Guelph community has been a huge source of support – including voluntary associations, social services and nonprofit organizations, the university, the Mayor and countless other organizations and individuals).  The support and involvement extended across the region, the province, the nation – even the globe! Friends spread the word in multiple languages.

We utilized social media as well as traditional media. We worked hard to get the HIV & AIDS community involved as much as possible, asking for help from as many HIV/AIDS affiliated organizations across Canada (and into the United States and beyond) to help us – and that included the fabulous PositiveLite.com blogging community!

The really cool thing is when you start to see your voters become promoters. That especially took off as our supporters learned why this contest was so important. It wasn’t just about getting a great website so that we could solicit donations. It was about making sure that life-saving information was available to people as they need it. It was about overcoming significant barriers like stigma, shame, isolation and fear.  Supporters began to learn more about us and the issues we faced, and they started to share this information with their own networks.

Here’s an example.  I saw an acquaintance – who has no affiliation with the AIDS Committee - post this on Facebook when encouraging her friends to vote:

Not only is the AIDS Committee of Guelph an organization deserving of and in need of a new website, but the nature of their work means that having a well designed site that's easy to use is extremely important as social stigma, fear and a host of other issues might mean it's their first (or only) point of contact with some individuals needing their services.

It is inspiring to see how our messages have circulated through social media, prompting individuals outside our circles to learn, share and talk about HIV.  It seems this contest has helped us raise awareness of who we are, what we do, and most importantly, the issues that we work to address every day.

More than 15,000 votes were sent in favour of the AIDS Committee of Guelph. I’m told it was a very close call – that we lost only by a hundred or so.  I also recently learned that our total was more than double the amount of the winning organization from last year.  The fact that we came so close to winning while competing against an organization based in Ottawa – a city that dwarfs Guelph in size and political power – is incredibly inspiring.  It is a testament to how much our supporters care for this agency and its cause. It also speaks to how the HIV & AIDS sector works as a family. 

With this contest we have heightened our local and global response to HIV and AIDS – and that has truly been our most important goal, regardless of winning or losing this contest.

On behalf of the staff and Board of Directors at the AIDS Committee, I would like to express their heartfelt thanks for everyone who voted and promoted the contest.  A special thank you also to rTraction, from London Ontario, for hosting Canada’s Worst Charity Website contest and congratulations to the Wild Bird Care Centre of Nepean Ontario on their win.

I love my fine feathered friends, they are amazing creatures, and they sing beautifully but................ 

No one could ever accuse me of being anti-nature or a bird hater. Birds have been a large part of my photography excursions over the past three years. Today, I am a little miffed that a website that brings awareness to birds in need of care continues to lead an AIDS service organization (ASO)  to win a website upgrade by means of an online challenge. I think, this is why HIV will remain a big part of the world today and in the future. 

In show business they say don't follow kids or animal acts, they will always win in the end. I hope this isn't the case here but I am ready to concede that it will be. I spent most of yesterday promoting the challenge on Twitter and Facebook and it took off quickly; for a while we were running neck and neck, we even held first place briefly. This morning I wake up to find we were more than 600 votes behind again. I will keep pumping out the "Vote" messages online because if you don't try, you don't even come close. We are after all, in second place at this time. 

The competition is about helping charities raise awareness and strengthen a connection in their communities. The AIDS Commitee of Guelph and Wellington County  believes the upgrade is imperative in helping the organization disseminate health information in an accessible way to the population it serves. 

As you can see, this irks me so much. Everyone can and will talk about birds everywhere, anytime. The news media never have anything negative to write about birds, “but if you want us to talk about HIV prevention and awareness, we’ll put it in the back pages - somewhere". Now if someone is charged with non-disclosure, it would be front page material with the person’s name and photo, supplied by the local police station. 

When people learn they are HIV positive, stigma can prevent them from going to the ASO’s office, so the internet is where they may turn to. ASOs need all the social media access they can muster to provide prevention and awareness and most of all, support. This ASO needs that website update. 

Birds will always soar and sing, HIV Prevention will be hidden and shushed. Not on my watch. 

Thanks for letting me rant and to show I'm not a bird hater, here are a few shots I've taken during this long winter. 

And there ARE a few days left to put  the AIDS Committee of Guelph in the lead for the title of Canada’s Worst Charity Website and thus win the organization $20,000 for a refit. . Click here to vote. The competition closes april 5.