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  Issue # 01

This issue updated & posted on 07/22/05

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In The News

This page will consist of News Articles and Information dealing with HIV related issues, treatment studies and news. I will state the date, source and title of all articles as best I can display them here. In addition I will be featuring any other material on this page, poems, writings from others who are HIV positive and want to share a story or two, etc. If you have something you'd like to share please feel free to email me your story, poem or thought to robertedouglas@bellsouth.net

 In The News

The TOC (table of contents) will contain bookmark links to the repost of the article that is listed on this page, The repost will be linked to the actual site the article came from.

 
     

 Name of Article

   
  Ohio AIDS agencies call for Ryan White fund increases
  Four Harvard Medical School researchers part of $300 million NIH center for HIV research consortium
  Atlanta gay man accused of deliberately spreading HIV
  Why Were the HIV Prevention Trials in Commercial Sex Workers Abandoned?

 

 

 

 

 

 

 

Ohio AIDS agencies call for Ryan White fund increases

Columbus--Presenting a united front, the five largest AIDS agencies in Ohio on July 13 called for the federal government to reauthorize the Ryan White Comprehensive AIDS Resources Emergency Act with more money.

Their letter of recommendations was signed by executive directors Aaron Riley of the Columbus AIDS Task Force, Bill Hardy of the AIDS Resource Center Ohio, Earl Pike of the AIDS Taskforce of Greater Cleveland, Victoria Brooks of AIDS Volunteers of Cincinnati and Kevin Sullivan of the Ohio AIDS Coalition.

The Ryan White CARE Act, named for a teenager who died of AIDS in 1990, helps fund services and treatment for people with the disease. It must be reauthorized by Congress periodically; the current bill runs out on September 1.

The House of Representatives has already approved a Ryan White act with no funding increases. The Senate Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies on July 12 approved only a $10 million increase for the AIDS Drug Assistance Programs, while leaving all other funding the same.

AIDS service organization leaders note that an increase of hundreds of millions of dollars is necessary for the ADAP program, especially after the Centers for Disease Control and Prevention increased their estimates of the number of people with HIV in the nation to over 1.1 million earlier this year.

The statement by the Ohio AIDS organization directors laid out four core principles that should be taken into account when re-authorizing the Ryan White act.

First, the funding must be enough to accomplish its goals.

“Today’s funding does not account for the nearly 250,000 people living with HIV in the United State who do not currently access any services,” said Pike. “If we are going to continue to push to get individuals into systems of care and treatment--which has been the needed emphasis--we need to ensure that those services will be available.”

In addition to securing enough funding for services, those services must be available no matter where they are needed.

“The equity should be there across state lines, and within states,” Hardy noted. “People living with HIV in San Francisco and in southern U.S. cities, people living within rural areas and in major metropolitan areas, should have the same access to critical services.”

“Paying for medication is not enough,” said Brooks, noting the need for ancillary services like case management. “If individuals do not have support services that will help them actually access medical care, then we essentially have a full medicine cabinet in a locked room.”

The final principle is that the legislation should not take away the power of local organizations and municipalities to make decisions based on their own needs.

The group pointed to abstinence-only-until-marriage support in the federal government as something that could endanger the effectiveness of local services.

“The strength of the CARE Act has been its unwillingness to impose burdensome cookie-cutter mandates on state and local initiatives,” Riley stated. “Even here in Ohio, there are vast differences across the state, and we need to respect those differences.”

The National Association of People with AIDS six days later released similar principles, urging that the Ryan White CARE Act not “become a vehicle for legislating on controversial social issues related to HIV/AIDS prevention.”

They also call for “supporting the dignity and independence of people living with HIV/AIDS by enhancing their role in all aspects of the CARE Act.”

 

Four Harvard Medical School researchers part of $300 million NIH center for HIV research consortium

Reposted from Harvard University Gazette Tuesday Thursday July 21, 2005

Four Harvard Medical School (HMS) faculty will serve in leadership roles within the Center for HIV/AIDS Vaccine Immunology (CHAVI), a consortium of universities and academic medical centers established today (July 14) by the National Institute of Allergy and Infectious Diseases (NIAD). The center's goal will be to solve major problems in HIV vaccine development and design. Barton Haynes, a professor at Duke University Medical Center, will head the initiative.

CHAVI will receive $15 million in its first year and may receive more than $300 million in the next seven years, according to the National Institutes of Health (NIH). CHAVI's mission is to address major obstacles to HIV vaccine development and to design, develop, and test novel HIV vaccine candidates. The award transforms HIV research in the United States into a cooperative and collaborative system.

Two of the four senior scientific leadership positions will be filled by Norman Letvin, HMS professor of medicine at Beth Israel Deaconess Medical Center; and Joseph Sodroski, HMS professor of pathology at Dana-Farber Cancer Institute. Along with Haynes, these leaders will be responsible for the overall scientific work conducted by CHAVI. They will direct CHAVI research in their own labs and may also form research partnerships between CHAVI and other academic and industrial labs around the world.

Three of the five research core activities will be filled by Stephen Harrison, HMS professor of biological chemistry and molecular pharmacology and of pediatrics at Children's Hospital Boston and Harvard Medical School; Raphael Dolin, HMS dean for academic and clinical programs and professor of medicine at Brigham and Women's Hospital and BIDMC; and Letvin. Stephen Harrison will lead the structural biology core, Raphael Dolin will lead the clinical core, and Letvin, also a scientific leader, will head the vaccine production core.

The NIAID, part of the National Institutes of Health, established CHAVI in response to recommendations of the Global HIV Vaccine Enterprise, a virtual consortium endorsed by world leaders at a G-8 summit in June 2004. The Global HIV Vaccine Enterprise was originally proposed by NIAID Director Anthony Fauci, Haynes, and almost two dozen other prominent HIV vaccine researchers and public health officials in a June 2003 commentary in Science magazine.

CHAVI researchers will focus on solving several unanswered questions about HIV, including how it infects the body in its earliest stages; designing, developing, and testing improved vaccines; and evaluating promising HIV vaccine candidates in small-scale clinical trials. CHAVI will also fund a large-scale study to determine how the immune system of the macaque monkey fends off SIV, the macaque equivalent of HIV.

Approximately 40 million people are living with HIV/AIDS globally, and the rate of new HIV infections continues to exceed 13,000 per day, according to the Joint United Nations Program on HIV/AIDS. Although AIDS drugs have extended the lives of many in wealthy nations, according to global health experts an effective HIV vaccine would be an extremely valuable addition to the comprehensive prevention strategies necessary to halt the spread of HIV in Africa, Southeast Asia, and Eastern Europe, as well as other parts of the world.

In addition to Haynes and the HMS researchers, the CHAVI senior scientific leaders include George Shaw of the University of Alabama, Birmingham, School of Medicine, and Andrew McMichael of Oxford University. The two other core roles will be filled by David Goldstein of Duke University and Myron Cohen of the University of North Carolina, Chapel Hill.

CHAVI will be a "virtual consortium" consisting of a collaborative group of scientists at multiple sites - research centers, universities, and companies - around the world. In future years, CHAVI may also solicit and support high-priority new ideas and discovery efforts from the research community

 

Atlanta gay man accused of deliberately spreading HIV


Reposted from The Advocate.Com, Friday July 22,2005

Garry Wayne Carriker was a fourth-year medical student with a charming style that he worked to his advantage around Atlanta’s bustling gay scene. But just months after he would have graduated from Emory University Medical School, Carriker's career is on hold as he sits in jail, awaiting trial on sex-crime charges that have put Atlanta's gay community on edge.

His crime? Police say the 26-year-old knew he was HIV-positive but went ahead with unprotected consensual sex with another man without warning him. And then, when Carriker was released on bond in March, he was twice arrested on similar charges in a nearby county.

Carriker's case is one of the first in Georgia prosecuted on charges of knowingly transmitting HIV through consensual sex. It brings the state into the vortex of an ongoing legal debate that pits a growing public health crisis against the bounds of privacy. Prosecutors have dusted off a rarely used Georgia law to charge Carriker with felony reckless misconduct, which could keep him in prison for 10 years.

"It's like shooting bullets into the crowd," said Atlanta attorney Adam Jaffe, who is arguing a civil lawsuit against Carriker. "Eventually someone's going to get killed."

Some activists argue that criminalizing HIV discourages people at risk from being tested and cripples prevention efforts. "From a public health perspective, the most important thing is that both sexual partners, not just the HIV-positive one, take responsibility for preventing infection," said Joel Ginsberg, interim director of the San Francisco-based Gay and Lesbian Medical Association. "Criminal prosecution could undermine public health if it discourages testing."

Carriker had been dating John Withrow for five months when he revealed to him in April 2004 that he was HIV-positive, according to incident reports. Citing a little-known statute that makes it a felony to not disclose one's HIV status, a distraught Withrow was turned down by several reluctant attorneys before prosecutors in tightly knit suburban Fayette County, where Withrow lives, decided to press charges.

"The reason I came forward to file a complaint was to stop him from victimizing someone else," said Withrow, who said he has not yet tested positive for the virus.

Carriker posted bond, but since then two other men, both in Atlanta's Fulton County, have claimed Carriker had unprotected sex with them and failed to disclose his HIV status. Superior court judge Johnnie Caldwell Jr. revoked Carriker's $5,600 bond, and he now faces three counts of felony reckless conduct. Prosecutors must now prove that Carriker knew he was HIV-positive during the alleged relationships and did not warn his partners he was infected.

Carriker, a 2001 graduate of the U.S. Air Force Academy, could not be reached for comment. His attorney in the Fayette charges, George Sparrow, did not return repeated telephone calls over two weeks. Clay Collins, who is representing Carriker in the Fulton cases, would not comment on the case, aside from saying it is "on track" and could be tried in September.

Carriker's arrest sent a jolt through Atlanta's vibrant gay community. The city's Midtown section, with many gay clubs, is where two of the alleged victims say they met Carriker. One concerned activist launched a Web site devoted to the case that, until recently, posted Carriker's photo, listed the clubs he frequented, and urged visitors to get tested if they were involved with him.

Withrow's attorneys say the case is a reminder that gay men who believe their sexual partners knowingly exposed them to the virus have legal recourse. "They don't want to go to police and tell them they had unprotected sex," said Tom Nagel, one of Withrow's attorneys. "I'm sure it's happened many times before, but people aren't comfortable going into a police department telling a bunch of big burly guys with guns."

Nagel turned to a rarely used statute in Georgia, one of 28 states with specific laws that make it a crime for HIV-positive people to purposefully expose others to the disease, according to the American Civil Liberties Union. Between 1986 and 2001 there were only 316 criminal HIV prosecutions in the United States, said Zita Lazzarini, who directs the health law division at the University of Connecticut's School of Medicine. In contrast, tens of thousands of sexual assault cases are filed every year.

Lazzarini and two other scientists pored over HIV data for four years to try to link legislation criminalizing HIV exposure to a decrease in incidents. The result: "It is hard to say that these random prosecutions, which happen somewhat rarely, are going to change what people do around the country or in a particular state," she said. The culprits, she said, "don't realize it's a law, they don't think they'll get caught, and they don't think they'll get punished."

What irks some gay activists is the tacit--and perhaps deadly--assumption that Carriker's case brings to light. Many in the gay community, Ginsberg said, assume that if one partner doesn't ask if the other is HIV-positive, then he is willing to run the risk of infection.

HIV apathy is no news to national gay groups, some of which have aggressively worked to compel at-risk populations to be proactive in protecting themselves. The San Francisco AIDS Foundation has run a series of ads targeting gays who assume their partners aren't infected just because they aren't volunteering their HIV status; the ads ask, "How do you know what you know?"

Ginsberg said this kind of attitude makes both parties culpable. "It's fuzzier than simply walking into a crowded area and shooting a gun," he said. "The infected should, of course, be responsible, but the partner shouldn't be infallible either."

Others say forcibly disclosing one's HIV status is a privacy breach. And the legislation's one-size-fits-all nature, which in many states makes no distinction between protected and unprotected sex, allows some prosecutors to abuse the statute's intent, said Lazzarini, who coauthored the book HIV and the Law.

To Al Dixon, the Fayette assistant district attorney who is trying the Carriker case, it's a clear-cut moral issue. "If you're going to have a sexual relationship with someone, they have the right to know whether you have HIV," he said. "That's the only privacy issue I can think of." (AP)

 

 

Why Were the HIV Prevention Trials in Commercial Sex Workers Abandoned?

Reposted from Medical News Today, Wednesday Jul 20, 2005

One promising approach to help stem the global HIV epidemic is to give commercial sex workers an HIV medication (such as the drug tenofovir) before they have high risk sex in the hope of reducing their chances of becoming infected, an approach called “pre-exposure prophylaxis” (PREP). But activist groups, including Act Up-Paris have “halted the progress of at least two important clinical trials of tenofovir as PREP and brought negative attention to tenofovir, somewhat similar to that visited on thalidomide more than four decades ago,” say two researchers in an essay in the open access global health journal PLoS Medicine.

The dramatic protest at the XV International AIDS Conference in Bangkok, Thailand last year against a PREP trial of tenofovir among Cambodian commercial sex workers caught the world's media attention. But Jerome Singh, of the Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, and Edward Mills of the Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada, argue that “if tenofovir is someday proven to be clinically efficacious as a PREP, today's irresponsible reporting and activism surrounding tenofovir could cause those in need to snub the drug if, or when, it becomes licensed for use as a PREP.”

In a commentary on the essay, Joep Lange, who was the President of the International AIDS Society at the time of the Bangkok conference, criticizes the protestors who derailed the PREP trials.

In the absence of an effective HIV vaccine, which is felt to be the only tool that can definitively break the epidemic, Lange says that there is a pressing need to develop female-controlled prevention technologies that do not require the male partner's consent, and the protestors are getting in the way of such development. “Activist groups have now managed to derail several PREP trials, arguably the most important studies for those at high risk of acquiring HIV infection around the globe.”

Lange is highly critical of the tactics used by those who have managed to shut down the PREP trials. “The methods of these specific activist groups,” he says, “are uninformed demagogy, intimidation, and ‘AIDS Exceptionalism', the last in the sense that they exploit their HIV-positive status to get away with behavior that would not be accepted from others.”

“Those who will suffer the most from the misguided ethical imperialism that derailed the PREP trials do not live in Paris, but as usual in Nairobi, Johannesburg, Phnom Penh, and Calcutta.”

Citation: Singh JA, Mills EJ (2005) The abandoned trials of pre-exposure prophylaxis for HIV: What went wrong? PLoS Med 2(9): e234.

 

 

 

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