June 24-26th, 2013
8am-5pm each day
Big Horn Resort, Billings, MT
Please register by May 14th!!!
A key concept for anyone considering the success of anti-HIV treatment in improving the health of individuals and in preventing onward transmission in their communities is the ‘treatment cascade’ or ‘care continuum’. This shows how, at every stage, patients are not retained in the healthcare system or are unable to access the medical care they need.
Yesterday, a friend sent me the following:
“Today I saw this headline:
West Nile Outbreak Largest Ever, 41 dead
and it made me think of this:
Rare Cancer Seen In 41 Homosexuals
…and wondering about what makes a disease a crisis versus a judgment. The number of victims was the same.”
Indeed.
And to further the irony, the famous speech given by Mary Fisher to the Republican National Convention in 1992- 11 years after the rise of “gay cancer” was highlighted in a feature by the New York Times today:
TWENTY years ago this month, Mary Fisher took the stage of the Republican National Convention at the Houston Astrodome and delivered a 13-minute prime-time speech that was seen by many as a sharp rebuke of her party’s negligence in the face of the growing AIDS epidemic.
Mary Fisher in 1992 made what is considered one of the best American speeches of the 20th century.
Ms. Fisher, a mother of two young children who had worked in Gerald Ford’s White House, addressed the delegates as someone who was H.I.V. positive herself. “Tonight, I represent an AIDS community whose members have been reluctantly drafted from every segment of American society,” she said. “I am one with a black infant struggling with tubes in a Philadelphia hospital.” She added, “I am one with the lonely gay man sheltering a flickering candle from the cold wind of his family’s rejection.”
It was a speech that was both surprising and poignant. Few, including Ms. Fisher herself, expected that she would survive a disease that had already killed more than 150,000 Americans by the summer of 1992.
But Mary Fisher is still alive — and still taking issue with her political party.
As she should. The discrimination and loathing that prevented government intervention is still with us. It’s made itself known in issues of women’s health, gender inequity, transgender rights and the House defense of DOMA.
However, West Nile will probably not become the epidemic that AIDS did. Because mosquitos don’t discriminate.
They bite everyone.
Infected/Affected by HIV/AIDS?
Join the National Association of People With AIDS (NAPWA). NAPWA is doing amazing work advocating for people HIV infected- and affected. It’s important that they have people from rural areas in their membership, so if you are HIV+ and live in Montana (or other rural areas) I would encourage you to join. From their mission statement:
Founded as a 501(c)(3) charitable organization in 1983, NAPWA advocates for the lives and dignity of all people living with HIV/AIDS, especially the more than a million Americans who live with it today. We want the epidemic to end, and we want life to be better for people with HIV until it does.
They are offering- for the first time ever- a free one year membership. To join me as a NAPWA member, click here: http://www.napwa.org/freemembership
FYI:
People who are incarcerated are at increased risk for acquiring and transmitting HIV and other infections. Correctional health, public health, and community-based organizations need to improve HIV prevention and care for incarcerated populations through 1) routine HIV screening and voluntary HIV testing within prisons and jails and 2) other effective prevention strategies, including those that address inmates’ transition back into the community. Correctional institutions can be important partners in preventing and treating HIV to protect and improve inmate and community health.
Included in the 2012 International Antiviral Society-USA panel recommendations for human immunodeficiency virus (HIV) patient care is that all adult patients, regardless of CD4 cell count, should be offered antiretroviral therapy (ART), according to an article in the July 25 issue of JAMA, a theme issue on HIV/AIDS. Other new recommendations include changes in therapeutic options and modifications in the timing and choice of ART for patients with an opportunistic illness such as tuberculosis.
Melanie A. Thompson, M.D., of the AIDS Research Consortium of Atlanta, presented the findings of the article at a JAMA media briefing at the International AIDS Conference.
Journal of the American Medical Association (Photo credit: Wikipedia)
“Since the first antiretroviral drug was approved 25 years ago, improvements in the potency, tolerability, simplicity, and availability of ART have resulted in dramatically reduced numbers of opportunistic diseases and deaths where ART is accessible,” according to background information in the article. “New trial data and drug regimens that have become available in the last 2 years warrant an update to guidelines for ART in HIV-infected adults in resource-rich settings.”
The benefit of suppressing the virus, in my opinion, is greater than the possible toxicity of medication and navigating possible side effects. We know that as long as HIV is in the body, unchecked, it’s doing damage. It’s more likely than possible that people who start antiretroviral therapy early will have less problems with secondary conditions (joint pain, arthritis, memory problems) as they progress in their lives. I think this is tremendous news.
The waiting list numbers continue steady, just over 2,000, down from 9,000 in September of last year.
Coming off another National HIV Testing Day, we have to wonder how some states can encourage their citizens to get tested but not help them get lifesaving medicines if they test positive.
We also wonder what kind of cost analyses the waiting list states are doing. The cost of clearing the waiting lists completely just isn’t that great. Virginia has just under 600 PLWHA on its waiting list. If drugs cost $15,000 for one ADAP beneficiary for one year, drugs for 600 will cost $9 million – and we just don’t believe $9 million can’t be found in an $85 billion fiscal 2013 Virginia state budget. PLWHA on Virginia’s and other states’ waiting lists will cost the public sector a lot more if they don’t get drugs that can keep them from progressing to AIDS.
Here are the latest numbers from our friends at NASTAD:
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From NAPWA: Recently released supplemental federal funding is slowly bringing state waiting lists down – 2,552 this week. Regional disparities are troubling, though. Ninety percent of Americans on ADAP waiting lists are in the South. The only non-Southern state with comparable numbers is Nebraska. The South is where HIV is spreading fastest, and providing HIV drugs to those who need them would help prevent new infections.
Here are the latest numbers from our friends at NASTAD:
…from The CDC’s Annual Report from the Division of HIV/AIDS Prevention (DHAP), Accelerating Progress, Investing for Impact. This report provides an overview of some of the HIV prevention activities conducted and supported by the Centers for Disease Control and Prevention (CDC) during late 2010 to the end of 2011.
Too few Americans with HIV are getting the testing, treatment, and care they need to stay healthy and prevent transmission to others.
Surprisingly, only 28% of all HIV-infected persons are considered to have HIV under control ( viral load less than 200/ml). That’s not enough.
Percentage of HIV-infected Individuals Engaged in Selected Stages of the Continuum of HIV Care, 2010-11
All HIV positive individuals- 100%
Aware of their infection- 80%
Linked to HIV care- 62%
Retained in HIV care- 41%
Receive antiretroviral therapy- 36%
Have their virus under control*- 28%
*Plasma viral load < 200 cells/ml
Source: MMWR 60(47);1618-1623
HIV infection has increased unexpectedly in Missoula County- 12 new cases in five months- almost half the number of all reported cases in Montana last year.
“We tend to see small numbers of new cases every year, but to have this many new cases – at this count 12 – documented in a five-month period is an unusually high number,” Missoula City-County Health Department Director Ellen Leahy said on Wednesday. “Twelve cases in one county in five months is an outbreak.”
HIV causes acquired immune deficiency syndrome or AIDS, a debilitating and sometimes fatal disease. It is spread by unprotected sexual contact or infected blood transfer, such as sharing infected hypodermic needles. Leahy said all the Missoula cases appeared to stem from sexual activity.
The announcement was made after consulting with many community groups, including Partnership Health Center, the Montana Gay Men’s Task Force and the Open Aid Alliance. Open Aid director Christa Weathers said the decision to publicize the outbreak was a hard one, because health officials depend on people self-reporting their condition to track the disease’s spread.
“It’s hard to issue a public health risk without creating alarm, or without pointing fingers at any group of people,” Weathers said. “It’s a great opportunity to remind people this is a risk and why testing is so important. But we don’t want to discourage anyone who may know they may need to get tested, but they’re afraid to come in and then this hits the media and they’re gone.”
So far, all the confirmed cases are adult males. But Leahy warned that women who don’t consider themselves members of a high-risk group for HIV infection have also been exposed.
“It’s sexually spread, but it’s time to remind ourselves – you really cannot know if you’re infected unless you’ve been tested,” Leahy said. “We recommend health clinics regularly offer HIV testing to sexually active patients. Rather than presume someone is in a risk group, it’s risk behavior, not membership in any group, that they need to think about.”
Several of my sources say the newly-infected persons are young men who simply didn’t practice safe sex, thinking “It’s Montana- I’m not at risk”. These men, mostly in their twenties, I’m told, will now have a lifetime of medication, stigma and health issues to deal with. It saddens me.
Today is a good day to be tested. For a list of Montana free Rapid HIV Testing sites, click here.
If you’re in Bozeman, call AIDS Outreach 406-451-5718 (the number in the link above is incorrect) or go to AIDSOutreachMT.org
