Category Archives: HIV

AIDS Activists Arrested At Rehberg’s Office

by D Gregory Smith

…for protesting the needle exchange ban “sneaked” into the Federal Funding Bill in December- despite scientific research which shows that it does not promote drug use, but does stem the progress of infectious disease.  From The Missoula Indy:

via wikipedia

A demonstration by AIDS activists Wednesday morning targeted Rep. Denny Rehberg of Montana and other congressmen for their role in “sneaking in” a federal ban on clean needle exchange programs. Ten activists were arrested outside Rehberg’s office. Capitol Police put the total number of those arrested at 29; activist organizations say the number was actually 32.

The Huffington Post described the background of the demonstration:

“Rehberg was targeted for his role as chair of the House Appropriations subcommittee on health and human services, where he led the effort to ban funding for needle exchange programs, adding it to a House spending bill that funded the federal government through fiscal year 2012…

The ban was originally adopted in 1989 but was finally lifted by Congress in 2009. Republicans lawmakers quietly slipped the ban back into their spending bill in December of last year.”

In addition to Rehberg, activists targeted Rep. Hal Rogers (R-Ky.) and House Speaker John Boehner (R-Ohio). There were also rallies in New York outside the offices of Sens. Chuck Schumer and Kirsten Gillibrand. The groups taking credit for the demonstrations were Housing Works, Health Global Access Project and Citiwide Harm Reduction.

Activists are against the ban because studies show that clean needle programs help curb the spread of HIV and hepatitis C, and reduce the rate of new HIV infections among injection drug users by as much as 80 percent. The Huffington Post article also notes that additional research shows “syringe exchange programs do not increase the numbers of injection drug users and can further reduce long-term healthcare costs for people with HIV or hepatitis C.”

Indy reporter Jessica Mayrer wrote a 2010 cover story about outreach workers across Montana working on HIV and hepatitis C prevention programs, and how drastic cuts to funding were affecting their efforts.

The false meme that is promoted is this: clean needles encourage drug use and do not prevent the spread of disease.
The truth is this: clean needles do not significantly increase drug use and do prevent the spread of disease.

The only logical conclusion is this: the lawmakers who promoted this ban want those who use needles to spread and to die of deadly disease.

They are not interested in public health, they are interested in shaming people with disease (addiction, Hep C, HIV). Completely and utterly irresponsible.

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HIV Diminishes Lung Function

by D Gregory Smith

We know that uncontrolled HIV can lead to a host of problems (see illustration). You can now count breathing among them.

English: Main symptoms of acute HIV infection....

Image via Wikipedia

A new study has shown that if you have untreated HIV, you are much more prone to a rapid decline in lung function. Because we know that smoking negatively affects lung function, this finding adds urgency to the message that persons with HIV will benefit greatly from not smoking.

The study seems to corroborate soft-tissue organ damage by unchecked HIV, and is yet another argument buttressing early treatment and lowering viral levels among persons with HIV disease. From AIDSMEDS:

Though the study results from a Johns Hopkins University School of Medicine team note that people living with HIV—particularly those with viral loads not being kept in check with antiretroviral (ARV) therapy—have reduced lung strength and a more rapid loss of pulmonary function compared with HIV-negative controls, the researchers also point out that cigarette smoking was very common in the cohort studies and remains an important risk factor to contend with.

As explained by Michael Drummond, MD, of Johns Hopkins during his introductory remarks, HIV infection has been shown to increase the risk of obstructive lung diseases (OLD), such as emphysema and chronic bronchitis—both under the umbrella of chronic obstructive pulmonary disease (COPD)—and asthma.

According to a study reported in 2000, there was a greater prevalence of emphysema—documented using chest X-rays—in smokers living with HIV. And in a 2006 study, HIV infection was found to independently increase the risk of a COPD diagnosis by 47 percent.

More recently, in a study authored by Drummond and his colleagues in 2011, an HIV viral load in excess of 200,000 copies was associated with a 3.4-fold increase in the odds of having an OLD diagnosis using gold-standard pulmonary function tests. The cohort has enrolled more than 4,000 injection drug users, roughly a quarter of whom are people living with HIV.

People with uncontrolled HIV infection had a loss in lung function at a sharply higher rate than both HIV-negative people and those with good viral control. It means that if you smoke, you’re just going to make that loss of lung function happen faster. I quit smoking almost three years ago. In fact, I wrote about it right here.

There were a lot of reasons. But mostly,  I quit because I wanted to consciously choose a healthy life. And I wanted to be able to credibly help others to do that, too. These facts from Nancy Reynolds study on HIV and smoking helped bring me out of the smokers’ corner for good:

  • The lungs of a person with HIV are more susceptible to cancer, emphysema, pneumonia,acute bronchitis and tuberculosis. This risk increases dramatically among HIV+ smokers.
  • The incidence of cancers, especially lung and cervical cancer are higher among HIV+ smokers and develop at a significantly younger age than the general population.
  • And the biggie: Smokers with HIV negate some of the effects of antiretroviaral medications by smoking. Thus, HIV+ smokers had a 36% greater chance of developing an AIDS-defining condition and a 53% higher risk of dying than HIV+ persons who did not smoke.

In the last few years after I quit smoking, my health has steadily improved. My cardiac function increased. My CD4 counts went up. My bilirubin counts went down- so did my bad cholesterol. All good things. I can exercise more without gasping, and I look good (if I do say so myself).

So, again, I’ll make a plea: I don’t want to be one of those newly-converted who scowls every time somebody lights up a cigarette. I really don’t. I understand how much fun smoking is, and how complicated. I just want you to have the facts. The very disturbing facts.

And maybe, if you’re a Person With HIV, they’ll hit you like they did me and you’ll improve the quality and length of your life. Just maybe.

And if you know someone who’s HIV+ who still smokes, show them this article- and ask them if they need support to quit. There are a lot of resources out there- and a lot of good reasons to choose from.

Even more now.

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ADAP Watch March 12, 2012

by D Gregory Smith

From our friends at NAPWA:

 

The President has called for The End of AIDS in America, and that means an end to ADAP waiting lists. Everyone who needs HIV antiretroviral medicines should be getting them, and we can reduce long-term health care costs by making sure they do.
This is an extraordinarily difficult political climate, though, so we don’t expect much movement on the waiting lists until after the elections. We’re grateful to the Administration for the new money that brought the counts down from 9,000-plus to just under 4,000, and we think it’s time for states like Virginia and Georgia to join the Administration and pay their fair share. Belly up to the bar, boys!
Here are the latest waiting list numbers from our friends at NASTAD. Let’s not forget that these are the visible waiting lists. Too many states have vanished PLWHA who used to qualify for ADAP assistance by setting income eligibility ceilings unreasonably low.

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Tester Stands Up

by D Gregory Smith

Senator Jon Tester’s office released the following today:

Jon Tester, U.S. Senator from Montana

Image via Wikipedia

Senator Jon Tester today released the following statement after voting against a controversial amendment by Sen. Roy Blunt, R-Mo., that would have allowed employers to deny health insurance coverage, including contraception, for any employee based on “moral convictions”:

“This is a reckless attempt to undermine individual freedom and restrict access to health care for women.  This measure is unprecedented and out-of-touch with Montana, and it would have prevented women from making their own healthcare decisions.”

The amendment did not define “moral convictions,” meaning an employer could have denied insurance coverage for anything from blood transfusions and diabetes screenings to HPV vaccinations and treatment of HIV.

The measure failed by a vote of 51-48, failing to reach the 60 votes needed for approval.

It sounds like it would have given employers the right to discriminate for insurance coverage.

I’m especially glad the release specifically mentioned HIV- we have hundreds of Montanans living with HIV who are enrolled in health insurance through their employers….

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The AIDS Quilt 25 Years Later

by D Gregory Smith

And remember, people are still dying….

 

 

http://www.aidsquilt.org

Watch Our Mardi Gras Interview On KBZK

by D Gregory Smith

Here!

 

The event information:

Mark Your Calendars!

by D Gregory Smith

It’s that time of year- it’s time for AIDS Outreach Mardi Gras!

ADAP Waiting List 1/26/12

by D Gregory Smith

Kaiser Permanente Announces HIV Challenge

by D Gregory Smith

When healthcare gets it right, I think it’s important to notice.
Contrary to the HMO stereotype, Kaiser Permanente has taken on the challenge of HIV and instituted policies and guidelines for the effective care and treatment of persons with HIV- to dramatic effect:

English: The Ordway Building, One Kaiser Plaza...

Image via Wikipedia

Kaiser Permanente announced (January 26th) the Kaiser Permanente HIV Challenge to help health care providers nationwide improve health equity for people living with HIV by increasing access to HIV care and improving health outcomes.

The HIV Challenge was announced at the Center for Medicare & Medicaid Innovation Care Innovations Summit in Washington, D.C. ( www.hcidc.org ).

Kaiser Permanente, the nation’s largest nonprofit health care provider, has treated more than 60,000 people since the HIV epidemic emerged 30 years ago, and has reduced disparities among its current HIV population of more than 20,000 people by working to meet or exceed the objectives of the U.S. National HIV / AIDS Strategy.

The crux of the HIV Challenge (kp.org/hivchallenge) is to challenge other private health care providers and public and community health clinics to increase the number of HIV-positive people getting effective treatment by sharing Kaiser Permanente’s toolkit of clinical best practices, provider and patient education materials, mentoring, training and health IT expertise.

(Watch the excellent video series about Kaiser’s HIV Challenge here)

HIV is still an epidemic in the United States, with 56,000 people becoming infected each year and more than 1.1 million Americans living with HIV, but one in five people with HIV don’t know they are infected.

“The organizations presenting challenges here today are pushing the best minds in the country to create a better health care system. They represent exciting solutions to help address some of the nation’s most urgent health needs,” said CMS Acting Administrator Marilyn Tavenner.

Health care disparities are gaps in the quality of care associated with inequities encountered by racial, ethnic, poor and marginalized groups. The HIV Challenge is part of Kaiser Permanente’s larger work to identify, measure, research and eliminate disparities in health and health care in the United States. To learn more go to kp.org/healthdisparities.

“Too many people are unaware they have HIV because access to effective prevention and care is insufficient,” said Michael Horberg, MD, director of HIV/AIDS for Kaiser Permanente, executive director of research for Mid-Atlantic Permanente Medical Group, and a member of the Presidential Advisory Council on HIV/AIDS. “People with HIV need to get into treatment because quality HIV treatment prevents others from getting infected. Patients on effective therapy and better case management are living longer and more productive lives. However, quality HIV treatment requires effort.”

Kaiser Permanente has demonstrated excellence in HIV clinical care outcomes with:

  • HIV mortality rates that are half the national average
  • 94 percent median treatment adherence among patients regularly in care and on antiretroviral therapy
  • No disparities among its black and Latino HIV-positive patients for both mortality and medication rates, compared to a 15 percent higher rate in the United States for mortality and for medication
  • 89 percent of its HIV-positive patients are in HIV-specific care within 90 days, compared to 50 percent in the U.S. within one year
  • 69 percent of all its HIV-positive patients have maximal viral control compared to 19 percent to 35 percent nationally

As part of its HIV Challenge effort, Kaiser Permanente is sharing these best practices and tools for private health care providers and community health clinics to replicate: quality improvement programs that measure gaps in care; testing, prevention and treatment guidelines; how to set up multi-disciplinary care team models that emphasize the “medical home” so HIV specialists, care managers, clinical pharmacists and providers work together; and education for both the provider and patient.

For more details on the HIV Challenge, to download the best-practices toolkit and to watch videos of success stories in setting up HIV clinics and reducing disparities, go to: kp.org/hivchallenge

“Our success in the treatment of patients with HIV/AIDS results from the excellence of our clinicians, our advanced IT systems, our integrated delivery system and our effective coordination across specialties,” said Robert Pearl, MD, chief executive officer and executive medical director of The Permanente Medical Group and Mid-Atlantic Permanente Medical Group. “In the same way that we have reduced the chances of our patients dying from cardiovascular disease and cancer significantly below the national averages, we have achieved outstanding clinical outcomes for our patients with HIV/AIDS.”

The National HIV/AIDS Strategy ( http://www.aids.gov/federal-resources/policies/national-hiv-aids-strategy/ ) calls for increased testing so that all Americans can know their HIV status, increased access to culturally sensitive prevention messages, community-targeted prevention and condom and clean needle access. NHAS also calls for improving access to quality HIV care because HIV medications not only improve individuals’ health and extend their life expectancy, they also reduce their risk of transmitting HIV to others. A recent scientific study found that effectively treating HIV patients with antiretroviral medications reduces HIV transmission by 96 percent. The study, known as HPTN 052, found that treating people with antiretroviral drugs before they are symptomatic can reduce the amount of virus in the blood sufficiently to reduce the risk of sexual transmission of HIV to an uninfected partner.

The Kaiser Permanente HIV Challenge is part of Kaiser Permanente’s ongoing research of HIV and HIV treatment. Published Kaiser Permanente research studies include:

  • A study that found there are no disparities by race or ethnicity in risk of AIDS and death among HIV-infected patients in a setting of similar access to care, despite lower anti-retroviral therapy adherence among Latinos and blacks compared to whites.
  • A study that found HIV-infected patients are at increased risk for cancer as a result of both their impaired immune system and lifestyle factors, such as smoking.
  • A study that found 17 measures, such as screening and prevention for infections and monitoring of antiretroviral therapy, should be adopted uniformly to improve the quality of HIV care and treatment nationwide.
  • A study that found that cholesterol medications can work well among certain HIV patients who are at risk for cardiovascular disease.

About the Care Innovations Summit:

Sponsored jointly by the Department of Health and Human Services, the Centers for Medicare & Medicaid Services, Health Affairs, and the West Wireless Health Institute, the Care Innovations Summit brings together more than 1,000 health care leaders, entrepreneurs, innovators, government officials, and finance experts to stimulate investment in a high-quality, sustainable health care system. Made possible by the Affordable Care Act and the Obama Administration’s commitment to open government, the Summit represents a new opportunity for industry and government to work together to help spur innovation in the public and private sectors to improve health care quality as never before and lower costs through improvement.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: http://www.kp.org/newscenter .

For more information:
Danielle Cass, danielle.x.cass@kp.org, 510-267-5354
Farra Levin, farra.r.levin@kp.org, 510-267-7364

SOURCE Kaiser Permanente

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Study: HIV+ Women Cope Better With Pets

by D Gregory Smith

Phyllis and Bandit

I’m a dog lover. I’ve had many important dogs in my life- from the dog I got for my sixth birthday, Ruff- to Bandit and Phyllis, our dogs today. Animals can provide a lot of joy, comfort and support- and for a lot of persons with HIV, they often provide an excellent reason to take better care of themselves.

Science Daily reports today on a study showing that HIV+ women with pets cope much better than their petless counterparts. Excerpt:

(Allison) Webel set out to better understand how women manage their HIV/AIDS and stay on track to take their medications, follow doctors’ orders and live healthy lifestyles. She conducted 12 focus groups with 48 women to find out what they did to stay healthy. The women had an average age of 42, about 90 percent had children, and more than half were single.

During the focus groups, six predominant social roles emerged that helped and hindered these women in managing their illness: pet owner, mother/grandmother, faith believer, advocate, stigmatized patient, and employee. All roles had a positive impact except stigmatized patient, which prevented women from revealing their illness and seeking out appropriate supports.

“Much information is available about the impact of work and family roles, but little is known about other social roles that women assume,” Webel said.

Being a pet owner was an important surprise, added Webel, who collaborated with co-author Patricia Higgins, a professor of nursing at Case Western Reserve University.

“Pets — primarily dogs — gave these women a sense of support and pleasure,” Webel said.

When discussing the effect their pets have on their lives, the women weighed in. “She’s going to be right there when I’m hurting,” a cat owner said. Another said: “Dogs know when you’re in a bad mood…she knows that I’m sick, and everywhere I go, she goes. She wants to protect me.”

The human and animal bond in healing and therapy is being recognized, Webel said, as more animals are visiting nursing homes to connect to people with dementia or hospitals to visit children with long hospital stays.

I’m sure that this translates across genders, as well. I’ve known plenty of chronically ill men who have strong bonds with their pets.

Psychologically, it’s much more difficult to be depressed when there’s a pet in your life- taking care of someone/something other than yourself can be very beneficial and provide relief from feelings of isolation, sadness and fear. Organizations like PAWS (Pets Are Wonderful Support) have known this for years- that for animal lovers, nothing helps speed healing like the love of a pet- now science may make this an even more integral component of treating chronic illness….

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