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.
The FDA approved “the Quad”- a four-medication-in-one-pill treatment for controlling HIV. Two of the medications comprising Stribild, tenofovir and emtricitabine, have been previously combined and sold under the brand name Truvada (itself approved a few weeks ago as a preventative or prophylactic for HIV, see related articles below).
Two of the medications are new, and – as a condition of approval- will require greater testing in women and children, as well as studying possibilities and occasions of resistance.
This is good news.
Simplifying regimens is a helpful strategy in helping keep HIV-infected persons faithful to their medication schedules, a key in effectively treating HIV. Cost is yet to be determined- and most HIV regimens cost in excess of $18,000.00 a year (mine cost $24k).
Still no picnic- but good news for those who need a simpler med schedule.
The Administration has pledged new money to end the waiting lists, but they will linger for some time. Making sure that everyone who needs ART drugs can get them is an obvious first step towards ending this country’s HIV/AIDS epidemic, but when the waiting lists are gone, we’ll have to move on to the hard work of changing attitudes towards people with HIV and ensuring access to health care for all Americans, not just those living with HIV.
It was grimly entertaining, explaining to Conference delegates from Canada and Germany what ADAP is and why we have waiting lists, when it’s so obviously better public health policy and so obviously more fiscally prudent to treat everyone with HIV who wants treatment. After she got past her initial disbelief, a German delegate gently suggested that there are better ways to handle this sort of thing. We wouldn’t need ADAPs, let alone have ADAP waiting lists, if we had a rationally designed national health care system.
Here are the latest numbers from our friends at NASTAD:
More than 2 million people are incarcerated in jails and prisons in the United States.
People who are incarcerated are at increased risk for acquiring and transmitting HIV.
The correctional setting is often the first place incarcerated men and women are diagnosed with HIV and provided treatment.
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.
Throughout the world, research has consistently shown that drug criminalization forces people who use drugs away from public health services and into hidden environments where HIV risks become significantly elevated. Mass incarceration of nonviolent drug offenders also plays a major role in spreading the pandemic, as inhumane conditions and lack of HIV prevention or treatment measures in prison lead to HIV outbreaks and AIDS cases behind bars – and among families and communities once those imprisoned are released.
Yet in countries where addiction is treated as a health issue, the fight against HIV/AIDS is being won. New HIV infections in countries such as Australia, Germany and Switzerland have been virtually eliminated among people who use drugs, just as mother-to-child HIV transmission has been eliminated in countries that make medicines for pregnant women accessible.
In the United States, however, the federal government has resisted evidence-based HIV prevention strategies — costing us hundreds of thousands of lives and billions of dollars. Congress re-instated a longstanding ban last December that prohibits using federal funds for syringe access programs — a move that will cost thousands of more lives in years to come.
Money talks- just remind your politicians that the money they are not spending on “immorality” is costing the taxpayers 1000x the amount in the long run…
The federal government Monday announced more than $1.89 billion in funding to states to fight the HIV epidemic with access to care and with more cash for the failing AIDS Drug Assistance Program.
According to an HHS press release, $813 million of that money will go directly to the ADAP programming. An additional $8,386,340 will be issued as a supplement to 36 states and territories currently facing a litany of unmet needs and access issues. The additional money is designed to help those programs reduce or eliminate their waiting lists. They also released an additional $40 million to assist states and territories currently refusing coverage for people in need to reduce the number of people waiting.
ADAP provides access to the costly anti-retroviral medications that have turned HIV into a more manageable disease since its appearance 30 years ago. The drugs can cost tens of thousands of dollars a year in the U.S. The program also assists in paying for drugs to treat opportunistic infections that HIV positive persons can suffer as a result of diminished immune functions.
The ADAP Advocacy Association shows that as of Sept. 22, 10 states had waiting lists totaling nearly 9,000 people awaiting access to the life saving medications:
ADAPs with Waiting Lists
(8,785 individuals in 10 states*, as of September 22, 2011)
Florida: 4,098 people
Georgia: 1,732 people
Idaho: 37 people
Louisana: 1,112 people
Montana: 28 people
North Carolina: 354 people
Ohio: 9 people
South Carolina: 367 people
Utah: 59 people
Virginia: 989 people
In addition to funding ADAP programming, the feds also announced millions in funding for direct medical care as well as programming to assist minorities — who are particularly hard hit by the epidemic — in accessing medical care for the infection.
Kudos to all the activists and HIV care advocates who worked hard for this- and for those of you who signed our petition….
University of Utah researchers have discovered a new class of compounds that stick to the sugary coating of the AIDS virus and inhibit it from infecting cells — an early step toward a new treatment to prevent sexual transmission of the virus.
Development and laboratory testing of the potential new microbicide to prevent human immunodeficiency virus infection is outlined in a study set for online publication in the journal Molecular Pharmaceutics.
…”Most of the anti-HIV drugs in clinical trials target the machinery involved in viral replication,” says the study’s senior author, Patrick F. Kiser, associate professor of bioengineering and adjunct associate professor of pharmaceutics and pharmaceutical chemistry at the University of Utah.
“There is a gap in the HIV treatment pipeline for cost-effective and mass-producible viral entry inhibitors that can inactivate the virus before it has a chance to interact with target cells,” he says.
As scientists learn more about how HIV attaches to CD4 cells, there will be more and possibly less problematic ways to treat and prevent HIV infection.