August 27, 2008

August 27, 2008
Welcome to another day in my life. I hope you are having a great week so far.

If you read my blog often, yesterday was my latest appointment with my Infectious Disease doctor and unfortunately I am still battling a bad lung infection along with some other effects from recent health problems. I have to go back for another visit tomorrow because he wants to listen to my lungs again and make sure they are not retaining fluid in them. The new antibiotics that I was given yesterday make me very tired so I spent most of the day in bed. I originally hoped to go take some photograph of a local abandoned church today but I was just too tired and it was way too hot to get out there today. Hopefully I will make it in the next few days as I have been itching to shoot the old school before it is demolished to make way for our Interstate 10 improvements.

So since I have been on bed rest for the past several weeks, I have been watching much more television than I normally watch. During this time of year in Florida, the average temperatures are up to 100 degrees with the heat index being over 110 degrees which is way more hot than I can comfortably handle. It amazes me how insidious so much of the broadcasting is today. Now do not get me wrong, there are several channels which provide intelligent thought provoking programming but by and large the vast majority of programming has to be made for morons. I guess I would just rather live life or learn something instead of just sitting entranced in front of the boob tube.

I would like to thank all of you for your great emails you have sent in reply to my blog entries. While it is great to have people comment on my entries, I enjoy your requests for different types of information especially those related to HIV and AIDS and advocacy work. So I will start adding more information in my blog entries about living and dealing with HIV infection. All the other info that your emails have said you enjoy will still be included so this new information will be in addition to things you have already been reading. So once again, thanks for your input. This blog is as much for your benefit as it is for myself.

So in that vein of thought, I would like to talk about some findings form the recent international HIV/AIDS conference in Mexico City and something I have heard discussed many times between HIV positive people. First of all, I need to say that HIV research is very fast moving. The Swiss issued their statement there were no recorded cases of HIV transmission when a person with HIV had a viral load below about 10,000. But a case was reported to the Mexico City conference of a transmission involving a person with HIV who wasnít on HIV treatment with a viral load around 300. Now a case has been reported of HIV transmission when a person with HIV was on treatment and had an undetectable viral load. Importantly, the case involved a gay couple, and itís worth noting that less is known about the effect of treatment on the risk of transmission in gay men than in heterosexuals. The partner with HIV had been on treatment for about five years when the transmission is thought to have occurred. His adherence was reported to be very good and neither partner reported sexually transmitted infections, or sex with another person. The two men did, however, report unprotected anal sex together on a number of occasions. The doctors who reported the case conducted tests which showed the HIV the two men were infected with had a very similar genetic structure. They therefore believe that this is the first recorded case of HIV transmission originating from a person on HIV treatment with an undetectable viral load. However, there are some problems with this case report. The person infected with HIV had only ever had one previous HIV test and that was years before he is thought to have been infected by his partner. Furthermore, it was an anonymous test. Nor was there any information about which role the men took in sex insertive, receptive, or both. The Swiss doctors also note that in their own experience, reported transmissions involving a person on treatment always turned out to have another source. But they also say that while there will be cases of transmission from people with an undetectable viral load, these transmissions will be so rare that they donít have any real public health implications. To illustrate their point, they draw a comparison with the risks of HIV transmission from oral sex. French doctors have also published research with possible implications about the effect of treatment on viral load in semen. They took blood and semen samples at the same time (called paired samples) from HIV-positive men who were participating in an assisted conception study. All the men were taking HIV treatment and none had a sexually transmitted infection. The lower limit of detection for viral load in blood was 40 and 200 for semen. In all viral load was undetectable in 85% of these paired blood and semen samples. But in 5% of samples, viral load was undetectable in blood, but detectable in semen. Earlier research has suggested that if a man had an undetectable viral load in his blood, then it was also undetectable in his semen Ė unless he had a sexually transmitted infection. So whether you are HIV negative or positive remember that you need to use protection every single time to prevent infection or reinfection with HIV or as I tell people in my speeches "if you are going to play in the rain make sure you wear a raincoat!."

In recent blog entries, you relived going through Tropical Storm Fay with me as it hit Florida three different times. I stated talking about our next possible hurricane Gustav in the past couple of blog entries. Now for the latest update. The death toll from Hurricane Gustav is up to 22 in Haiti and the Dominican Republic. In the neighboring Dominican Republic, eight people have died in a landslide including two infants. Oil prices jumped above $119 a barrel as workers began to evacuate from the offshore rigs responsible for a quarter of U.S. crude production. This morning, Gustav was moving off of Haiti's southwestern peninsula into the waters between Cuba and Jamaica. Its tentative track pointed directly at the Cayman Islands, an offshore banking center where residents boarded up homes and stocked up on emergency supplies in preparation for a possible direct hit Friday. Friday is the anniversary of Hurricane Katrina's strike on Louisiana and Mississippi, and Gustav's tentative track raised the possibility of a Labor Day landfall there. But the average error in five-day forecasts is about 310 miles in either direction, meaning the likeliest targets could be anywhere from south Texas to the Florida panhandle. New Orleans officials began planning for possible evacuations, and urged people who might need help in the event of an evacuation to call an emergency information number. Gustav is raising concern particularly because there are few surrounding wind currents capable of shearing off the top of the storm and diminishing its power. Combined with the deep warm waters, rapid intensification could occur in a couple of days. Gustav diminished to a tropical storm over Haiti but was still dumping heavy rains as it moved west-northwest at 5 mph, and forecasters said it could regain hurricane strength soon. The storm was centered about 110 miles west of Port-au-Prince and 125 miles southeast of Guantanamo. So I will update you more on Gustav as new information is delivered.

Thanks for checking out another day in my life. Keep your feet on the ground while you reach for the stars.

Wishing you health, hope and happiness.

big bear hug,

Daddy Dab