March 10, 2011

March 10, 2011

On the Road Again

Welcome to another day in my life. Today is Thursday and I hope you are having a safe and great day so far. Today is another travel day for Dab the AIDS Bear and me.

After enjoying time with my Dad after arriving in Pensacola yesterday, we have to head to Fort Walton Beach this afternoon for the Positive Living Conference where we will be until Sunday. Then we will head back to Pensacola to spend a couple of more days with Dad before heading back to south Florida.

Yesterday I started a blog on Truvada being used for HIV prevention and will conclude the blog today.

Stigma Attached

Knowledge of prevention is not uniform, not everyone understands the results and there is still some stigma associated with anti-retroviral drugs.

The AIDS meeting this week in Boston will also explore the use of other preventatives, which may be used in connection with Truvada in some populations, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which funded the Truvada study.

There are several methods to reduce the chances of HIV infection, including condoms, circumcision and clean needles for intravenous drug users. Progress is being made with other approaches, including topical gels and other drug regimens that will be also reported on at this week’s AIDS conference.

They will likely be used together in different combinations for groups at high risk for HIV infection, Fauci said in a telephone interview.

Combination Impact

“We are starting to become more and more aware that prevention of HIV is not going to be a uni-dimensional phenomenon,” Fauci said. “It is almost certainly going to be a combination of things that together will have a major impact.”

Researchers are also looking at which population might best be helped by use of Truvada as a preventative. The study results apply only to men who have sex with men. Added trials in intravenous drug users and heterosexuals will be complete starting later this year.

The most likely to benefit, doctors say, may be those who can not be guaranteed safe sex protection including condoms, or those who do not wish to use one. That might include prostitutes in some areas, or the partners of people who already have AIDS.

Most new infections in New York City involve young people, often minorities, who can not afford the $35 per pill price for a drug that must be taken daily, Markowitz said.

Government programs for poor and unemployed people already infected with HIV have waiting lists topping 6,700 people, according to the National Alliance of State & Territorial AIDS Directors in Washington, D.C.

Morning After Pill

A prevention approach similar to a morning after pill may have been a better approach, potentially easing problems of cost, long term risk and the challenge of taking a daily drug, said Kevin Robert Frost, chief executive officer of the New York based Foundation for AIDS Research. It is unclear how much benefit the study will yield in the real world, he said.

“This may be the most important scientific breakthrough we have had so far to date that we do not know what to do with,” Frost said in a telephone interview. “At the end of the day this study may prove valuable for the proof of concept that it represents and not for any specific application.”

International health organizations like the World Health Organization and UNAIDS, are now discussing how the approach known as pre-exposure prophylaxis, or PrEP, should be used globally, said Robert Grant, lead researcher in the Truvada study and associate professor of medicine at the Gladstone Institute of Virology and Immunology at the University of California in San Francisco. Demonstration Projects

The Centers for Disease Control and Prevention is convening panels of experts to discuss how to best roll out wider use of Truvada as a preventative, a strategy they refer to as PrEP. The National Institutes of Health and the Department of Health and Human Services are considering demonstration projects that would establish clinics or programs to offer the pill to high risk, uninfected men.

Grant said more research is needed to find ways to ensure people take the medicine regularly. Only about half those in the study used the drug consistently, and those who didn’t received no protection. Situations in which one partner is HIV positive and the other is not may benefit most, he said.

“In principle, people are thrilled that there are new concepts available,” Grant said. “We need to let them have time to find out how to best use it.”

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab