Fw: Hot Topics at The Body’s “Ask the Experts” Forums

From: “News at The Body” <update@news.thebody.com>
Date: 26 Jul 2011 18:20:45 -0400
To: <nelsonvergel@yahoo.com>
ReplyTo: “News at The Body” <update@news.thebody.com>
Subject: Hot Topics at The Body’s “Ask the Experts” Forums

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July 26, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



LIVING WITH HIV/AIDS
 How Did a Bone Marrow Transplant Cure a Man of HIV?
I’ve read about the American gentleman in Berlin who was functionally cured of HIV with a bone marrow transplant that was done to treat his leukemia. I’ve also heard that this isn’t a viable treatment option due to the risk involved. I had a friend whose child didn’t survive a bone marrow procedure, so I get that. But why did this particular transplant work against HIV? How were the bone marrow donor’s cells different from most other people’s, and what did they do to “Berlin patient” Tim Brown’s cells?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum

 Any Tips for Dealing With Acne?
I tried the anabolic steroid Deca-Durabolin (nandrolone decanoate) for about five months and saw some good results in my lean muscle mass along with lifting weights. However, I had such severe acne breakouts that I had to stop taking nandrolone. Is this a common side effect of steroid and testosterone use? What can be done to manage acne in general?

Nelson Vergel responds in the “Nutrition and Exercise” forum
when experts blog
Want more insights from some of TheBody.com’s forum experts? Check out their blogs! Three of the HIV professionals from our “Ask the Experts” forums also have blogs on TheBody.com. All longtime HIV survivors themselves, they regularly blog about their thoughts on HIV treatment research; unique perspectives on the history of the epidemic; tips for living a more fulfilling life with HIV; and much more.


David Fawcett, Ph.D., L.C.S.W. (“Mental Health” and “Substance Use” forums):
Riding the Tiger: Life Lessons From an HIV-Positive Therapist

Bob Frascino, M.D. (“Safe Sex and HIV Prevention” and “Fatigue and Anemia” forums):
Life, Love, Sex, HIV and Other Unscheduled Events

Nelson Vergel, B.S.Ch.E., M.B.A. (“Nutrition and Exercise” forum):
Outsmarting HIV: A Survivor’s Perspective


HIV/AIDS TREATMENT
 Why Should My Partner Switch to “More Modern Meds” if He’s Doing Well?
My partner has been HIV positive since 2009, and his viral load has been undetectable ever since he started taking Retrovir (zidovudine, AZT) and Truvada (tenofovir/FTC). Now his doctors want him to switch out the Retrovir for Kaletra (lopinavir/ritonavir). According to them, Kaletra is “modern” compared to Retrovir. Why would the doctors want to do this? Is it wise to switch off meds that seem to be working?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum

  Viral Load Low but Detectable Soon After Seroconversion: Should I Start Meds?
I believe I seroconverted to HIV positive in mid-April; I was diagnosed in early May. My first lab test results showed that my CD4 count was 485 and my viral load was 366. Four weeks later my CD4 count was 603 and my viral load was 223. Given these numbers, should I start HIV meds now or continue to monitor?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum
OTHER HEALTH ISSUES & HIV/AIDS
 How Should I Start Managing My High Cholesterol?
I was diagnosed with HIV in 2000 and started taking HIV meds immediately. My viral load has been undetectable since 2001 and my CD4 count remains at or around 400. Three years ago I was put on Atripla (efavirenz/tenofovir/FTC). For the past 11 years I’ve tolerated all my meds with no side effects. My current challenge is trying to manage my hypertension and high cholesterol. What are some first steps in doing that?

Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum

 Started Using Again: How Long Before Meth Has an Impact?
I’ve been HIV positive for more than 10 years, and recently I started using crystal meth again. How long will it take for the drug to cause problems with my HIV health?

David Fawcett, Ph.D., L.C.S.W., responds in the “Substance Use and HIV” forum

More Questions About Other Health Issues & HIV/AIDS:

Connect With Others Can’t Get Health Care and Pay Bills: Anybody Know About Help for the Underinsured?
(A recent post from the "Living With HIV" board)

My insurance has a high deductible of close to $3,000 that applies to blood work, which is expected to be more than this annually. I know that ADAP can cover med deductibles and costs, but I heard that there are organizations that will assist the underinsured with deductibles. … My health insurance premiums alone are over $6,000 a year. But since I am working and have insurance, I do not qualify for very-low-income programs in my state. Has anyone in a similar situation been able to get assistance with medical bills in other ways? I don’t want to have to go into bankruptcy to get medical care. — Bensf

Click here to join this discussion, or to start your own!

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UNDERSTANDING HIV/AIDS LABS
 Could My HIV Med Regimen Be Causing My High Liver Enzyme Levels?
I just got the results of my most recent labs and my liver enzymes are quite elevated. My physician’s assistant was mystified about this. I’m a little scared, to tell you the truth. I’ve been on Norvir (ritonavir), Reyataz (atazanavir) and Truvada (tenofovir/FTC) for seven years and have never had such an issue. What do you think, and what would you suggest?

Mark Holodniy, M.D., F.A.C.P., C.I.C., responds in the “Understanding Your Labs” forum
HIV & HEPATITIS TRANSMISSION
 Just Tested Positive for Hepatitis C: Can My Wife and I Safely Have a Baby?
I recently tested positive for hepatitis C; fortunately my wife tested negative. We’ve been trying to have a baby for the past four years with no luck, so we’re thinking of trying in vitro fertilization (IVF). Is IVF still an option considering my hep C status (I’m not currently being treated)? Can we still have a healthy baby? Would a fertility clinic agree to work with us? What’s the possibility that this disease might be transmitted to my wife or baby?

Barbara McGovern, M.D., responds in the “Hepatitis & HIV Coinfection” forum

 If I Swim With My Period, Do I Put Others at Risk for HIV or Hepatitis C?
I’m coinfected with HIV and hepatitis C. I have never, not once since my HIV diagnosis in 1988, gone swimming while I have my period. I’ve heard it’s safe to swim in a pool as the chemicals kill the viruses, but I still can’t bring myself to enter a swimming area that others share as I have quite a heavy menstrual flow as well. Am I being ridiculous?

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

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Activist Central
 NYC and Housing Works Launch re-fashioNYC

 Call to Action: Sign a Petition to Support Youth Participation in Global HIV/AIDS Decision-Making

 Tell Washington, D.C. to Fully Fund ADAP and Other HIV/AIDS Programs to Prevent Needless Deaths

 NMAC’s ADAP Action Campaign: Get Free Flip Video Camera to Collect Stories

For Doctors: How You Can Help Your Patients Who Are Running Out of HIV Treatment Options

July 6, 2011

In a previous blog post, I reviewed the current situation for the minority of patients with HIV who have run out of treatment options.
Of the HIV medications in development with potential activity against highly resistant HIV (i.e., patients with GSS=0), two may become available within the next year: ibalizumab (formerly TNX-355), a monoclonal antibody currently under development by TaiMed Biologics, and dolutegravir (formerly GSK1349572), a second-generation integrase inhibitor made by ViiV Healthcare).
Ibalizumab has a completely new mode of action, so most patients should respond to it when using it with at least one other active agent. It is different from the entry inhibitor maraviroc (Selzentry, Celsentri) in that it blocks the CD4 receptor on T cells rather than blocking the CCR5 co-receptor. This means it could be effective against virus that uses either the CCR5 or CXCR4 co-receptor. It is a genetically engineered monoclonal antibody administered once every two weeks intravenously. TaiMed has finished its dosing phase 2b study and will be presenting the data in the near future. TaiMed is also developing a subcutaneous administration of ibalizumab; phase 3 studies should take place involving HIV-infected patients in eight to 12 months.
Dolutegravir has shown activity against many raltegravir (Isentress)-resistant viruses at a dose of 50 mg twice a day. Dolutegravir’s phase 3 study, which is seeking patients with raltegravir resistance, is now enrolling nationwide. However, patients are required to have a GSS=1 to join the study. For those who do not meet the entry criteria, but need help, there may be another option: The company is planning to open an expanded access program for its drug by year’s end.
However, “year’s end” is not near enough for patients who are in dire need of new, active antiretrovirals. There are many patients who cannot join the phase 3 studies, and who cannot wait eight to 12 months for both drugs to become available through their respective expanded access programs.
In these extreme cases, physicians can apply for “single patient Investigational New Drug (IND)” access to either or both of these antiretrovirals. Both TaiMed and ViiV/GlaxoSmithKline have shown good faith in helping patients in deep salvage, and they are willing to provide their drugs for patients with declining health and high mortality risk.
The following steps must be followed by physicians for each drug they want to access on behalf of one of their patients.

How to Apply for Single Patient IND Access to an Investigational Drug

If the patient’s HIV has evidence of resistance to all commercially available antiretrovirals and his/her viral load suggests that his/her HIV is not responding to the current drug regimen, a phenotypic resistance test needs to be performed along with a tropism test. It is important to also know if phenotypic resistance to enfuvirtide (T-20, Fuzeon) is present. Additionally, genotypic integrase mutations need to be characterized to assess the patient’s potential response to dolutegravir.
Once the test results have confirmed that the patient has developed resistance to all commercially available or expanded access HIV medications, and provided the patient’s health is at risk (i.e., CD4+ cell count under 100 cells/mL and declining clinical outlook), physicians can follow this procedure required by the U.S. Food and Drug Administration (FDA). (Note that the FDA has also changed its regulations to accept patient access for small groups of patients, which could save a lot of paperwork.)

  1. The treating physician should call the company that is developing the investigational antiretroviral to find out if it is willing to provide the drug for free before it has been approved. (Drugs have to have gone through dosing and safety studies before they can be made available in this manner. Also, antiretroviral interaction data are valuable, although ViiV and TaiMed do not expect negative drug-drug interactions from the combination of dolutegravir and ibalizumab.)
  2. After each manufacturer agrees to provide its respective investigational drug via single patient IND, the doctor should follow the procedure described on this FDA Web page to fill the required forms and get institutional review board (IRB) approval.

This procedure is hardly used by doctors in HIV care due to lack of information or concerns about its complexity. But in actuality, it’s very straightforward: three simple forms, a signed patient consent form and IRB approval are needed. Many local IRBs will even expedite approval of this kind of request due to its urgency.
Also, single patient IND can be approved verbally by the FDA if the patient has an expected survival of less than 30 days (this is called emergency IND). This will allow the drug company to ship the drug in an expedited manner, but the forms I mention above will still need to be processed while drug shipment is taking place.
If you need a sample patient consent form and cover letter for IRB submission, I recommend using these, which were used in the past for access to darunavir (TMC114, Prezista) and etravirine (TMC125, Intelence) while they both were investigational drugs:

ViiV and TaiMed can also make copies of consent forms for their drugs available if requested by the physician applying for access on behalf of his/her patient.
I welcome e-mails from physicians who need more information or would like additional help gaining access to investigational drugs for their HIV-infected patients whose virus is resistant to all currently available drugs. Please send e-mails to nelsonvergel@gmail.com.

This article was provided by The Body PRO. You can find this article online by typing this address into your Web browser:
http://www.thebodypro.com/content/62832/how-you-can-help-your-patients-who-are-running-out.html

Nelson’s Top 10 Tricks for Fat Loss

June 28, 2011

  1. Get real. Ask yourself: What is getting in the way of my health? What excuses am I using to not start giving a damn? There is no perfect time to start. Do it now, even if it means one change per week in your lifestyle choices. You deserve to feel and look the best you can!
  2. You cannot change what you do not measure!
    • Download a step counter (pedometer) app to your phone or buy one to carry with you all day. Research has shown that 10,000 steps a day keep people from gaining weight and may help those wanting to lose weight. It approximately equates to 3 miles. If by 6 pm you have not reached that goal, you can make up for the difference on a treadmill, walking the dog, walking to the store, etc. Read more on this.
    • Weigh yourself 3 times a week in the morning while on an empty stomach.
    • Get yourself a ring to wear on one of your fingers, or use the one you are wearing now; it’s the best way to find out if you are inflamed or holding too much water. When tighter, you need to exercise to decrease inflammation and water retention.
    • If you have a progressive doctor who can refer you for a full DEXA body scan, good for you. This is the best way to know your body composition in every part of your body.
  3. Change the way you drink and eat:
    • Avoid drinking sodas, fruit juices (eat fruit instead), more than two glasses of wine a day. Carry a water container in your car, office, and any place you hang out, and sip from it all day (you can add flavored Benefiber or Citrucell to that water if you need to drink something with flavor).
    • Also, avoid eating sweets, white bread, bagels, muffins, and most cereals (they are loaded with sugar and high-fructose corn syrup). Instead eat whole grain, dark-colored bread (if you have to), and never consume carbohydrates by themselves (adding good fats and fiber to carbs slows down glucose and insulin spikes in the blood that may predispose you to metabolic syndrome and fat gain). Watch a great lecture that will open your eyes to the effect of sugar on health.
    • Consume 20 grams of fiber (soluble and insoluble) per day. For most of us, this is hard to do unless we eat beans, nuts, and 4 servings of fruit and vegetables. Fiber improves insulin sensitivity, makes you feel full longer, keeps your gut healthy (friendly gut bacteria that produce vitamins love fiber), keeps you regular, and can lower the chances of getting colon cancer. Buy Citrucell or Benefiber, two over-the-counter products available in most grocery stores. Try to consume 12 grams of fiber a day from these supplements in water. You can also add them to soups, oatmeal, scrambled eggs, yogurt, water to sip all day at work, sauces, and home-made salad dressing.
    • To ensure that you have enough fruits and vegetables at home, buy frozen ones (frozen fruits and vegetables tend to be cheaper and loaded with vitamins since they are picked at their prime).
    • Follow a slow carb (low glycemic index) diet. Read this article carefully!
    • Twice a day, snack on almonds, pistachios, walnuts, and other nuts at work to get your good fats and fiber, and to make you less likely to cheat later. If you get tired of their taste, mix them with some dried fruit. Research has shown that people who eat nuts tend to have lower LDL cholesterol.
    • Avoid junk and fast food. The best way to do this is to have enough food at home and to bring lunch to work. Cook a lot of food on weekends and freeze meals in small containers you can take to work or heat up at home. Get yourself a slow cooker and use its enclosed cookbook to prepare warm foods that you can come home to. Do not sabotage yourself by bringing sweets and junk into your home. If you do, you’ll eventually eat them (most of the time, in one sitting!).
    • Watch your cravings at night, when most people find it the most difficult to avoid overdrinking alcohol or eating ice cream, cookies, and comfort foods.
    • Eat a large breakfast, a moderate lunch, and a small dinner. I know this sounds completely different to what most of us are doing every day.
    1. Skipping breakfast makes you more prone to overcompensate by eating more calories late in the day. Your body has spent 7-8 hours without food and is starved for nutrients in the morning. Do not feed it sugar and white flour products at this important time, like many people are accustomed to doing due to being rushed. Eggs, oatmeal (the type that has no added sugar, and you can add whey protein powder to it!), Greek-style yogurt with nuts and fiber supplements, low-fat cottage cheese with fruit (if you’re not lactose intolerant), almond butter sandwiches on multigrain (high-fiber) bread, and fruit are all good choices for breakfast.
    2. For lunch have some soup and a glass of water first and wait 10 minutes to trick your body into feeling full faster. Grilled chicken with vegetables, tuna salad over greens and nuts, a Greek salad with sliced steak, and any Mediterranean food choices are good.
    3. For dinner, fill yourself with stir fried (use olive oil!) vegetables and lean meats. Two hours before bed, you can have half an almond butter sandwich or yogurt with fruit. You will not be hungry and desperate with this diet!
  4. Do resistance exercise with machines at the gym if you are a beginner, or weights if you have more experience. Here are some other exercise recommendations.
  5. Get your hormones checked and supplemented if low
    • If you are having a hard time losing weight and you are doing all of the above, have your doctor check your blood levels of free testosterone and thyroid hormones (TSH, T3 and T4) (yes, women and men!). Low hormone blood levels can impair fat loss and energy levels required to exercise. They can also make your less prone to be motivated to follow a healthy regimen. Readmore about testosterone here.
  6. If you have access to a glucose tolerance test, take it. This test will determine how your body uses glucose for energy and compare it to a normal response. If you have impaired glucose tolerance, your doctor may want to prescribe metformin, an insulin sensitizer that may help people lose fat by helping their insulin work better at controlling blood sugar and metabolism.
  7. If your belly is hard and you cannot pinch much fat, you may mostly have visceral fat. You may want to talk to your doctor about a new FDA-approved product for HIV-associated visceral fat calledEgrifta (tesamorelin). Egrifta is a growth hormone-releasing factor that makes your pituitary gland make your own growth hormone. Growth hormone has been shown to help burn fat. If you do not have insurance, you can apply for patient assistance (more on Egrifta.com).
  8. Drinking a tablespoon of apple cider vinegar before every meal has been shown to improve glucose tolerance and insulin response. Better glucose tolerance and lower insulin resistance can make it easier to lose fat. Read more on this.
  9. Supplements:
  10. Find a support system that is there for you through all of your new lifestyle changes. Having an exercise/diet buddy is the best way to improve adherence to your diet and exercise program. Join groups online. Surround yourself with friends who support you all the way and enable you to succeed!

Send Nelson an e-mail.

Timothy Brown: The Other Side of the Cure

July 15, 2011

By now, we have all read several stories about Timothy Brown and watched his interviews on TV. For the few who have been living in a cocoon in the last few weeks and have not watched the news, I remind them that Tim, once known as the “Berlin patient,” is the man who was cured of HIV through a long and risky procedure of chemotherapy, radiation and a CCR5-negative stem cell transplant.

Ever since I saw the first poster presentation at the 2007 CROI conference that mentioned his case, I have been wondering what it would feel like to be cured. Until that moment, that thought had never crossed my mind. What would it be like not to have to take pills every day, not to have to worry about side effects, not to have to go see a doctor so frequently, not to have to be afraid of rejection, not to have to spend so much time reading medical information, not to be worried about drug resistance and death, not to feel different from others?

Timothy Brown and Nelson Vergel

I was happy to have met Timothy Brown this week while shooting my upcoming documentary on the challenges of HIV cure research. This great opportunity not only gave me a chance to get to know him but also to find out more about how it feels to be free of HIV while living in the United States.
Timothy graciously agreed to meet me for an interview in San Francisco, even though he had been asked to do this so many times in the past few months. He showed up dressed nicely in a suit, looking like a handsome businessman ready for an important meeting. I and my friend and camera person Greg Fowler put him through a series of questions, many that he had heard before, yet he kept his candid and approachable attitude throughout the interview while we had glaring lights on his face. I was able to ask him some personal questions about his struggle through his long but successful ordeal.
About a year ago, Timothy moved to the United States from Berlin, where he’d received the chemotherapy, radiation and two bone marrow transplants that got his leukemia in remission and his HIV wiped out of his body. The entire procedure was paid for by the German government. His oncologist and creative thinker, Dr. Gero Hütter, was a great advocate and supporter of his health who did not give up even after the first stem cell transplant failed to control Tim’s leukemia. Tim did not have to worry about his ability to pay for this expensive procedure; it was a benefit of living in a country that provides its people with health care. He is sure that had he been living in the U.S., he would not have fared that well and he would not be cured. For a doctor to think outside the box and be allowed to do such an innovative procedure would have required a lengthy process of institutional review boards in the United States, which would have deemed it too risky even in Tim’s justified risk-to-benefit situation.
Timothy’s lengthy one-year ordeal at the hospital did not stop when he left it. Walking home one night, he was mugged and hit on the head while he fell on his shoulder. His injuries are persistent to this day and he needs physical therapy. Due to the loss of his support system in Berlin, Tim decided to come to his home country to start a new life after years of living in Europe. What he found out after arriving here surprised him.
Now that Timothy is back in San Francisco he faces the obstacles of a system with no universal health care, in which he has to go through a long process to apply for benefits. He is HIV negative, so he cannot apply to be covered by Ryan White for his medical needs. His health is good, but he is still on his path to strengthen a body that has been affected by harsh chemotherapy after a year stay in the hospital and by injuries caused by his attacker. He is happy to have made medical history as the first living person cured from HIV, but he is now shocked about how complicated the U.S. benefits and health system’s bureaucracy has been. He told me that it is amazing that a country which was not his mother land cured him; and now his home country cannot support his continuing struggle to strengthen his health.
We all make assumptions about people we see on TV. His case is no exception. I assumed that he must be a man who is not only lucky but who has a support system that ensures his continuing healing. So I was surprised about how far from the truth that is in his case. He is not able to work due to his physical therapy needs, lives on a small budget with several roommates, and is trying to quickly adjust to the challenges of reentering a world he left behind years ago. Many TV programs and magazines have covered his success story, yet none has offered any help to make his life easier in this country. Hopefully, we as a community can be supportive of him as we open doors that can lead to his fast recovery and entry into the world of the living. He is committed to being a strong voice in HIV cure advocacy, and some of us in the activist world will ensure that he is supported in his wish. Fortunately, his strong and fighting spirit along with his grounded and welcoming energy will get him to the other side of his cure: his long-term wellness and stability.
As I left San Francisco today, I did so with the knowledge that I’d met a great and warmhearted survivor that needs our support. I am committed to helping to connect him to the network of my peers who will welcome him to our world of communal wisdom. As I see it, he is HIV negative now but very much part of our struggle. And we need him healthy and happy!
Send Nelson an e-mail.

Fw: TheBodyPRO.com Newsletter: The New “Undetectable”; Finding Help for Deep Salvage Patients; and More

From: “The Body PRO” <news@thebodypro.com>
Date: 12 Jul 2011 16:13:53 -0400
To: <powertx@aol.com>
ReplyTo: “The Body PRO” <news@thebodypro.com>
Subject: TheBodyPRO.com Newsletter: The New “Undetectable”; Finding Help for Deep Salvage Patients; and More

If you have trouble reading this e-mail, you can read the online version at: www.thebodypro.com/newsletter.html
 
Welcome to The Body PRO Newsletter, a bi-weekly review of the latest breaking news and research in HIV medicine, aimed specifically at informing health care professionals.
July 12, 2011
In This Newsletter:
•  HIV CARE TODAY
HIV Care Today is a multi-author blog featuring people on the frontlines of HIV treatment, prevention and patient/client care. This blog serves as a platform for health care professionals to discuss the everyday challenges of their jobs, recent developments in their fields and issues relevant to the evolution of HIV/AIDS care.

Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S.New Viral Load Technologies: Potential for a Real-Time Virologic Mess
“We have told our patients that one of the goals of HIV antiretroviral therapy is to reduce the viral load to the lowest level possible. In other words, the goal is to get to ‘undetectable,'” Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S., writes. “But what happens when the lowest level of quantification changes for a patient that has been previously undetectable?”

Nelson VergelHow You Can Help Your Patients Who Are Running Out of HIV Treatment Options
Pipeline HIV medications such as dolutegravir and ibalizumab hold the tantalizing promise of new hope for patients with extensive HIV drug resistance, but neither is far enough along in development to warrant an expanded access program. How can you get your hands on these drugs if you have patients who quite literally need them now? Nelson Vergel, B.S.Ch.E., M.B.A., knows a way.

David FawcettThe HIV/AIDS Spectrum Project: Building Capacity to Improve Care for Mental Health and Substance Use
Amidst the intense focus on the physical health of our HIV-infected patients and clients, it is easy to lose sight of the significant mental health challenges these individuals often face. Enter the Spectrum project, which “aims to build the capacity of mental health workers to effectively address the complexities of mental health and substance use disorders experienced by individuals living with HIV/AIDS in our communities,” as David Fawcett, Ph.D., L.C.S.W., explains.

More Headlines on HIV Care and Antiretroviral Therapy:


  Back to Top

•  HIV NEWS & VIEWS
Are You Ready?Paul Kawata: How Epidemiological Changes Will Affect U.S. HIV/AIDS Organizations
“Is the HIV/AIDS community ready for a potentially significant reallocation of resources? What do these numbers mean to your agency?” In a recent missive to HIV/AIDS service providers in the U.S., Paul Kawata, the executive director of the National Minority AIDS Council, continues his examination of how local organizations are likely to be impacted by major upcoming changes in HIV/AIDS funding.

HIV/AIDS Organization Spotlight: AIDS Action Committee of Massachusetts
More than 30,000 HIV-infected people were living in Massachusetts at the end of 2009, far higher than the number a decade earlier. HIV/AIDS organizations increasingly struggle to provide services to that growing number of patients. We spoke with Rebecca Haag, the president and CEO of AIDS Action Committee, about what her organization — one of the largest HIV service providers in Massachusetts — does and the challenges it faces.

Mark S. KingMark S. King: Should AIDS Activists and Pharma Just Get Along?
“I’m having an identity crisis,” Mark S. King says. “Am I an AIDS activist, ready to question authority and demand high standards of service for those living with HIV/AIDS? Or am I a ‘resource’ for the pharmaceutical industry, so that they might craft more effective community programs that will lead AIDS patients ‘to care’?”

More News Headlines:


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•  THE PATIENT PERSPECTIVE: FEATURED ON THEBODY.COM
Maria T. MejiaMaria T. Mejia: Keys to a Good Doctor/Patient Relationship (Video)
“It’s like a marriage,” Maria T. Mejia says. “If there is no communication or respect, there will be a divorce!” She’s talking, of course, about the relationship between an HIV-infected person and his or her doctor. It’s easy to overlook how important it is that a patient educates him/herself and establish a solid partnership with his/her doctor. But as Maria explains in this video blog, it’s a critical component of good health care.

Team4HIVHopeHIV-Infected Bikers Take the Ultimate Trek
If you doubt an HIV-infected person’s ability to stand up to the most grueling tests of a body’s strength and endurance, then Team4HIVHope has something to tell you. The group recently completed a 3,000-mile, 24-hour-a-day bicycle race across the U.S. In this blog entry, cyclist Steven Berveling recounts the journey — and the lessons it taught him, such as: “I learnt the hard way that I could not ride for about 2-1/2 hours after taking my [efavirenz-containing] HIV tablets.”

handholding“Am I Undatable Because I’m HIV+?”
“How do I deal with HIV stigma and dating without giving up hope?” asks a reader of the HIV/AIDS newsletter Being Alive. Relationship therapist Joe Kort, Ph.D., responds with practical advice and some tough love: “Using one’s status as an excuse or feeling victimized by it is a recipe for poor self-esteem and bad dating experiences.”
  Back to Top

•  HIV/STD TRANSMISSION
LOVEBrotherly Love: HIV Rate Skyrockets Among Philadelphia’s Black Men Who Have Sex With Men
In a recent report, Philadelphia’s AIDS office reported that HIV incidence among gay and bisexual men rose 29% from 2007 through 2009. Since African Americans make up nearly half of Philly’s population and HIV rates are higher among African Americans in general, this does not suggest that HIV-fighting efforts are moving infection rates in the right direction in the City of Brotherly Love.

More Headlines on HIV/STD Transmission:


  Back to Top

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Also Worth Noting

HIV Management Today In HIV Management Today, an informative online series from TheBodyPRO.com, we consult with some of the top clinical minds in HIV on some of the most important issues in HIV/AIDS clinical management.

•  Assessing and Acting on Cardiovascular Disease Risk in HIV-Infected Patients, featuring Marshall Glesby, M.D., Ph.D., and Jens Lundgren, M.D.

•  A Closer Look at Tesamorelin (Egrifta), a Newly Approved Treatment for HIV-Associated Lipohypertrophy, featuring Daniel Berger, M.D.

•  New Paradigms of First-Line HIV Therapy: Determining When (and With What) to Start, featuring Eric Daar, M.D., and Trevor Hawkins, M.D.

•  Clinical Management of the HIV-Infected Woman, featuring Kimberly Smith, M.D., M.P.H., and Valerie Stone, M.D., M.P.H.

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Fw: Hot Topics at The Body’s “Ask the Experts” Forums

From: “News at The Body” <update@news.thebody.com>
Date: 12 Jul 2011 16:55:42 -0400
To: <nelsonvergel@yahoo.com>
ReplyTo: “News at The Body” <update@news.thebody.com>
Subject: Hot Topics at The Body’s “Ask the Experts” Forums

If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html

July 12, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



LIVING WITH HIV/AIDS
 How Can I Lose Weight Without Gaining Too Much Muscle?
I’m 47 years old, 5 feet 8 inches tall and I weigh 220 pounds. I’d like to lose 40 to 50 pounds without building up too much muscle. My ideal look is lean and very defined, but not bulky. Do you have any quick weight-loss tips?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 Is Smoking Marijuana Worse for HIVers Than for HIV-Negative Users?
Does smoking pot have an effect on a person’s CD4 count? Does it cause any additional harm to HIV-positive people that it doesn’t cause in people living without HIV?

David Fawcett, Ph.D., L.C.S.W., responds in the “Substance Use and HIV” forum
BODY SHAPE CHANGES & HIV/AIDS
 What Should HIVers Be Aware of Before Having Cosmetic Surgery?
Are procedures like liposuction and “tummy tucks” safe for people living with HIV? What should an HIV-positive person be aware of before having this type of surgery?

Nelson Vergel responds in the “Nutrition and Exercise” forum
Visual AIDS: Art from HIV-Positive Artists
image from the July 2011 Visual AIDS gallery Detail from:
“Untitled,” 2001
Mooshka

Visit the July 2011 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month’s gallery, entitled "I Don’t Have a Clue …," is curated by Aaron Krach.

HIV/AIDS TREATMENT
 What’s the Link Between Joint Pain and Selzentry?
I was experiencing extreme pain in my finger joints, elbows, shoulders, back and knees, to the point where I could barely function. I was taking Selzentry (maraviroc, Celsentri); since I stopped taking it about three weeks ago, the pain has pretty much subsided. Naturally this leads me to believe Selzentry was the culprit for my pain. What do you think? Is joint pain a common side effect of this drug?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum

 Is It Really Better to Start HIV Meds ASAP?
I’m a 36-year-old guy, newly HIV positive and really struggling to understand the subject of when to start HIV treatment. You’ve mentioned on this forum in the past that you believe evidence will emerge that starting HIV meds earlier is better for preserving the immune system. I’ve also read that being on meds for too long isn’t good either and that it’s better to just start taking them at the recommended time. How do I figure out what the best thing is for me to do?

Nelson Vergel responds in the “Nutrition and Exercise” forum
OTHER HEALTH ISSUES & HIV/AIDS
 Tips for Managing Anxiety and Depression?
I was given an AIDS diagnosis in 2008, at age 32. I was very ill and in the hospital for a week. Now my CD4 count is around 750 and my viral load is 12,000. I’ve had mild depression for years but since my diagnosis it’s gotten worse. At first I had bad panic attacks. I started an antidepressant and a beta-blocker, and they helped a lot. I have seen a therapist and was diagnosed with post-traumatic stress disorder (PTSD). My biggest problem now is anxiety when traveling. I have this irrational fear that something bad will happen to me far from home, and then I panic. Is there anything I can do when I’m on my own (not in a therapy session) to help manage episodes like this?

David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum

 Is My Low-Testosterone Treatment OK for People Living With HIV?
I’m HIV positive, my CD4 count is 450, my viral load is below 20 copies and I take Epzicom (abacavir/3TC, Kivexa) and Isentress (raltegravir). I was recently diagnosed with secondary hypogonadism (low levels of certain sex hormones). My endocrinologist prescribed Femara (letrozole) to increase my testosterone level. Has this course of treatment been studied in HIV-positive people? What else should I be aware of when it comes to this condition?

Nelson Vergel responds in the “Nutrition and Exercise” forum
Connect With Others How Can I Quit Smoking Cigarettes?
(A recent post from the "Living With HIV" board)

Since the 4th of July, I have been trying to get myself independent of smoking cigarettes. Although I have yet to kick the habit completely, I have been able to cut down. I used to smoke two packs a day, but now I’m down to half a pack a day. That’s a big drop for me. You see, I’ve been smoking since they were only 48 cents a pack. I’ve had some issues putting them down before, tried pills, patches and other things that didn’t work. It’s kind of funny how we know we’re doing all we can to make ourselves healthy, yet some of us continue to hinder our health with these things. Does anyone have any quitting advice? — alive2

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UNDERSTANDING HIV/AIDS LABS
 Viral Load Low but Detectable: What Should I Be Keeping an Eye On?
I was diagnosed with HIV in March 2009. My viral load is 892 and my CD4 count is 952. My viral load tends to hover in the 900-to-1,000 range, and my CD4 count tends to stay in the 700-to-800 range. Is this average progression? Are my numbers likely to remain stable for a while longer? What factors might upset this trend? Should I think about starting HIV meds soon?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum
STRANGE BUT TRUE
 Risk of Sticking Random Objects Where the Sun Doesn’t Shine?
I was alone and being stupid, and I put an old toothbrush and a sun umbrella tube in my anus. I did it a few times, and bled once or twice. I only washed these objects with water before I stuck them up there. Has anyone ever become HIV positive in this way? I’m killing myself inside with this question!

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

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Activist Central
 July 20 — One Year of the National HIV/AIDS Strategy: How Are We Doing?

 NYC and Housing Works Launch re-fashioNYC

 Call to Action: Sign a Petition to Support Youth Participation in Global HIV/AIDS Decision-Making

 Action Alert: Condemn NY Post for Revealing Strauss-Kahn Victim Lives in AIDS Housing

 Tell Washington, D.C. to Fully Fund ADAP and Other HIV/AIDS Programs to Prevent Needless Deaths

 NMAC’s ADAP Action Campaign: Get Free Flip Video Camera to Collect Stories