The Ryan White Story – Gone Too Soon

Over the past few weeks you’ve been learning about the prejudice and discrimination faced by Ryan White because of his HIV infection.  This series concludes with a tribute to the life of Ryan White from the view point of one of his friends, Michael Jackson, who would have celebrated his 53rd birthday today if he was still with us.

The 1980’s, from a HIV/AIDS viewpoint was a time when many people panicked and about a new fatal and contagious disease, people were highly on guard with those who contracted it.  Most people were afraid of individuals who had HIV and if known to them, wouldn’t sit near them, talk to them and if it were possible refuse to breathe the same air!  It was exactly this time that Michael Jackson fearlessly invited Ryan to his home, and publicly embraced him inviting others not to be fearful of people living with HIV.

Ryan Whites mother, Jeanne White-Ginder has fond memories of Michael’s friendship with her son and you can read more about Ryan and Michael’s friendship here.

Two years after Ryan died, Michael Jackson released “Gone Too Soon” on World AIDS Day, 1993 dedicating it to Ryan White.  The video shows footage of Michael and Ryan together, as well as scenes from Ryan’s funeral.  Michael also performed the song at Bill Clinton’s inaugural celebration to serve as a promotional platform for HIV & AIDS funding adding:

I would like to take a moment from this very public ceremony to speak of something very personal. It concerns a dear friend of mine who is no longer with us. His name is Ryan White. He was a hemophiliac who was diagnosed with the AIDS virus [sic] when he was eleven. He died shortly after turning eighteen, the very time most young people are beginning to explore life’s wonderful possibilities. My friend Ryan was a very bright, very brave, and very normal young man who never wanted to be a symbol or a spokesperson for a deadly disease. Over the years, I’ve shared many silly, happy, and painful moments with Ryan and I was with him at the end of his brief but eventful journey. Ryan is gone and just as anyone who has lost a loved one to AIDS, I miss him deeply and constantly. He is gone, but I want his life to have meaning beyond his passing. It is my hope, President-elect Clinton, that you and your administration commit the resources needed to eliminate this awful disease that took my friend, and ended so many promising lives before their time.

“Gone Too Soon” later received more exposure, following the deaths of both Diana, Princess of Wales and Michael Jackson himself.

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Information about the effort and influence surrounding HIV/AIDS prominent activists is available here.

Big increase in HIV and syphilis diagnoses in US among young black gay men

HIV and syphilis diagnoses among  young gay and other men who have sex with men (MSM) increased in most metropolitan areas of the US between 2004 and 2008, investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

The increase in diagnoses was especially marked in young (13-24) black men, among whom HIV diagnoses increased by 85% and syphilis diagnoses by 203%.

“Young black MSM have disproportionately high rates of HIV diagnoses…highlighting the need for prevention efforts which address the behavioral and structural factors that place these men at risk,” write the investigators.

A recent study using data from the Centers for Disease Control and Surveillance showed that although rates of new HIV diagnoses in the US are steady, they are increasing in young gay men and black men. Diagnoses of HIV and syphilis are especially high in younger black MSM.

However, it is possible that recent increases in reported rates of both infections have been skewed by large numbers of diagnoses in a few large cities. In 2008, two cities accounted for 20% of all cases of syphilis in gay men and a fifth of all HIV diagnoses in gay and other MSM were located in three cities.

Therefore, investigators analysed reported HIV and syphilis diagnoses in gay and other MSM from 73 metropolitan areas across the US. All had a population of at least 500,000, and to be included in the analysis the areas had to have a population of at least 500 black individuals aged between 13 and 14.

Rates of HIV and syphilis diagnoses between 2004 and 2008 were monitored. The results were stratified according to age and race.

The total number of HIV diagnoses in gay and other MSM increased between 2004 and 2008 in all 73 areas by an average of 11%. Over the same period syphilis diagnoses almost doubled (88%).

However, the largest percentage increase in HIV diagnoses was among black men aged 13 to 24. HIV diagnoses in all other age and race groups remained relatively stable.

A comparison of the 2004 and 2008 data showed that increases in HIV diagnoses in black MSM aged 13 to 24 occurred in 85% of the areas included in the study. Increases were observed in more areas for black men in this age group than for Hispanic (62%) or white (58%) MSM of a similar age.

The number of HIV diagnoses among young black MSM was 69% higher in 2008 compared to 2004.

Similar patterns were present for syphilis diagnoses. These increased in 70% of areas among black men aged 13 to 24. Overall, the number of syphilis diagnoses in young black gay men increased by 203% between 2004 and 2008.

The majority of areas (79%) had increases in both HIV and syphilis diagnoses in black men aged 13 to 24. Concurrent increases in HIV and syphilis diagnoses among Hispanic MSM in the same age group were recorded in 73% of areas, but concurrent increases in both infections among young white men occurred in only 50% of areas.

“These findings document that increases in HIV and syphilis diagnoses among young black men are not limited to a few large areas, but are widespread among areas with different population sizes,” comment the investigators.

They believe that some of the increase could be due to changes in US testing guidelines. In 2006, opt-out HIV testing was introduced and all individuals at high risk of HIV were recommended to have an annual HIV test. Moreover, in 2007 a major programme commenced designed to increase testing among African Americans.

However, the investigators also suggest: “increases in transmission may also explain the observed increases in diagnoses of HIV and syphilis.” They add: “the observed increase in HIV diagnoses among MSM aged 13-24 years suggests an increase in transmission.”

The investigators further argue that the massive increases in syphilis diagnoses point to high rates of risky sexual behaviour, commenting: “syphilis diagnoses can serve as a ‘real-time’ marker of unprotected sexual intercourse that may result in the transmission of syphilis or HIV.”

The authors were especially concerned about the especially large increase in new HIV diagnoses among younger gay men. They write: “young MSM report being unprepared for their first sexual encounter, such as being ill-equipped to negotiate safer sex or not knowing how to use lubricant to reduce tearing and bleeding during anal sex.”

Separate research has shown that sexual risk behaviour in among US is similar across racial groups. The investigators suggest that the especially large increase in new diagnoses among young black men in their study could be due to “social factors, such as sexual network configurations (e.g. sex with black and older partners).” They also note that rates of undiagnosed HIV are especially high among African Americans.

“Infections among young MSM are unacceptably high,” conclude the investigators, “as the underlying causes of the epidemic are likely to be multifactorial, combining multiple strategies may prove most beneficial in improving the sexual health of this increasingly vulnerable population.”

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Related articles

• New Data Show Syphilis Threatens the Health of a New Generation of Gay and Bisexual Men (cdc.gov)
• Heterosexual HIV/AIDS Prevalent In Low Income Areas More Than Rich (lass.org.uk)
• Joe. My. God.: HIV Infections Rise For Young Black Men (thesexreport.org)

The Ryan White Story (Continued)

During the course of his short young life Ryan White changed the face of HIV and AIDS as we knew it, forever. He is, to this day, an inspiration and hero for many people living with HIV/AIDS. This is his story, part 10 of 10.

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HIV drug-prevention strategy carries risks [PrEP]

Earlier this month, we posted a video containing data from the iPrEx trial from the IAS 2011 conference stating that tenofovir/emtricitabine (Truvada) reduced new HIV infections by 42% overall, and by more than 90% among people who demonstrated good adherence.

When the US Food and Drug Administration approved Viagra in 1998, officials never considered one possible side effect of the drug: higher rates of sexually transmitted diseases among men who, thanks to Viagra, would become more sexually active. A powerful tool in the fight against HIV is raising similar questions about the possibility of unintended public-health consequences if drugs are approved for use in healthy people and cause them to alter their behaviour.

Several studies in the past year have reported that the very drugs used to treat people with HIV can also stop healthy people from becoming infected (see table below).

People taking the drugs may adopt riskier behaviours because they feel protected — a phenomenon known as ‘risk disinhibition’ — undermining the benefit of the drugs and potentially infecting others. Moreover, those who become infected while taking the preventive regimen might develop drug-resistant viruses that they could then transmit to others. “You have this wonderful scientific breakthrough,” says Kevin Frost, chief executive of the Foundation for AIDS Research in New York City. “But what are the practical implications?”

Researchers will mull over these issues today at a meeting convened by the Forum for Collaborative HIV Research in Washington DC. The questions have become more urgent since January, when the drug firm Gilead of Foster City, California, announced that it plans this year to ask the Food and Drug Administration (FDA) to approve its HIV drug Truvada for use in healthy people — in what is known as pre-exposure prophylaxis, or PrEP. Truvada, which contains the antiretroviral drugs tenofovir and emtricitabine, has been used in many of the PrEP trials. In the three clinical trials that have reported benefits for PrEP so far, once-a-day pills have cut a person’s risk of acquiring HIV by between 44% and 73%, a variation that is due primarily to differences in how strictly patients stuck to the daily regimen.

Asking the FDA to evaluate questions about risk disinhibition and drug resistance might push the agency into uncharted territory. “When you’re talking about a population issue, is that something that the FDA should be looking at at all?” asks Jur Strobos, deputy director of the Forum for Collaborative HIV Research.

The clinical trials don’t offer clear guidance. Some of the successful trials found that people on PrEP actually used condoms more frequently while receiving PrEP treatment, countering the risk-disinhibition argument. And only a few instances of drug resistance occurred, and these did not compromise patients’ treatments.

But the controlled setting of a clinical trial, in which participants received intensive prevention counselling and were tested monthly for HIV, is very different from the real world. “We think of PrEP as a pill, but we all recognize that PrEP is about a much broader programme,” says Mitchell Warren, director of the AIDS Vaccine Advocacy Coalition in New York City. “How you would deliver the kind of testing and monitoring that would go into that programme is a very important question.”

The US Centers for Disease Control and Prevention (CDC) has recommended testing patients for HIV before they begin taking the drugs and again at two- to three-month intervals. The FDA could also require drug companies to set up a registry of patients taking the drugs and ask that patients provide proof of a negative HIV test before getting their medications refilled.

Deciding who to treat with PrEP could also be a challenge. The CDC reported on 3 August that rates of new HIV infection in the United States are stable overall, but are rising in young men who have sex with men. Yet if these men aren’t using the prevention measures already available, there’s little reason to think doctors will have an easier time convincing them to take a daily pill.

The question of who should get PrEP is more difficult in many developing nations, which cannot even afford to treat everyone currently infected with HIV. PrEP would cost hundreds of dollars per patient per year in developing countries, and many thousands of dollars in rich nations.

Even with regimens costing less than £1 per day, developing nations will be forced to choose between providing more treatment for those who already need it and potentially preventing new infections. Myron Cohen, a doctor and researcher at the University of North Carolina at Chapel Hill, points out that half of young girls in some parts of sub-Saharan Africa become infected with HIV by their mid-twenties. “That’s unacceptable, so I see that as one potential population for PrEP,” says Cohen.

Although the cost-effectiveness of PrEP increases in higher-risk populations, it will be politically dicey for financially strapped countries to justify distributing drugs to those in these groups. “Even if you thought the best use of the pills would be for sex workers, it would be very difficult to take a limited supply of pills and give them to high-risk populations at the expense of people who are dying of infection,” says Cohen.

Original Article written by Erika Check Hayden at Nature.com

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Related articles

• IAS 2011: iPrEx Shows PrEP is Durable [VIDEO] (lass.org.uk)
• CDC Trial and Another Major Study Find PrEP Can Reduce Risk of HIV Infection among Heterosexuals (bespacific.com)
• PrEP can significantly lower risk of getting HIV, but is the public buying? (scienceblog.com)
• Drug study sees up to 92-percent cut in HIV risk (calgaryherald.com)
• ARVs Taken By HIV- Partners Can Reduce HIV Transmission (ladyenews.wordpress.com)

Annie Lennox on HIV Activism

Annie Lennox is an Oscar, Brit and Grammy award-winning pop musician and vocalist.

Known as a pop culture icon for her distinctive contralto vocals and visual performances, Annie has been named “The Greatest White Soul Singer Alive” by VH1 and one of The 100 Greatest Singers of All Time by Rolling Stone.  She has earned the distinction of “most successful female British artist in UK music history” because of her global commercial success since the early 1980s. Including her work within Eurythmics, Annie is one of the world’s best-selling music artists, having sold over 80 million records worldwide.

In addition to her career as a musician, Annie is also a political and social activist, notable for raising money and awareness for HIV charities in Africa.

For the last nine years, she has devoted the majority of her time to her SING campaign, raising awareness and money to combat HIV/AIDS. She shares the experiences that have inspired her, from working with Nelson Mandela to meeting a little African girl in a desperate situation.

The following video features Annie speaking at a TED conference, raising awareness of HIV/AIDS.

Related articles

• Lennox Slams World Leaders Over Hiv Policy (redbeardedoctopus.wordpress.com)
• AIDS2010 Begins with Sex, Drugs, and Annie Lennox (pinkbananaworld.com)
• Is Feminism Still The REAL “F” Word? (psychologytoday.com)
• Annie Lennox performs at Aids rally (bbc.co.uk)
• Singer Annie Lennox collects OBE (pakistannewsupdate.wordpress.com)

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EQ Festival At The Musician

Tucked away in a quiet back street in the heart of Leicester, The Musician is the Midlands premier independent music venue. With live music at least six nights a week, it holds 220 people and features comfortable seating, full disabled access, easy parking and a selection of real ales.

Since opening in 2000, The Musician’s reputation has been built on presenting the very best home grown and international performers in a relaxed and friendly environment. With a supremely eclectic booking policy the venue regularly features everything from contemporary singer-songwriters to rock, blues, folk, ska, punk, world, bluegrass, reggae, metal, soul, indie, avant-garde and Americana.

We hope you’ll come down on the 26th August to join the festivties which is helping to raise money for Leicestershire AIDS Support Services, acts performing on the night include:

Counteraction, Shapeshifter/Multimorph, Grace & The Magic Roots, Roger Pugh and Sleeping Through Rapture.

Tickets costs a mere £2.50 and the party starts at 6:30pm, til late, see you there!

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HIV & Nutrition

Good nutrition can be a problem for many people with HIV.  When your body fights any infection, it uses more energy and you need to eat more than normal.  But when you feel sick, you eat less than normal, good diets and nutrition help many people living HIV feel healthier.

Studies have found that people living with HIV with a healthy diet and good nutritional status can better tolerate HIV drugs, maintain weight and muscle mass more easily, and feel better overall.

Nutrients are things like fats, protein, carbohydrates, vitamins, minerals, and other important chemicals.  You need proper levels of different nutrients in order to build and repair cells, keep hormones regulated, fight infection, and maintain energy levels.  For the most part, we can’t make nutrients.  We get what we need from food and (when that’s not possible) dietary supplements.

Good nutrition depends on many things, including:

• What you’re eating (how much, what type of food, etc.)
• How you digest and absorb nutrients
• How different parts of your body use these nutrients

HIV-related changes in any of these factors can affect your nutritional status. Over time, this can lead to a variety of nutritional problems, including:

• Weight loss
• Muscle wasting
• High levels of fats and sugars in the blood
• Vitamin and mineral deficiencies

Many of these HIV-related problems can be avoided, or partially managed, using nutritional strategies.

A dietician (Emma) visits LASS on a monthly basis to offer helpful advice and information, she’s with us tomorrow (Friday, 19^th August) between 12:00 – 13:00 and will talk about methods to adapt recipes to gain or lose weight which may be helpful.

Service users are welcome to attend to speak with Emma to get more  information

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Related articles

• Exercise Guidelines Published for People with HIV Over 50 (lass.org.uk)
• Accelerated Hardening Of The Arteries In Patients With HIV; Traditional Risks The Main Cause (lass.org.uk)
• Special Nutritional Needs (enfamil.com)

TheBody.com – New Resource Centre on Starting HIV Treatment

TheBody.com is a website heavy with news, information and resources from a medical viewpoint.  They use their site to lower the barrier between patients and doctors by offering the chance to speak directly with healthcare professionals and medical experts online.  They aim to demystify HIV/AIDS treatment options which they hope will improve the quality of life for all people living with HIV/AIDS.

The Body have just have just released their brand new resource centre for commencing HIV treatment, with advice on how to prepare yourself for treatment, treatment guidelines, understanding the basics, FAQ’s, interviews, personal perspectives and more.

Don’t forget that LASS service users can also contact us directly any questions or concerns you may have and we’re happy to help.  If you are affected by, or live with HIV but don’t yet access our services and you live within Leicester, Leicestershire or Rutland please contact us for help.

The number of people living with HIV in the UK could reach a record 100,000 cases by next year, according to The Health Protection Agency (HPA).  They believe that unless unless more focus is given to HIV prevention and routine testing, more people could become infected.

Do you know your HIV status?  We offer a completely free and confidential rapid HIV test  and you’ll get the results within 60 seconds from a simple finger prick test.  We use the Insti HIV test produced by BioLytical laboratories.  The test is 99.96% accurate from 90 days post contact for detecting HIV 1 and 2 antibodies.  Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995

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Related articles

• Are You at Risk of Contracting HIV? (lass.org.uk)
• Heterosexual HIV/AIDS Prevalent In Low Income Areas More Than Rich (lass.org.uk)
• Aging & HIV Positive: A Growing Demographic (lass.org.uk)
• No Hiding Place for HIV/AIDS (lass.org.uk)

On Heat – Hot News From TRADE: Your Local Gay Health Charity

TRADE have released their bumper edition of on heat with hot news from your local gay health charity.

In this edition they bring you news of their Health & Wellbeing Marquee at Leicester Pride 2011, Kwick Prick rapid HIV testing now available at TRADE, the launch of the re-vamped Calling all Divas booklet for lesbian and bisexual women, an update on the Rainbow Asian Project and a whole load of other stuff! – Click below to download your copy today.

On Heat Autumn 2011 BUMPER EDITION.pdf

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Exercise Guidelines Published for People with HIV Over 50

A combination of aerobic and resistance exercises, three times a week for at least six weeks, is recommended to improve cardiovascular, metabolic and muscle function in people living with HIV older than 50 years of age, according to suggested guidelines published ahead of print by the Journal of the Association of Nurses in AIDS Care.

A great deal has been written about the potential benefits of regular exercise, particularly for older individuals living with, or at risk for, various age-related health complications. Because people living with HIV appear to face a higher risk of certain age-related problems—notably increased rates of cardiovascular disease (CVD) and various metabolic health issues at younger ages—and may also be taking numerous medications, there has been interest in utilizing drug-free lifestyle changes to improve disease-free survival.

Anella Yahiaoui, a research assistant at the University of Washington, and her colleagues set out to develop exercise recommendations for people living with HIV, based on the quantity and quality of exercise-based research that has been conducted and published.

Much of the available HIV-specific research—12 studies were included in the analysis—focused on younger individuals and primarily demonstrated positive effects of aerobic and resistance exercise on symptoms of wasting syndrome, notably muscle size and strength. Data were limited with respect to the effects of exercise on today’s most concerning age-related health complications among people living with HIV.

Yahiaoui’s team therefore included data from studies exploring the benefits of exercise in frail HIV-negative adults over the age of 65 and HIV-negative adults over the age of 55 with metabolic syndrome—a group of risk factors, similar to those seen in HIV-positive people with lipodystrophy, that occur together and increase the risk for CVD, stroke and type 2 diabetes.

Among the HIV-negative study volunteers with metabolic syndrome, exercise was independently associated with improvements in lipid levels and markers of insulin resistance, compared with matched patients who did not exercise. Among frail patients, some studies showed benefits associated with aerobic and resistance exercise, whereas others did not.

Based on the review of published data, Yahiaoui and her colleagues were able to devise a handful of key recommendations for people living with HIV over the age of 50.  Aerobic exercise, for example, should be performed at least three times a week for 20 to 40 minutes, aiming for a heart rate between 50 and 90 percent of the maximum heart rate.

Resistance exercises—which includes weight lifting and calisthenics, such as pushups, pull-ups and sit-ups—should involve each major muscle group and be performed after an aerobic exercise has been completed, again at least three times a week. One or two sets of six to eight repetitions of each exercise, with 20 to 30 seconds between each set, is  the recommended initial goal, eventually building up to three sets of ten repetitions of each exercise as endurance and strength improves.

Stretching, before and after exercising, is also recommended to prevent injuries.

There is, however, the possibility of too much of a good thing, the authors warn.  Athletes who exercise frequently and strenuously are at an increased risk of various infections, which can potentially lead to serious health problems in people living with HIV. In turn, Yahiaoui’s group cautions, exercise should not exceed 90 minutes of strenuous activity.

“Further research is warranted to study the benefits and risks of physical exercise in older HIV-infected patients,” the authors conclude.

Original Article via Aidsmeds.com

Also see “Aging & HIV Positive: A Growing Demographic”

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