Aids, Aids Treatment, Hiv, Aids Drugs

Positive or Negatif? HIV Test

2009-06-24T16:08:00.000-07:00

Many people ask the question, "Why should you get tested for HIV?"

There are a lot of reasons that people get tested for HIV. Maybe you’re sexually active and have engaged in behaviors that put you at risk of HIV infection. Maybe you’re starting a new relationship and have decided to get tested together. Whatever the case, there are many reasons why you should consider getting tested for HIV. If you've had sexual intercourse (vaginal, oral, or anal) without a condom or you've learned that a partner was not monogamous, or you have been sexually assaulted. Sometimes condoms are not reliable and they break.

If you have been sharing needles or syringes to inject drugs (including steroids) or for body piercing, tattooing, or any other reasons. If you have had multiple sexual partners, found out that a partner has shared needles, learned that a past or current partner is HIV-positive, discovered that a partner has been exposed to HIV, had a recent diagnosis of another sexually transmitted disease (STD) or if you are pregnant.

HIV home tests can tell if you have been infected with HIV. When HIV infection occurs, the body develops antibodies to the virus. The HIV test checks to see if your body is making these antibodies. However, it doesn’t test for AIDS.

There are three different ways to be tested for HIV: a blood sample, saliva or a urine sample. HIV home testing kits require a blood sample, which can be easily obtained by pricking your finger. HIV home test kits come with a detailed instruction booklet with illustrations which will take you through pre-test registration and counseling; collecting your blood sample; shipping that sample to an accredited laboratory then calling back for test results. You have the option of post-test counseling and referrals. Your results will then be available anywhere from 3-7 days, depending on which HIV home testing kit you purchase.

A positive test result means that your body is making HIV antibodies. If the test finds antibodies, that means you are infected with HIV. However, it doesn’t mean you have AIDS or will develop AIDS soon.

A negative test result means no HIV antibodies were found in your body. But, you could still be infected if you have been exposed to HIV in the last six months. Your body may not have produced enough HIV antibodies to show up yet. Consider getting tested again in a few months.

If you test positive, find a health-care professional who has experience with HIV treatment. The earlier you begin treatment, the more likely the virus will develop slowly, so you can stay healthy longer. Many HIV positive people live for many years without developing AIDS, but the odds are better the earlier you start treatment.

If you test negative, practice abstinence or practice safer sex. Use a latex condom during each act of vaginal, oral, or anal intercourse. Don’t share needles or syringes to inject drugs or for any other reason. Remember, if you had unprotected sex or any other risky behavior that can transmit HIV in the last six months prior to getting tested, you will need to get a follow-up test in six months to be sure you are not infected.

HIV home testing kits offer anonymity because they use code numbers or names to identify your test. Your name is never used. You use the code to get your results. You are the only person who knows your results. With anonymous testing, you get to decide who to tell and when.

Living With AIDS

2009-02-25T19:32:00.004-08:00

Living With AIDS

One of the most devastating epidemics in human history began with little fanfare in 1981 when the U.S. Centers for Disease Control and Prevention quietly released a nine-paragraph report detailing five cases of an unusual disease in gay men.
The disease in the report, which came to be known as AIDS, soon would grab headlines nationwide. In the years since, it's never let go. Shortly after the report's release, doctors and scientists worldwide rapidly realized they were up against a new and little-understood viral foe with an almost sinister ability to outwit that most powerful of disease fighters--the human immune system. In turn, public fears mounted as news reports detailed the lack of medical weapons with which to assault this new, frightening disease and its potential to spread to those previously not thought to be at risk.
In the past two decades, many of these fears have been realized. AIDS has indeed become a 21st century plague. Fifty-eight million people worldwide have been infected with HIV, the virus that causes AIDS, according to the Joint United Nations Program on HIV/AIDS. Twenty-two million have died after the virus rendered their immune system nearly defenseless, leaving them open to some types of cancer, nerve degeneration and opportunistic infections such as tuberculosis and pneumonia that physicians once thought were under control.
Over the past 20 years, AIDS has become a part of life everywhere on the planet. Few people have been unaffected by its tragic toll, and it remains one of the most feared of all infections. That's not likely to change as the third decade of AIDS begins. Despite medical advances, a cure is elusive. AIDS is a serious, difficult-to-treat and ultimately fatal disease, though the outlook for those living with it has steadily improved in the United States as new drugs have gained approval from the Food and Drug Administration.
Twenty years of public discussion about AIDS has also yielded slow progress in the ongoing debate about how to fight the disease and care for those who have it. Today, the financial, political and social issues that stem from AIDS are discussed as much as its symptoms, and those issues grow more complex each year.
Simply put, "AIDS remains a challenge for us all," says Keith Henry, M.D., an internationally known researcher and clinician at the University of Minnesota and Hennepin County Medical Center in Minneapolis.
Understanding the VirusAlthough AIDS was first recognized in 1981, HIV, the human immunodeficiency virus that causes AIDS, was not identified until 1983. Since then, researchers have been studying how the virus attacks and replicates itself inside cells of the immune system.
HIV is a virus--essentially a submicroscopic parasite consisting of a core of RNA wrapped in a protein coat--that cannot replicate without invading living cells. At its most basic, a virus takes over the cell's mission control center to make the cell do HIV's bidding instead of functioning normally. Viruses responsible for influenza and the common cold operate similarly. However, while cold and flu viruses can make people miserable for a time, in healthy people they are usually defeated handily by the immune system.
HIV is different. It directly attacks the cells of the immune system, the body's defense system. Specifically, HIV goes after a type of immune cell called the CD4 lymphocyte. CD4 cells play a crucial role in the immune system because they coordinate the attack by white blood cells and antibodies on viruses and other body invaders.
HIV has a stealthy ability to escape detection as an enemy by CD4 cells. It then attaches to these cells and enters them. Once inside, the virus's genetic material takes command of the CD4 cell and forces it to make copies of the virus.
New copies of the virus burst forth from the cell, which then dies, and go in search of other cells to invade. The cycle continues again and again, with up to10 billion new HIV virus particles produced every day by the commandeered cells. About 2 billion new CD4 cells are needed each day if this process is to be kept in check.
But the body can't keep up. In fact, the number of CD4 cells drops off sharply as HIV's foothold in the body strengthens. The body becomes unable to protect itself not only from HIV, but also from other viruses, bacteria, fungi and parasites. This is when someone infected with HIV develops Acquired Immune Deficiency Syndrome, or AIDS.
Battling the VirusThese unique abilities of HIV have made the medical fight against it extremely challenging. Scientists and physicians hadn't seen anything like the virus before, and in the early 1980s there were no drugs to treat it. There also were few measures to combat the opportunistic infections that invaded the bodies of people whose immune systems had been decimated by HIV.
Prevention is the most effective weapon against HIV and AIDS. During the 1980s, gay rights organizations and public health professionals spearheaded campaigns to provide those most at risk for sexual transmission of the disease with some straightforward advice on how to prevent it--namely, the use of condoms.
Information aimed at intravenous drug users, who can acquire the virus by sharing needles with someone who is infected with HIV, also became available. The campaigns were often controversial, but AIDS researchers believe that they were effective, and helped to slow the spread of the disease both within at-risk communities and outside them.
"The message seemed to get through,'' says Tim Schacker, M.D., an AIDS researcher and clinician at the University of Minnesota in Minneapolis.
AIDS advocacy organizations, now part of the landscape in every large city and a fixture during lobbying time at the state and federal level, also came into being. Their purpose was to seek support and money for prevention campaigns and also to direct public funds towards finding a cure.
"Education led to advocacy, that led to meetings with the FDA,'' said Martin Delaney, founding director of the AIDS advocacy group Project Inform in San Francisco.
A corner seemed to be turned in the late 1980s and early 1990s. Public hysteria over the new virus began to recede. At the same time, prevention and lobbying campaigns matured, and medical research began bearing fruit in the form of new drugs.
The Golden EraDespite their complex workings and complicated names, AIDS drugs are based on a relatively straightforward concept. By stopping or retarding the duplication of HIV inside the body's cells, the virus is prevented from overwhelming the immune system as it does when left unchecked. Researchers creating early HIV medicines followed this concept, and current medication has built on the theory.
The first drug to treat AIDS, the well-known AZT (zidovudine), was approved by the FDA in the United States in 1987. Initially created as a potential treatment for cancer, AZT was heralded as a wonder drug. Given the time and circumstances, it's understandable why. AZT was the first drug to show true promise in keeping the virus in check.
Consequently, AIDS patients and advocates began to demand access to the drug even while it was still in clinical trials. To accommodate patients' needs, the FDA streamlined the approval process to help get the drug to those who needed it while still ensuring its safety.
AZT belongs to a group of AIDS drugs known as nucleoside analogue reverse transcriptase inhibitors (NRTIs), which was the first group of drugs developed to fight the virus. These drugs work by interfering with an enzyme called reverse transcriptase that the virus needs to integrate itself into a human cell. In addition to AZT (Retrovir, zidovudine), NRTI drugs include Epivir (lamivudine, 3TC), Videx (didanosine, ddI), Hivid (zalcitabine, ddC), Zerit (stavudine, d4t), and one of the newest drugs on the market, Ziagen (abacavir).
However, AZT and the other NRTIs were no cure. While they seemed to lower the amount of virus in the blood--called the viral load--for a time or keep it in check, they didn't eradicate the virus from the body completely. Another troubling finding: AZT, which had held so much promise, began to lose its effectiveness as the virus began to change to overcome the drug's effect. Though inroads were being made, researchers knew there was still a long battle ahead.
"It was getting better, but people were still dying," says Jeffrey S. Murray, M.D., M.P.H., a veteran FDA researcher and clinician in the fight against AIDS. More weapons against HIV were needed. Gradually, the medical arsenal expanded.
A major addition has been the protease inhibitors, which became widely available in 1995. Protease inhibitors include Crixivan (indinavir), Norvir (ritonavir), Viracept (nelfinavir), Fortovase (saquinavir), and Agenerase (amprenavir). Like NRTIs, these drugs interfere with the virus's ability to replicate in the body and inhibit the action of another key enzyme (protease). This enzyme is responsible for breaking apart large HIV proteins within the virus into smaller ones.
Another group of drugs to treat AIDS is the non-nucleoside reverse transcriptase inhibitors, or NNRTIs. Like AZT and other NRTIs, these drugs also interfere with the reverse transcriptase enzyme to prevent HIV from replicating in the body. NNRTI drugs include Viramune (nevirapine), Sustiva (efavirenz) and Rescriptor (delavirdine).
Combination 'Cocktails'None of these drugs proved to be a solution in and of themselves, particularly as the virus would again mutate to overcome the drug's effects. However, scientists began to realize that the drugs together packed a powerful punch against the virus. In 1995, the National Institute of Allergy and Infectious Diseases (NIAID) showed that combining these drugs slows the high rate of mutation, a characteristic of HIV.
The drug combinations became known as cocktails, a breezy name for a major advance in the battle against HIV. A new treatment era was born, accompanied by previously unknown levels of optimism.
Between 1996 and 1997, the number of AIDS-related deaths dropped 42 percent. Another decline, this time of 20 percent, followed between 1997 and 1998. In a report released by the Kaiser Family Foundation, AIDS-related deaths numbered 44,991 in 1993. Just five years later, the toll had dropped to only 17,171.
"That was the golden age," says the FDA's Murray.
It was at this time when Ken Eppich of Minneapolis, then 53, was told he was HIV-positive.
Eppich, who is gay, clearly remembers the sunny fall day in 1994 when he learned his diagnosis. Equally clear in his memory is the almost instant acceptance of his fate. Eppich believed that he would die soon, like so many of the friends and colleagues he had known with the disease.
"I thought I had 18 months to live,'' Eppich says.
Eppich set about making a will and making peace with himself. "I was OK with it. I'd had a good life.''
Eppich's experience, however, epitomizes the changing expectations for AIDS patients brought on by this golden era. Having first learned of AIDS in the 1980s, he and his friends and family viewed AIDS as a death sentence.
"I never asked for a prognosis and my doctor wisely didn't offer one. My friends were sure I was dying and my brother felt that the Thanksgiving of 1994 would be my last,'' Eppich says.
Instead, he was given a bunch of drugs he'd never heard of. He took them, he read up on them--to the point that his doctor joked that the patient was the one really prescribing the medications--and made major changes in his life to stay healthy. And he lived.
Seven years later, in September 2001, Eppich found himself at a cabin in northern Minnesota on another clear, fall day with friends. They hoisted a toast to him and to his life.
"(AIDS) is a part of me, but it doesn't define or control me,'' says Eppich. "I think of it as a manageable, chronic illness rather than a fatal disease.''
Reality CheckLike Eppich, AIDS patients, today, can plan for their futures. But the optimism brought by the new drugs of the 1990s has dimmed as doctors and their patients have realized that the virus won't be vanquished so easily. Nor have the societal issues raised by the disease gone away.
The cocktails, the source of so much hope, have become less effective. As HIV replicates in the body, it is able to change ever so slightly. These changes have allowed it to steel itself against new drug enemies. Changing cocktail combinations has helped curb resistance, but researchers say there just aren't enough drugs or combinations to stay ahead of the constantly mutating virus.
"It isn't even a question of when we're going to start losing people," says Murray. "We already have because we have run out of new effective drugs to try."
New drugs are currently in the pipeline and moving ahead at a rapid pace, according to Murray. Research on potential AIDS vaccines is underway, but progress has been slower. In fact, some have referred to the vaccine pipeline as a "pipette." Since 1987, more than 40 different AIDS vaccines have been tested on a limited basis. Only one, AIDSVAX, has been thought promising enough to merit testing in humans in a large-scale study. Much of the research is being done in Thailand, though some of the work is also underway in the United States.
As the drug arsenal has expanded, so too has the debate about the disease, both within the medical community and outside it. In fact, the drugs that spawned the "golden era" of AIDS treatment have usually been at the heart of the discussion.
One major issue is that the drugs are expensive. Treatment for HIV and AIDS patients cost the United States government $6.9 billion in fiscal year 1999, up from $4.5 billion just two years before, according to the Kaiser Family Foundation.
The drugs also can be difficult to take. They must be taken on a strict schedule, and patients must remain on them for life. "Although some follow drug regimens nearly perfectly, perfect adherence is difficult," says Murray. "However, patients need to know that poor adherence to drugs may set them up for resistance."
Other pills prescribed to combat the side effects of anti-HIV drugs complicate the regimen. Eppich's day, for example, typically begins around 6:30 a.m. with a trip to the refrigerator, where one of his medications is kept. He then mixes the drug with a liquid and injects it into his side. Then he starts taking the first round of the 60-plus pills he takes every day. It's an hour and a half before he can start his day.
While the drugs keep the virus at bay, they often can make him feel less than healthy. He's nauseated sometimes and tired. Then there's another problem that he jokes about, but finds troublesome nonetheless. "I call it the eternal diarrhea," he says. "It's a part of life.''
As more people have taken the drugs, more has become known about this side effect and others. Particularly troubling side effects include liver toxicity, nerve damage, diabetes, high cholesterol levels and unusual accumulations of fat in the neck and abdomen.
Physicians such as the University of Minnesota's Henry have monitored these effects and have listened to their patients. As a result, medical wisdom has changed. In February 2001, federal treatment guidelines changed significantly. Instead of recommending aggressively treating new AIDS patients with drugs, the guidelines now call for waiting until the immune system weakens significantly or until HIV in the blood reaches certain levels.
The reason for this, says Henry, who was an international advocate for this change in philosophy, is that toxicities linked with the use of AIDS drugs appear to outweigh the benefits of early treatment with the drugs.
False ComplacencyAs the specter of AIDS receded, physicians, researchers and AIDS advocates began to notice that the effectiveness of the prevention message--the call for safe sex and drug practices made so stridently by AIDS advocates--also seemed to ebb.
The incidence of HIV infections began to climb in the late 1990s. So did the incidence of some sexually transmitted diseases--such as gonorrhea--that are closely linked with the type of behavior associated with HIV transmission and are believed by some researchers to even play a role in HIV transmission.
Physicians and AIDS advocates believe these events may be linked to the development of the AIDS drugs. A new generation of people in AIDS risk groups, experts say, now appears to believe that the drugs will protect or cure them of the virus and that an AIDS diagnosis today isn't serious.
"I hear about this all the time from patients,'' said Schacker, who sees patients at a Minneapolis clinic. "There is this belief that the drugs are so powerful that they can abandon safe sex practices. I am very concerned about it, and it's safe to say that [other researchers] are, too.''
So are AIDS advocates such as Project Inform's Delaney. He says some of the problems are caused by unrealistic expectations created by pharmaceutical companies.
"There were some overly cheery drug ads," Delaney says. "The message was, 'Don't worry about AIDS. It makes you prettier, it makes you sexier, it makes you stronger.'"
Researchers, physicians and advocates are beginning to target the issue and debate solutions. One researcher, Simon Rosser, Ph.D., M.P.H., of the University of Minnesota's Program in Human Sexuality, believes that an old tool, safe sex public health campaigns, needs to be dusted off and--more significantly--updated.
Rosser, who studies transmission of sexually transmitted diseases and the psychology involved, notes that dramatic advances have been made in treating AIDS. Yet little has been done, he says, to tailor public health messages and find ways to make them more effective.
"Essentially, we are using the same techniques that were used in the 1980s,'' Rosser says.
Delaney echoes Rosser's concerns, but says that researchers also need to make sure they remain vigilant in their fight against the disease. In his opinion, some of the urgency to find new treatments for AIDS may have been lost.
"The urgency of the old days is past, so the research is drifting in the doldrums of the past,'' Delaney says. "We're not going to let that happen.''
What's Ahead?As the third decade of AIDS begins, physicians, patients and advocates find themselves looking ahead while still dealing with issues like prevention that have been contended with since the historic CDC report in 1981. A cure, once thought to be imminent, is still years away.
Despite this, those within the AIDS community of researchers, patients and advocates believe that progress has been made against the disease. Researchers know more than ever about the virus, experts say. That there are debates about treatment guidelines also is an advance, since once there were no treatments. The highly visible role in public debate played by AIDS patients and advocates has also helped to lift the stigma once associated with the disease, as well as helped ensure public funding for research and prevention.
The challenge now, experts say, is to bring the tools that have made progress against AIDS in the United States to other countries. High on the list are Africa and Asia, where lack of education and medicine have allowed the virus to spread and kill nearly unchecked.
Project Inform, for example, plans to help find cheaper tools for the diagnosis of HIV and effective ways to lobby the government for increased funding of the international AIDS effort. It may not seem like much, says Delaney and other experts, but perhaps the main lesson from the struggle against AIDS is that the fight will be a long one and that small advances add up.
"We haven't lost hope,'' says Murray.
Ann Christiansen Bullers is a free-lance writer in Prairie Village, Kan.
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AIDS: Activism and Advocacy During the late 1980s, some AIDS activists and others were critical of the FDA, saying the agency was holding up the availability of drugs for treatment. With a lack of effective therapies, people demanded government-sponsored research, large-scale "Manhattan Project-style" drug development, and the availability of a myriad of untested treatment approaches.
Unfortunately, many of the resulting efforts--often driven by sheer desperation--proved to be misguided. Some people mistakenly believed that the FDA's role was to develop new drugs. But even those who knew that the FDA's role is to review the results of drug research--not to develop and market new drugs--thought that the agency's approach was too conservative, given that people were dying from lack of treatment. In other words: How great a risk could even inadequate drugs pose when the inevitable outcome was death?
In 1988, the FDA created an AIDS coordination staff, now part of the agency's office of special health issues, to act as a bridge between the advocacy community and the agency. The two-way flow of information fostered by the office encouraged education and understanding on both sides. And the old adversarial relationship has given way to one that is more cooperative and constructive after more than a decade of working together.
The FDA has actively sought input on regulatory issues from AIDS patients. More than 45 patient representatives have participated on FDA advisory committees considering HIV/AIDS-related issues in recent years. The FDA realizes the value of the patient perspective. And the patient community has developed a better understanding and appreciation of the importance of regulatory oversight. The various benefits of this relationship have spilled into other areas well beyond HIV/AIDS.
--Richard M. Klein, director of HIV/AIDS programs, FDA office of special health issues
Publication No. (FDA) 01-1314
by Anne Christiansen Bullers

Kaposi's Sarcoma

2009-02-23T17:31:00.002-08:00

What is Kaposi's Sarcoma?

An AIDS-defining illness caused by the HHV-8 virus, consisting of individual cancerous lesions caused by an overgrowth of blood vessels. KS typically appears as pink or purple painless spots or nodules on the surface of the skin or oral cavity. KS also can occur internally, especially in the intestines, lymph nodes, and lungs, and in this case is life threatening. The cancer may spread and also attack the eyes.

Food Safety Advice for People With AIDS

2009-02-21T12:29:00.002-08:00

Bacteria and Food Poisoning

"It must have been something I ate!" How many times do people say this following about of nausea, upset stomach, cramps, diarrhea, or vomiting?
Indeed, these can be the symptoms of food poisoning--illness caused by eating food on which harmful bacteria have grown. The bacteria that cause food poisoning are difficult to detect by a food's appearance, taste or smell. But they can cause illness ranging from mild to very severe and even life-threatening. The human body ordinarily is well-equipped to deal with these bacteria, but individuals with weakened immune systems--such as those with acquired immune deficiency syndrome (AIDS) and those infected with the human immunodefiency virus (HIV)--can be far greater risk of serious illness. Because of their weakened immune systems, these individuals are more susceptible to contracting a foodborne illness. Once contracted, these infections, with their severe vomiting and diarrhea, can be difficult to treat and they can come back again and again. This can further weaken the immune system and hasten the progression of HIV infection and be fatal for person with AIDS.
Since most foodborne illnesses result from improper handling of food, person with AIDS or HIV infection can help themselves by following basic food safety guidelines. Applying these guidelines when buying, preparing and storing food, along with having a basic knowledge of the most common harmful bacteria and the foods on which they are found or can grow, can allow persons with AIDS to eat defensively while choosing a nutritious diet.
People cannot get AIDS from food. The food safety advice in this brochure is intended to help persons with HIV infection to reduce the risk of food poisoning, thereby avoiding an illness that could worsen their condition or even cause death. While many kinds of bacteria can cause food poisoning, three are the most prevalent threat to persons with AIDS and HIV infections. These are: Campylobacter, Listeria and Salmonella.
The symptoms of Campylobacter infection (campylobacteriosis) include acute abdominal pain, diarrhea (which can be watery and contain blood), nausea, headache, muscle pain, and fever. Symptoms can begin 2 to 5 days after eating contaminated food and generally lasts 7 to 10 days. Campylobacter bacteria are most commonly found in raw or undercooked poultry, unpasteurized milk, and non-chlorinated water.
Listeriosis, the disease caused by Listeria, is characterized by flu-like symptoms of chills, fever and headache, sometimes accompanied by nausea and vomiting. These early symptoms can appear 2 to 30 days after exposure and can be followed by bacteremia (a bloodstream infection), meningitis (an inflammation of the membranes covering the spinal cord and brain), or encephalitis (an inflammation of the membranes of the brain itself). Foods found to contain Listeria are unpasteurized milk and cheeses, raw or undercooked meat, poultry, and fish.
Salmonellosis is the illness that can develop from eating foods containing Salmonella bacteria. It is characterized by flu-like symptoms, possibly accompanied by nausea, vomiting, abdominal cramps, and diarrhea. Symptoms can develop 6 to 48 hours after exposure and last up to a week. Foods most often associated with salmonellosis include raw or undercooked meat, poultry, fish, and eggs.
Shopping for FoodFor persons with AIDS, it is especially important to read food labels to select foods that pose the least risk of food poisoning. For example, all milk and cheese products should have the word "pasteurized" on the label. Products that contain any raw or undercooked meat or dairy products should be avoided, as well as products with a "sell by" or "best used by" date that has passed.
It is a good idea to put packaged meat, poultry or fish into plastic bag before placing it in the shopping cart. This prevents drippings from coming in contact with other foods and thus reduces the risks of cross-contamination--bacteria from one food contaminating another food.
The sale of food products with damaged packaging, the unsafe displaying of products (such as cooked shrimp on the same bed of ice as raw seafood), workers with poor personal hygiene, and unsanitary store conditions can add to the risk of foodborne illness. Not only should consumers avoid purchasing food products sold under such conditions, but the conditions should be reported to local health authorities.
After shopping, get chilled and frozen foods into refrigerator or freezer as soon as possible. Storing them in a warm car or office or even just carrying them around for a couple of hours can raise the foods' temperature enough to allow bacteria to grow.
At HomeMost cases of food poisoning are caused by improper food handling or preparation in the home. Keeping shelves, counter tops, refrigerators, freezers, utensils, sponges, and towels clean is one of the best ways to prevent bacterial contamination of food at home. It is especially important to wash all utensils and your hands with soap and hot water after handling one food and before handling another. This helps prevent cross-contamination in which, for example bacteria in raw meat could be transferred to other foods, such as salads or vegetables. For the same reason, wooden cutting boards should not be used for cutting raw meat, poultry or fish. Plastic boards are easier to clean and sanitize. Fresh fruits and vegetables should be thoroughly washed with water and refrigerated to reduce spoilage. the temperature in a refrigerator should be maintained at or below 40 deg F and food should be stored in covered containers.
Properly cooking food is another important guard against food poisoning. Heat kills bacteria. Most cookbooks give appropriate cooking times and temperature for different foods. A meat thermometer should be used to ensure complete cooking. Cook red meat until it is well done and poultry until the juices run clear. Thoroughly reheat leftovers (165 deg F).
Never eat raw eggs or foods that contain them. Pasteurized eggs should be used in place of shell eggs when making homemade ice cream, eggnog and mayonnaise. If you can't obtain pasteurized eggs, then you must omit the egg ingredient when making homemade ice cream. When cooking eggs, make sure that the yolk and white are firm, not runny. Here are cooking times and temperatures:
Scrambled-1 minute at medium stove top setting (250 deg F for electric frying pans).
Sunnyside-7 minutes at medium setting (250 deg F) or cook covered 4 minutes at 250 deg F.
Fried, over easy-3 minutes at medium setting (250 deg F) on one side, then turn and fry for another minute on the other side.
Poached-5 minutes in boiling water.
Boiled-7 minutes in boiling water. Microwave cooking requires special precautions. Most microwave recipes include a "standing time" after the cooking period to ensure that a proper temperature is reached throughout the food. Also, many microwave dishes must be removed from the oven and stirred from time to time-again, ensuring thorough cooking. It is particularly important to heat pre-cooked foods or leftovers thoroughly, whether in a microwave or conventional oven.
Eating OutRestaurants, like grocery stores, are required to follow sanitation guideline established by state and local health departments to ensure cleanliness and good hygiene. Persons with AIDS need to avoid the same foods in restaurants that they would at home. Always order food well-done; if it served medium to rare, send it back. A good way to determine doneness is to cut into the center of a steak, hamburger, or other piece of meat. If it is the least bit pink or bloody, it needs more cooking. Fish should be flaky, not rubbery, when cut.
Order fried eggs cooked on both sides instead of sunny side up, and avoid scrambled eggs that look runny. Caesar salad should also be avoided since it contains raw eggs. If unsure about the ingredients in a particular dish, ask before ordering.
Raw seafood poses a serious risk of food poisoning for persons with AIDS. Raw shellfish, like raw meat and poultry, should be assumed to harbor harmful bacteria. Oysters on the half shell, raw clams, sushi and sashimi should not be eaten. Lightly steamed seafood, such as mussels and snails, should be avoided.
Traveling AbroadNot all countries have the same high standards of hygiene and sanitation as the United States, so persons with AIDS should take additional precautions when traveling abroad.
Boil all water before drinking. Drink only beverages made with boiled water or canned or carbonated bottled drinks. Ice, too, should be made only from boiled water. Avoid uncooked vegetables and salads. All fruit should be peeled. Eat cooked foods while they are still hot.
A good rule of thumb is "Boil it, cook it, peel it, or forget it."
While food poisoning can usually be treated with rest and plenty fluids until solid food can be eaten again, persons with AIDS or HIV infection may experience prolonged and more serious symptoms requiring a doctor's care.
If a consumer or doctor believes that an attack of food poisoning was related to a particular food or restaurant, the local health department or the Food and Drug Administration should be contacted. Reporting the incident to health officials can help others avoid serious illness. The telephone number for FDA's Emergency Operations Branch is 301-443-1240 (this number is staffed 24 hours a day).
These food safety guidelines for persons with AIDS and HIV infection are no different than those recommended for anyone. But, in the case of persons with AIDS or HIV infection, contaminated food can have more serious consequences.
There are other high-risk groups--such as cancer patients, diabetics, transplant recipients, infants, pregnant women, and the elderly--who should also give special attention to those guidelines. For individuals in these high-risk groups, maintaining a nutritious diet is of great importance. Cooking and eating defensively need not interfere with a nutritious diet. But not being aware of the hazards and not taking appropriate steps to reduce the risk food poisoning can be life-threatening.

Requirements and Restrictions for HIV Positive People - Countries D-I

2009-02-20T12:50:00.002-08:00

Requirements and Restrictions for HIV Positive People - Countries D-I

Denmark
No restrictions for HIV positive people.

Dominican Republic
Foreigners seeking residency

Ecuador
An HIV negative test is required for a work permit of an application for permanent residency.

Egypt
Foreigners requiring work permits (spouses of work permit applicants are exempt)

El Salvador
HIV test required for people over 15 years old seeking permanent residency.

Eritrea
No restrictions for HIV positive people.

Estonia
No restrictions for HIV positive people unless applying for a work permit or residence.

Estonia
Foreigners seeking residency or work permits

Ethiopia
No HIV related restrictions.

Fiji
HIV positive people are not allowed to enter the Fiji Islands.

Finland
No restrictions but anyone knowingly transmit HIV may be deported.

Gabon
No HIV specific restrictions but a medical certificate is required for entry.

Georgia
All foreigners staying longer than 1 month

Germany, Federal Republic of
Applicants staying 180 days or longer in Bavaria (This requirement is for Bavaria only.)

Ghana
No HIV related restrictions.

Greece
Prostitutes (as defined by Greek law)

Guatemala
No HIV related restrictions.

Guinea
No HIV related restrictions.

Guyana
All foreigners staying longer than three months

Haiti
No HIV related restrictions.

Honduras
A medical certificate is required for a visa.

Hungary
Anyone staying over 1 year, and all intending immigrants (some employers may require workers to be tested)

Iceland
No HIV related restrictions however anyone found to have HIV is immediately entered into the national healthcare system.

India
All students over 18, anyone between the ages of 18 and 70 with a visa valid for 1 year or more, and anyone extending a stay to a year or more, excluding accredited journalists and those working in foreign missions.

Indonesia
Anyone HIV positive people are subject to residence regulations.

Iran
Anyone staying more than 3 months must produce an HIV test certificate.

Iraq
People with HIV are not allowed to enter the country. Anyone found to be HIV positive are immediately expelled from the country.

Ireland
No HIV related restrictions.

Israel
No HIV restrictions but anyone staying longer than 3 months must disclose their HIV status and have medical insurance.

Italy
No HIV related restrictions.

Drugs and Gender

2009-02-20T12:27:00.002-08:00

Drugs and Gender

Women woke up almost twice as fast from anesthesia as men in a study reported at the annual meeting of the American Society of Anesthesiologists, in October 1996. In another recent study, the class of painkillers called kappa opoioids seemed to work about twice as well for women as for men. These are but two of a growing number of clinical studies providing new information about possible differences in ways women and men respond to drugs.
Reporting on the anesthesia study, one of the researchers, Peter S. Glass of Duke University Medical Center, said the gender finding emerged unexpectedly during a study of how management of anesthetic drugs during surgery influences recovery time from general anesthesia. The study included 300 people. Women took an average of seven minutes to emerge from anesthesia, while men took 13. The difference occurred independently of differences in body weight.
In the painkiller study, according to a report published in the November 1996 issue of Nature Medicine, women having wisdom teeth removed had a better and longer response to these drugs than men, even when factors such as body size and menstrual cycle were considered.
Until recently, women were not routinely included in many human trials to determine whether drugs are safe and effective. The reason usually given was that excluding women protected them, since there was often no way to be sure that a woman was not pregnant or that the drug might not cause some problem that might interfere with future pregnancies. In addition, it was thought that women's hormonal cycling or other factors peculiar to being female might constitute variables that could skew trial results.
However, over the last several years, research has accumulated indicating that drug results from male-only trials may not apply equally to women, or may not give data on effects important to women. At one time, researchers thought most of the differences between the way men and women reacted to drugs might be attributed to differences in height, weight and hormones. This meant, for example, that simply because most men weigh more than most women, most men would be able to tolerate higher doses of medications without side effects.
Today many scientists think it's far more complicated. For example, the liver may be different enough in men and women to account for at lease part of why most women seem to metabolize drugs differently than men. And in the case of pain relief, there may be gender differences in pain tolerance and differences in the way each gender responds to various pain medications.
The rising recognition of these and other gender factors has brought changes in the way the Food and Drug Administration asks firms to test drugs and in the data the agency asks them to provide.
For example, in September 1995 FDA proposed to amend its investigational and new drug regulations to require drug sponsors to include data about gender, as well as age and race. The proposal does not require manufacturers to conduct additional studies. Rather, the manufacturers would simply provide information previously gathered in a new, more useful, format.
FDA suggested changes of this nature in 1993 as a revision to a 1977 Guideline, "General Considerations for Clinical Evaluation of Drugs, " after the agency found that few women were included in the earliest stages of drug clinical trials. In addition, the agency found that there had been little study of the effects on drug action of such factors as the menstrual cycle, menopause, and hormone use. The 1993 guideline left gender analysis voluntary; it was not a requirement.
Subsequent studies by FDA and the General Accounting Office have shown that women are often included in later phases of clinical trials, and are included in proportions similar to the proportion of women who have the condition the drug is being tested for. But FDA believes that inclusion alone is not enough. What is needed, in addition, is an effort to use data from the trials to discover potential gender differences.
Impact of HIVRachel Behrman, M.D., supervisory medical officer in FDA's division of antiviral drug products, says the issues surrounding these changes were brought to the forefront by efforts to treat HIV (the virus that causes AIDS) in women.
"The guidelines always provided that women with serious or life-threatening diseases could obtain an experimental drug in early phases of testing," say Behrman. "What's new is that now we're saying to drug manufacturers, 'Not only do we recommend that you study it in women, we may insist that you do so, if it's going to be used by women who have serious and life-threatening diseases.'"
She explains that because of the urgent need, drug testing for HIV is on a fast track, with condensed stages of controlled studies and, frequently, fewer people in them.
"Since the process moves so quickly, extensive clinical data collected over a long period of time often are not available," she says. "You need to know as soon as possible, for example, what adverse effects occur that might be dose-dependent, and work up those differences early in the drug development program. You don't want to wait for later stages of testing to begin to define dosage adjustments for men and women."
Many researchers feel the reason for including women in any phase 1 drug trial --- regardless of the seriousness of the disease --- should be to provide important data about the drug. This data includes whether women in general absorb, metabolize or excrete the drug differently from men, or have different reactions to the drug.
Early in the AIDS epidemic, very few women with HIV were included in studies. But their numbers are increasing. According to the National Institute of Allergy and Infectious Diseases (NIAID), in 1995 women accounted for 16.2 percent of adult participants in the AIDS Clinical Trials Group, the institute's largest clinical trials network. That percentage is up from 7 percent in 1988 and 8.4 percent in 1991.
In a study by FDA's Behrman, Kimberly Struble, Theresa Toigo and Debra Birnkrant, 136 of 156 clinical studies of HIV treatment conducted between 1988 and 1994 enrolled women. And, even in the 20 trials that did not include women, enrollment of women --- including those of childbearing ages --- was permitted. Enrollment of women in the other trials ranged up to 64 percent, with a mean of 11.6 percent.
Some HIV studies include only women. Better information on the length of survival and quality of life in HIV-infected women are research goals of the Women's Interagency HIV Study, conducted by the Centers for Disease Control and Prevention and NIAID. This large-scale study is designed to identify clinical signs of HIV infection in women, describe how the immune system declines, and look for factors that can affect the progression of the disease. It will also examine factors influencing women's access to health care.
Other NIAID-sponsored studies center on pregnancy and HIV. They are designed to examine the effect of antiviral drug treatment on both the mother and fetus, the influence of HIV on pregnancy, and the effects of pregnancy on the course of HIV infection. In addition, two experimental vaccines are being tested in pregnant women who are infected with HIV but are otherwise healthy. Phase 1 studies focus primarily on safety, but will also evaluate the vaccines' potential to reduce the amount of virus in the mother and to stimulate antibodies that will prevent infection of the fetus.
In August 1994, FDA approved the antiviral Retrovir (zidovudine, or AZT) to help prevent maternal-fetal transmission of HIV. A study of the drug for this use was halted early when preliminary data showed extremely encouraging results; that 8.3 percent of babies born to HIV-infected pregnant women treated with the drug became infected, compared with 25.5 percent of babies born to women on placebo.
Breast Cancer TrialsFDA has also been involved in a project to determine what resources are available for women seeking information about clinical trials of breast cancer treatments.
A 1995 study by FDA's Office of Special Health Issues and the agency's Office of Women's Health determined that there was no central source of clinical trials information that included both federally and privately sponsored clinical trials of breast cancer therapies.
The FDA researchers found that, in most cases, women seeking information about investigational drug studies directly from most university centers or other clinics were referred back to their doctors. Generally, only the Cancer Information Service (1-800-422-6237) of the National Cancer Institute (NCI) provided information on trials being conducted both at NCI and elsewhere. However, NCI, which relies mostly on its Physician Data Query (PDQ) database, did not usually have information about privately funded cancer research.
As a result, after consulting with NCI officials, FDA asked the Pharmaceutical Research and Manufacturers Association to encourage its members to submit information about their non-federally funded clinical trials to NCI's PDQ database. FDA and NCI also sent a letter to industry sponsors of drug trials informing them that they may submit information about active cancer clinical trials to NCI for possible inclusion in the PDQ database.
The days of routinely excluding women from clinical trials seem to be over. In fact, gender difference in drug effect is a growing area of research. In 1997, studies focusing on women included those on HIV, heart disease, various cancers, weight and eating disorders, menopause, and psychiatric disorders. It is hoped that information from such studies will improve the lives of women in the years to come.

Primal of a Kind in HIV Treatment

2009-02-19T12:42:00.002-08:00

Primal of a Kind in HIV Treatment

The Food and Drug Administration has approved Atripla Tablets, a fixed-dose combination of three widely used antiretroviral drugs in a single tablet for the treatment of HIV-1 infection in adults. Atripla is to be taken once a day alone or in combination with other antiretroviral products.

Atripla, the first one-pill, once-a-day product to treat HIV/AIDS, combines the active ingredients of Sustiva (efavirenz), Emtriva (emtricitabine), and Viread (tenofovir disoproxil fumarate). Bristol-Myers Squibb Co. and Gilead Sciences Inc. have formed a joint venture to commercialize Atripla in the United States. The collaboration is the first of its kind in the field of HIV/AIDS. In certain territories, Merck & Co. Inc. holds the rights to Sustiva. All three companies will work together to ensure the product is available to patients and physicians.

Atripla will be available for use in the United States as a new product approved under a new drug application. This designation will allow the drug to be considered for purchase for use in 15 other countries included in the President's Emergency Plan for AIDS Relief (PEPFAR).

Atripla's approval in July 2006 took less than three months and is the result of an expedited review process outlined in a guidance for industry from the FDA in May 2004. The FDA has now approved seven co-packaged or fixed-dose combination products since the guidance was issued.

Acting Commissioner of Food and Drugs Andrew C. von Eschenbach, M.D., calls the approval "a significant example of drug developers and FDA clearing the way to quickly deliver quality, lifesaving HIV/AIDS drugs to people who desperately need them in the United States and abroad."

The FDA approved Sustiva in 1998, Viread in 2001, and Emtriva in 2003. In addition, the safety and effectiveness of the combination of these three drugs were shown in a 48-week clinical study with 244 adults affected with HIV-1 receiving the drugs contained in Atripla. In the trial, 80 percent of the participants achieved a marked reduction of the human immunodeficiency virus and a substantial increase in the number of healthy CD4 cells—cells that fight against infection.

Atripla's labeling includes a boxed warning that the drug's use can cause a buildup of lactic acid in the blood. In people with chronic hepatitis B infection, the discontinuation of treatment with Atripla—which is not approved for this use—can result in severe flare-ups of hepatitis B infection. Other potential serious side effects reported for the use of Atripla's ingredients include liver toxicity, renal impairment, and severe depression. The most common side effects experienced by participants in the combination trial included headache, dizziness, abdominal pain, nausea, vomiting, and rash.

More than 1 million people are living with HIV and AIDS in the United States today, and 40,000 new cases are reported each year. Now, 28 FDA-approved products in the United States are used to treat HIV infection.

Also, within the last two years, the FDA has approved more than 20 treatments to be used as part of the PEPFAR program, a $15 billion initiative, which President Bush first announced in his 2003 State of the Union Address, to fight the international HIV/AIDS pandemic. PEPFAR is designed to prevent 7 million new HIV infections, treat at least 2 million people infected with HIV, and care for 10 million individuals affected with HIV, orphans with AIDS, and children vulnerable worldwide.

Source: Fda official web site

Experimental Anti-HIV Gel Shows Promise in Large-scale Study in Women

2009-02-18T12:39:00.002-08:00

Experimental Anti-HIV Gel Shows Promise in Large-scale Study in Women

Following is the text of a press release issued by the National Institutes of Health describing promising new microbicide data.

An investigational vaginal gel intended to prevent HIV infection in women has demonstrated encouraging signs of success in a clinical trial conducted in Africa and the United States. Findings of the recently concluded study, funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, were presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2009) in Montreal, Canada (February 8-11, 2009).

The study investigators found the microbicide gel--known as PRO 2000 (Indevus Pharmaceuticals, Inc., Lexington, Mass.)--to be safe and approximately 30 percent effective (33 percent effectiveness would have been considered statistically significant). This is the first human clinical study to suggest that a microbicide--a gel, foam or cream intended to prevent the sexual transmission of HIV and other sexually transmitted infections when applied topically inside the vagina or rectum--may prevent male-to-female sexual transmission of HIV infection.

“Although more data are needed to conclusively determine whether PRO 2000 protects women from HIV infection, the results of this study are encouraging,” said NIAID Director Anthony S. Fauci, M.D. The Phase II/IIb clinical trial, which enrolled more than 3,000 women, is NIH’s first large clinical study of a microbicide.

“An effective microbicide would be a valuable tool that women could use to protect themselves against HIV and one that could substantially reduce the number of new HIV infections worldwide,” Dr. Fauci added.

“The study, while not conclusive, provides a glimmer of hope to millions of women at risk for HIV, especially young women in Africa,” said lead investigator Salim S. Abdool Karim, MBChB, Ph.D., from the Center for the AIDS Program of Research in South Africa, who presented the findings at CROI. “It provides the first signal that a microbicide gel may be able to protect women from HIV infection.”

Currently, women make up half of all people worldwide living with HIV. In sub-Saharan Africa, women represent nearly 60 percent of adults living with HIV, and in several southern African countries young women are at least three times more likely to be HIV-positive than young men. In most cases, women become infected with HIV through sexual intercourse with an infected male partner. An effective microbicide could provide women with an HIV prevention method they initiate. This would be particularly helpful in situations where it is difficult or impossible for women to refuse sex or negotiate condom use with their male partners.

The study, known as HPTN 035, began in 2005 and enrolled 3,099 women at six sites in Africa and one in the United States. The clinical trial tested two candidate microbicide gels for safety and their ability to prevent HIV infection: PRO 2000 (0.5 percent dose), and BufferGel (ReProtect Inc., Baltimore). The U.S. Agency for International Development provided funding to manufacture BufferGel for the HPTN 035 study. PRO 2000 inhibits the entry of HIV into cells; BufferGel boosts the natural acidity of the vagina in the presence of seminal fluid, which can help to inactivate HIV and other pathogens.

The volunteers in HPTN 035 were divided at random into four equal-sized groups:

Those using BufferGel prior to engaging in sexual intercourse

Those using PRO 2000 before engaging in sexual intercourse

Women using placebo gel prior to engaging in sexual intercourse

Those who did not use gel before engaging in sexual intercourse

All participants received detailed information about the possible risks and benefits of trial participation before enrollment and were monitored monthly while in the study, which averaged 20 months. In addition, all the women were counseled on safe sex practices, given condoms, and tested and treated for sexually transmitted infections throughout the study.

Participants reported regular use of the investigational gels (81 percent of sex acts) and nearly all (99 percent) said they would use the products if approved for HIV prevention. Condom usage was also high throughout the course of the trial (74 percent).

In the final analysis, 194 women in the study became infected with HIV.. Of these infections, 36 occurred in the PRO 2000 group, 54 in the BufferGel group, 51 in the placebo group and 53 in those who did not use gel. Based on these data, PRO 2000 was 30 percent effective, while BufferGel had no detectable preventive effect on HIV infection. Both PRO 2000 and BufferGel were found to be safe.

HPTN 035 was conducted by the Microbicide Trials Network (MTN), an HIV/AIDS clinical trials network established in 2006 by NIAID with co-funding by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, all components of the NIH. Prior to the establishment of the MTN, the study was led by the NIAID-funded HIV Prevention Trials Network (HPTN), from which the study gets its name.

Roberta J. Black, Ph.D., chief of the Microbicide Research Branch in NIAID’s Division of AIDS, said, “Although a statistically significant protective effect was not observed, HPTN 035 successfully met its goal of determining whether either of the two candidate microbicides had sufficient promise to be considered for testing in a larger Phase III clinical study.”

Study participants are being informed of the findings and counseled on the continued need to follow safe sex practices in order to avoid possible HIV exposure. Women who became infected with HIV during the trial were counseled and referred to appropriate medical care and support, including antiretroviral therapy. These same women were also given the opportunity to participate in MTN 015, a clinical study examining the nature of HIV progression and treatment response in HIV-infected women who were using topical microbicides or oral antiretrovirals as an HIV preventive measure when they acquired HIV infection.

A separate clinical study sponsored by the Medical Research Council (MRC) and the Department for International Development of the United Kingdom that is currently testing PRO 2000 (0.5 percent dose) in preventing HIV infection among women in Africa could provide further insight into the microbicide’s effectiveness. That Phase III study involving nearly 9,400 women is set to conclude in August 2009.

Source:
NIAID News. Anti-HIV Gel Shows Promise in Large-scale Study in Women. Press release. February 9, 2009

Don't Rely on Symptoms to Decide if You Have HIV AIDS

2009-02-17T12:41:00.002-08:00

Don't Rely on Symptoms to Decide if You Have HIV AIDS

The importance of early diagnosis of HIV can't be overstated. Two-plus decades of HIV and AIDS research has proven that the earlier HIV is diagnosed, the better the prognosis and the likelihood of a long, healthy life. So how are HIV and AIDS diagnosed?
Diagnosing HIVDiagnosing HIV can be done using blood, saliva, or by using cells from the inside of the cheek. Because HIV carries such stigma and prejudices, great care is taken to protect the identity of those being tested. This is done in two ways:Confidential for a Fee - Your name will be linked to the test but the test results are kept confidential. Usually there is a fee assessed for these tests but most insurance plans will cover the charge. These tests are usually used by hospitals, labs, and doctor's offices.
Anonymous and Free - Tests can also be anonymous, meaning your name is not linked to the test at all. A random identifier using numbers, letters, or any fake name of your choice is used instead of your real name. The results are confidential, but even if someone gets the results by mistake, they would be unable to link you to the result. These tests are usually free and offered in community HIV agencies or health departments.

What is PCP?

2009-02-13T12:51:00.002-08:00

What is PCP?

Pneumocystis jiroveci (carinii) (NEW-mo-SIS-tis CA-RIN- nee-eye) pneumonia, or PCP is a severe infection found in people with HIV. It is caused by a fungus called Pneumocystis jiroveci. Most people infected with this fungus don’t get pneumonia because their immune systems are normal. People whose immune systems are badly damaged by HIV can get PCP. People with HIV are less likely to get PCP today than in earlier years. However, PCP is still the most common serious infection among people with AIDS in the United States.

How do I know if I have PCP?
If you have PCP, you probably will have fever, cough, or trouble breathing. People with PCP may die if the infection is not treated quickly. See your doctor immediately if you have these symptoms. PCP can be diagnosed only by laboratory tests of fluid or tissue from the lungs.

How do you catch PCP?
Most scientists believe PCP is spread in the air, but they don’t know if it lives in the soil or some- place else. The PCP germ is very common. Since it is difficult to prevent exposure to PCP, you should get medical care to prevent PCP.

How can I protect myself from PCP?
PCP can be prevented. The best drug for preventing PCP is the sulfa based antibiotic Bactrim. Note that allergies to Bactrim are common. If there is a Bactrim allergy, it can be replaced with either Dapsone or pentamidine.
Important Information! - Notify your doctor of any Bactrim or Sulfa allergy before taking Bactrim.

Prophylaxis Antibiotic Fact Sheets
I was vaccinated for pneumonia. Won’t that protect me against PCP?
No. What you had was the Pneumovax vaccine, a vaccine to protect you from bacterial pneumonia, but not against PCP. There is no vaccine for PCP.

Vaccine Fact Sheets

When should I start treatment to prevent PCP?
You should have your blood tested regularly to check the strength of your immune system. Your doctor should prescribe Bactrim to prevent PCP if your CD4 cell count falls below 200. Your doctor may also put you on Bactrim if you show certain symptoms, such as having a temperature above 100°F that lasts for 2 weeks or longer, or if you get a fungal infection in the mouth or throat (commonly called “thrush”). Having thrush is believed to raise your risk for getting PCP.

Understand your Blood Tests

What are the side effects of Bactrim?
Bactrim can make some people have a rash or feel sick. If the drug reaction is not severe, Bactrim should be continued because it works so much better than any other medicine to prevent PCP.

Are there other medicines to prevent PCP?
Yes. Check with your doctor about the possibility of other treatments. Take all of your medicines as prescribed by your doctor. Don’t change how many pills you are taking without speaking with your doctor.

Can I get PCP more than once?
Yes. If you have already had PCP you can get it again. TMP-SMX can prevent second infections with PCP. Therefore, you should take TMP-SMX even after you have had PCP to prevent getting it again.

Can children get PCP?
Yes. Children with HIV or AIDS can also get PCP. To learn more about children and PCP, call the AIDS Treatment Information Service at(800)448-0440.

Is PCP sexually transmitted?
No. PCP is not sexually transmitted.

A Growing Problem Among the Hispanic Population

2009-02-13T12:37:00.002-08:00

A Growing Problem Among the Hispanic Population

While HIV does not discriminate among different races, genders, or ethnicities, certain populations are carrying a larger burden of the HIV epidemic than others. The Hispanic population is seeing their HIV population continue to grow and become a large proportion of the new HIV cases. Let's take a look at the HIV epidemic and see the impact of HIV/AIDS among Hispanics.

Cumulative Effects of HIV/AIDS in the Hispanic Community
Although Hispanics make up only about 14 percent of the population of the United States and Puerto Rico, they account for 18 percent; almost 164,000 of the more than 886,500 AIDS cases diagnosed since the beginning of the epidemic.

AIDS in the Hispanic Community
By the end of 2002, nearly 88,000 Hispanics had died of AIDS.

Among people given a diagnosis of AIDS since 1994, a smaller proportion of Hispanics (61 percent), compared with whites (64 percent) and Asians/Pacific Islanders (69 percent), were alive after 9 years.

The proportion of surviving Hispanics was larger than the proportions of surviving American Indians and Alaska Natives (58 percent) and African Americans (55 percent).

Hispanics accounted for more than 8,000, or 20 percent, of the more than 42,000 new AIDS diagnoses in the United States in 2002.

Of the rates of AIDS diagnoses for all racial and ethnic groups, the second highest was the rate for Hispanics. Here is the breakdown:
African Americans - 76.4 cases per 100,000 people
Hispanics - 26.0 per 100,000 people
American Indians and Alaska Natives - 11.2 per 100,000 people
Whites - 7.0 per 100,000 people
Asians and Pacific Islanders - 4.9 per 100,000 people

The 76,052 Hispanics living with AIDS accounted for 20 percent of all people in the United States living with AIDS

HIV in the Hispanic Community

Hispanics accounted for 13 percent of new HIV/AIDS diagnoses reported in the 30 areas with long-term, confidential name-based HIV reporting in the United States.

From 1999 through 2002, the number of new HIV/AIDS diagnoses increased by 26 percent among Hispanics in the 30 areas.

Most Hispanic men are exposed to HIV through sexual contact with other men, followed by injection drug use and heterosexual contact.

Most Hispanic women are exposed to HIV through heterosexual contact, followed by injection drug use.

2009-02-13T12:21:00.002-08:00

We know the legal answer to the question; is HIV a disability

It All Started With A Trip To The DentistIn September of 1994, Sidney Abbott visited the office of dentist Randon Bragdon. This routine visit would spark a controversy that would eventually involve the United States Supreme Court. On that day, Dr. Bragdon refused to fill Ms. Abbott's simple cavity because she admitted to being HIV positive. Ms. Abbott felt she was being discriminated against because of her HIV.
A Disturbing TrendAt the time, Ms. Abbott's experience was just another in a growing number of such discrimination by doctors and dentists refusing to treat HIV positive people. AIDS activists and medical professionals feared that if this mentality were left to spread among a growing number healthcare professionals, the quality and availability of HIV care would decline, placing HIV infected people at a definite disadvantage and frankly in grave danger.
The Debate - Was Ms. Abbott's HIV a Disability?How did Dr. Bragdon justify his decision not to treat Ms. Abbott? The dentist argued that since Ms. Abbott showed no physical signs or symptoms of HIV or AIDS, she was not disabled and therefore was not protected by Federal law. The law Dr. Bragdon was referring to was The Americans with Disabilities Act (ADA), a law that forbids discrimination against people who are disabled.What Are The Signs and Symptoms of HIV?
Contact Info For Your Local ADA Office
Ms. Abbott countered that her HIV impacted her ability to reproduced, rendering her disabled. She felt that because she was disabled, Dr. Bragdon's refusal to treat her was in direct violation of the ADA. The Supreme Court agreed. In June of 1998, the High Court stated that people infected with HIV were entitled to protection under the Americans with Disabilities Act, regardless of their symptoms or lack of symptoms. Ironically, if that same arguement was made today, Ms. Abbott may have a hard time proving her case since we know that HIV does not prevent an HIV positive women from pregnancy and having children. This would mean that Ms. Abbott's contention that HIV prevented her from reproducing and therefore she was disabled, had no medical basis.
HIV and Pregnancy
How Does This Help You?The ADA says the HIV positive person has rights and protections from discrimination based on HIV disease. That person is also entitled to workplace accomodations that allow them to perform their jobs efficiently, while protecting the health of the employee. For instance, if an HIV positive person has peripheral neuropathy in the feet, the ADA says the employer must provide the employee with a chair that will allow him or her to sit down while working to ease the discomfort of the neuropathy. If their job can't be performed while sitting, the employer must make every effort to place that employee in a job they can do while sitting.What is Peripheral Neuropathy?
The rights and provisions provided by the ADA are protected by Federal law and confirmed and backed by The United States Supreme Court. Because people both symptomatic and asymptomatic HIV infected people are protected by the ADA, employers must make reasonable accommodations for the infected person. For instance, under the ADA, employers must allow time away from work to seek medical care such as doctors' visits, trips to the pharmacy to pick up medication, and time to take that medication in a private setting. In addition, employers must make reasonable accommodations regarding schedule modification, reassignment to vacant positions that are better suited to the person's limitations, and must provide equipment that will allow the person to better perform his or her job.
HIV in the Workplace - What to Know Before Returning to Work
What Should I Do if I Feel I'm Being Discriminated Against?If you feel you are being discriminated against or you feel that you may need the provisions of the ADA to perform your job, consult your doctor. Take an honest, objective look at your general state of health, stamina, mental health, and ability to perform your job. If you feel accommodations such as those provided by the ADA are needed, take your request with supporting medical information to support your claim to your local ADA office. They can guide you through the process step-by-step and show you how to get the workplace accomodations you are entitled to. If after filing your ADA request in good faith and your employer does not make reasonable efforts to accommodate you, consult legal services to see if you do truly have a case. The key is to be realistic in what you are capable of and what you expect from your company.Important Information!Keep in mind that if you file an ADA request it may mean that at some point in the process you will be required to allow your employer access to some parts of your medical record, including those associated withyour HIV care. Simply put, in order to get the accomodations you feel you need in order to work, making your HIV+ status known to your employer may be necessary.
Important Instructions!Never sign any document permitting your employer access to your medical records without first speaking with your doctor and attorney. If you can't afford an attorney, check with your local HIV/AIDS agency for the names of lawyers in your area that specialize in HIV legal matters (many of which are free of charge to those living with HIV).

Finding an HIV Specialist, Right Doctor

2009-02-13T12:18:00.002-08:00

Finding an HIV Specialist, Right Doctor

HIV is a complex disease that requires specially trained physicians to deliver the complex care necessary for a healthy life. Complicated drug regimens with a multitude of side effects; the long-term complications of HIV such as lipodystrophy and mitochondrial toxicity (lactic acidosis) makes treating HIV disease a challenge. So how do people living with HIV choose a physician? Here is a brief guide to help you make good decisions. Good decisions by you now will pay off in long-term benefits later.
What Questions Should I Ask?In order to choose the right doctor, you have to ask the right questions. Here are a few to get you started.Are you an HIV Specialist?The CDC now recommends that HIV infected people be treated by HIV specialists. The complexity of the disease necessitates the care of someone devoted solely to HIV.Why an HIV Specialist?
How much importance to you place on women's health issues?For women living with HIV, having a physician dedicated to women's health is essential. Treating HIV in women is a complexity all its own and requires someone who recognizes the special challenge of treating women with HIV.Women and HIV - Special Needs
What services does your clinic offer?Find a clinic that utilizes a multidisciplinary team of doctors, nurses, social workers, nutritionists, and pharmacists that can treat the entire person.The Ryan White CARE Act - Its Impact on HIV Services
What is your philosophy regarding patient participation in treatment decisions?Don't consider a doctor who does not encourage patient involvement in treatment decisions such as when to start medications and the use of alternative and complimentary therapies.
Know Your RightsAs a patient, you are entitled to basic rights. Make sure you know those rights.

Do You Know The Reason Of Aids?

2009-02-13T12:17:00.002-08:00

Do You Know The Reason Of Aids?

Most Americans believe they know what causes AIDS. For a decade, scientists, government officials, physicians, journalists, public-service ads, TV shows, and movies have told them that AIDS is caused by a retrovirus called HIV. This virus supposedly infects and kills the "T-cells" of the immune system, leading to an inevitably fatal immune deficiency after an asymptomatic period that averages 10 years or so. Most Americans do not know--because there has been a virtual media blackout on the subject--about a longstanding scientific controversy over the cause of AIDS, a controversy that has become increasingly heated as the official theory's predictions have turned out to be wrong.
Leading biochemical scientists, including University of California at Berkeley retrovirus expert Peter Duesberg and Nobel Prize winner Walter Gilbert, have been warning for years that there is no proof that HIV causes AIDS. The warnings were met first with silence, then with ridicule and contempt. In 1990, for example, Nature published a rare response from the HIV establishment, as represented by Robin A. Weiss of the Institute of Cancer Research in London and Harold W. Jaffe of the U.S. Centers for Disease Control. Weiss and Jaffe compared the doubters to people who think that bad air causes malaria. "We have?been told," they wrote, "that the human immuno-deficiency virus (HIV) originates from outer space, or as a genetically engineered virus for germ warfare which was tested in prisoners and spread from them. Peter H. Duesberg's proposition that HIV is not the cause of AIDS at all is, to our minds, equally absurd." Viewers of ABC's 1993 Day One special on the cause of AIDS--almost the only occasion on which network television has covered the controversy--saw Robert Gallo, the leading exponent of the HIV theory, stomp away from the microphone in a rage when asked to respond to the views of Gilbert and Duesberg.
Such displays of rage and ridicule are familiar to those who question the HIV theory of AIDS. Ever since 1984, when Gallo announced the discovery of what the newspapers call "HIV, the virus that causes AIDS," at a government press conference, the HIV theory has been the basis of all scientific work on AIDS. If the theory is mistaken, billions of dollars have been wasted--and immense harm has been done to persons who have tested positive for antibodies to HIV and therefore have been told to expect an early and painful death. The furious reactions to the suggestion that a colossal mistake may have been made are not surprising, given that the credibility of the biomedical establishment is at stake. It is time to think about the unthinkable, however, because there are at least three reasons for doubting the official theory that HIV causes AIDS.
First, after spending billions of dollars, HIV researchers are still unable to explain how HIV, a conventional retrovirus with a very simple genetic organization, damages the immune system, much less how to stop it. The present stalemate contrasts dramatically with the confidence expressed in 1984. At that time Gallo thought the virus killed cells directly by infecting them, and U.S. government officials predicted a vaccine would be available in two years. Ten years later no vaccine is in sight, and the certainty about how the virus destroys the immune system has dissolved in confusion.
Second, in the absence of any agreement about how HIV causes AIDS, the only evidence that HIV does cause AIDS is correlation. The correlation is imperfect at best, however. There are many cases of persons with all the symptoms of AIDS who do not have any HIV infection. There are also many cases of persons who have been infected by HIV for more than a decade and show no signs of illness.
Third, predictions based on the HIV theory have failed spectacularly. AIDS in the United States and Europe has not spread through the general population. Rather, it remains almost entirely confined to the original risk groups, mainly sexually promiscuous gay men and drug abusers. The number of HIV-infected Americans has remained constant for years instead of increasing rapidly as predicted, which suggests that HIV is an old virus that has been with us for centuries without causing an epidemic.
No one disputes what happens in the early stages of HIV infection. As other viruses do, HIV multiplies rapidly, and it sometimes is accompanied by a mild, flu-like illness. At this stage, while the virus is present in great quantity and causing at most mild illness in the ordinary way, it does no observable damage to the immune system. On the contrary, the immune system rallies as it is supposed to do and speedily reduces the virus to negligible levels. Once this happens, the primary infection is over. If HIV does destroy the immune system, it does so years after the immune system has virtually destroyed it. By then the virus typically infects very few of the immune system's T-cells.
Before these facts were well understood, Robert Gallo and his followers insisted that the virus does its damage by directly infecting and killing cells. In his 1991 autobiography, Gallo ridiculed HIV discoverer Luc Montagnier's view that the virus causes AIDS only in the company of as yet undiscovered "co-factors." Gallo argued that "multifactorial is multi-ignorance" and that, because being infected by HIV was "like being hit by a truck," there was no need to look for additional causes or indirect mechanisms of causation.
All that has changed. As Warner C. Greene, a professor of medicine at the University of California, San Francisco, explained in the September 1993 Scientific American, researchers are increasingly abandoning the direct cell-killing theory because HIV does not infect enough cells: "Even in patients in the late stages of HIV infection with very low blood T4 cell counts, the proportion of those cells that are producing HIV is tiny--about one in 40. In the early stages of chronic infection, fewer than one in 10,000 T4 cells in blood are doing so. If the virus were killing the cells just by directly infecting them, it would almost certainly have to infect a much larger fraction at any one time."
Gallo himself is now among those who are desperately looking for possible cofactors and exploring indirect mechanisms of causation. Perhaps the virus somehow causes other cells of the immune system to destroy T-cells or induces the T-cells to destroy themselves. Perhaps HIV can cause immune-system collapse even when it is no long present in the body. As Gallo put it at an AIDS conference last summer: "The molecular mimicry in which HIV imitates components of the immune system sets events into motion that may be able to proceed in the absence of further whole virus."
But researchers have not been able to confirm experimentally any of the increasingly exotic causal mechanisms that are being proposed, and they do not agree about which of the competing explanations is more plausible. When TheNew York Times interviewed the government's head AIDS researcher, Anthony Fauci, in February, reporter Natalie Angier summarized his view as a sort of stew of all the leading possibilities: "It [HIV] overexcites some immune signaling pathways, while eluding the detection of others. And though the main target of the virus appears to be the famed helper T-cells, or CD-4 cells, which it can infiltrate and kill, the virus also ends up stimulating the response of other immune cells so inappropriately that they eventually collapse from overwork or confusion." No other virus is credited with such a dazzling repertoire of destructive skills.
Perhaps it is the HIV scientists who are collapsing from overwork or confusion. The theory is getting ever more complicated, without getting any nearer to a solution. This is a classic sign of a deteriorating scientific paradigm. But as HIV scientists grow ever more confused about how the virus is supposed to be causing AIDS, their refusal to consider the possibility that it may not be the cause is as rigid as ever. On the rare occasions when they answer questions on the subject, they explain that "unassailable epidemiological evidence" has established HIV as the cause of AIDS. In short, they rely on correlation.
The seemingly close correlation between AIDS and HIV is largely an artifact of the misleading definition of AIDS used by the U.S. government's Centers for Disease Control. AIDS is a syndrome defined by the presence of one or more of 30 independent diseases--when accompanied by a positive result on a test that detects antibodies to HIV. The same disease conditions are not defined as AIDS when the antibody test is negative. Tuberculosis with a positive antibody test is AIDS; tuberculosis with a negative test is just TB.
The skewed definition of AIDS makes a close correlation with HIV inevitable, regardless of the facts. This situation was briefly exposed at the International AIDS Conference in Amsterdam in 1992, when the existence of dozens of suppressed "AIDS without HIV" cases first became publicly known. Instead of considering the obvious implications of these cases for the HIV theory, the authorities at the CDC, who had known about some of the cases for years but had kept the subject under wraps, quickly buried the anomaly by inventing a new disease called ICL (Idiopathic CD4+Lympho-cytopenia)--a conveniently forgettable name that means "AIDS without HIV."
There are probably thousands of cases of AIDS without HIV in the United States alone. Peter Duesberg found 4,621 cases recorded in the literature, 1,691 of them in this country. (Such cases tend to disappear from the official statistics because, once it's clear that HIV is absent, the CDC no longer counts them as AIDS.) In a 1993 article published in Bio/Technology, Duesberg documented the consistent failure of the CDC to report on the true incidence of positive HIV tests in AIDS cases. The CDC concedes that at least 40,000 "AIDS cases" were diagnosed on the basis of presumptive criteria--that is, without antibody testing, on the basis of diseases such as Kaposi's sarcoma. Yet these diseases can occur without HIV or immune deficiency. Perhaps some of the patients diagnosed as having AIDS would have tested negative, or actually did test negative, for HIV. Physicians and health departments have an incentive to diagnose patients with AIDS symptoms as AIDS cases whenever they can, because the federal government pays the medical expenses of AIDS patients under the Ryan White Act but not of persons equally sick with the same diseases who test negative for HIV antibodies.
The claimed correlation between HIV and AIDS is flawed at an even more fundamental level, however. Even if the "AIDS test" were administered in every case, the tests are unreliable. Authoritative papers in both Bio/Technology (June 1993) and the Journal of the American Medical Association (November 27, 1991) have shown that the tests are not standardized and give many "false positives" because they react to substances other than HIV antibodies. Even if that were not the case, the tests at best confirm the presence of antibodies and not the virus itself, much less the virus in an active, replicating state. Antibodies typically mean that the body has fought off a viral infection, and they may persist long after the virus itself has disappeared from the body. Since it is often difficult to find live virus even in the bodies of patients who are dying of AIDS, Gallo and others have to speculate that HIV can cause AIDS even when it is no longer present and only antibodies are left.
Just as there are cases of AIDS without HIV, there are cases of HIV-positive persons who remain healthy for over a decade and who may never suffer from AIDS. According to Warner C. Greene's article in Scientific American, "It is even possible that some rare strains [of HIV] are benign. Some homosexual men in the U.S. who have been infected with HIV for at least 11 years show as yet no signs of damage to their immune systems. My colleagues?and I are studying these long-term survivors to ascertain whether something unusual about their immune systems explains their response or whether they carry an avirulent strain of the virus."
The faulty correlation between HIV and AIDS would not disprove the HIV theory if there were strong independent evidence that HIV causes AIDS. As we have seen, however, researchers have been unable to establish a mechanism of causation. Nor have they succeeded in confirming the HIV model by inducing AIDS in animals. Chimps have repeatedly been infected with HIV, but none of them have developed AIDS. In the absence of a mechanism or an animal model, the HIV theory is based only upon a correlation that turns out to be primarily an artifact of the theory itself.
In light of the importance of the correlation argument, it is astonishing that no controlled studies have been done for three of the major risk groups: transfusion recipients, hemophiliacs, and drug abusers. Two ostensibly controlled studies involving men's groups in Vancouver and San Francisco purportedly show that AIDS developed only in the HIV-positive men and never in the "control group" of HIV negatives. These studies were designed not to test the HIV theory but to measure the rate at which HIV-positive gay men develop AIDS. They did not compare otherwise similar persons who differ only in HIV status, did not control effectively for drug use, and did not fully report the incidence of AIDS-defining diseases in the HIV-negative men. The research establishment accepted these studies uncritically because they give the HIV theory some badly needed support. But the main point they supposedly prove has already been thoroughly disproved: AIDS does occur in HIV-negative persons.
According to the official theory, HIV is a virus newly introduced into the American population, which has had no opportunity to develop any immunity. It follows that viral infection should spread rapidly, moving from the original risk groups (gays, drug addicts, transfusion recipients) into the general population. This is what the government agencies confidently predicted, and AIDS advertising to this day emphasizes the theme that "everyone is at risk."
The facts are otherwise. AIDS is still confined mainly to the original risk groups, and AIDS patients in the United States are still almost 90-percent male. Health-care workers, who are constantly exposed to blood and bodily fluids of AIDS patients, have no greater risk of contracting AIDS that the population at large. Among millions of health-care workers, the CDC claims only seven or eight (poorly documented) cases of AIDS supposedly developed through occupational exposure. By contrast, the CDC estimates that accidental needle sticks lead to more than 1,500 cases of hepatitis infection each year. Even prostitutes are not at risk for AIDS unless they also use drugs.
Far from threatening the general heterosexual population, AIDS is confined mainly to drug users and gay men in specific urban neighborhoods. According to a 1992 report by the prestigious U.S. National Research Council, "The convergence of evidence shows that the HIV/AIDS epidemic is settling into spatially and socially isolated groups and possibly becoming endemic within them." This factual picture is so different from what the theory predicts, and so threatening to funding, that the AIDS agencies have virtually ignored the National Research Council report and have continued to preach the fiction that "AIDS does not discriminate."
Not only is AIDS mostly confined to isolated groups in a few U.S. cities, but HIV infection is not increasing. Although a virus newly introduced to a susceptible population should spread rapidly, for several years the CDC has estimated that a steady 1 million Americans are HIV positive. Now it appears that the figure of 1 million is finally about to be revised--downward. According to a story by Lawrence Altman in the March 1 New York Times, new statistical studies indicate that only about 700,000 Americans are HIV positive, and the official estimate will accordingly be reduced sometime this summer.
While HIV infection remains steady at this modest level in the United States, World Health Organization officials claim that the same virus is spreading rapidly in Africa and Asia, creating a vast "pandemic" that threat ens to infect at least 40 million people by the year 2000, unless billions of dollars are provided for prevention to the organizations sounding the alarm. These worldwide figures, especially from Africa, are used to maintain the thesis that "everyone is at risk" in the United States. Instead of telling Americans that AIDS cases here are almost 90-percent male, for example, authorities say that worldwide the majority of AIDS sufferers are female. With the predictions of a mass epidemic in America and Europe failing so dramatically, AIDS organizations rely on the African figures to vindicate their theory.
But these African figures are extremely soft, based almost entirely on "clinical diagnoses," without even inaccurate HIV testing. What this means in practice is that Africans who die of diseases that have long been common there--especially wasting disease accompanied by diarrhea--are now classified as AIDS victims. Statistics on "African AIDS" are thus extremely manipulable, and witnesses are emerging who say that the epidemic is greatly exaggerated, if it exists at all.
In October 1993, the Sunday Times of London reported on interviews with Philippe and Evelyne Krynen, heads of a 230-employee medical relief organization in the Kagera province of Tanzania. The Krynens had first reported on African AIDS in 1989 and at that time were convinced that Kagera in particular was in the grip of a vast epidemic. Subsequent years of medical work in Kagera have changed their minds. They have learned that what they had thought were "AIDS orphans" were merely children left with relatives by parents who had moved away and that HIV-positive and HIV-negative villagers suffer from the same diseases and respond equally well to treatment. Philippe Krynen's verdict: "There is no AIDS. It is something that has been invented. There are no epidemiological grounds for it; it doesn't exist for us."
Krynen's remark calls attention to the fact that AIDS is not a disease. Rather, it is a syndrome defined by the presence of any of 30 separate and previously known diseases, accompanied by the actual or suspected presence of HIV. The definition has changed over time and is different for Africa (where HIV testing is rare) than for Europe and North America. The official CDC definition of AIDS in the United States was enormously broadened for 1993 in order to distribute more federal AIDS money to sick people, especially women with cervical cancer. As a direct result, AIDS cases more than doubled in 1993. Absent the HIV mystique, there would be no reason to believe that a single factor is causing cervical cancer in women, Kaposi's sarcoma in gay males, and slim disease in Africans.
The HIV paradigm is failing every scientific test. Research based upon it has failed to provide not only a cure or vaccine but even a theoretical explanation for the disease-causing mechanism. Such success as medical science has had with AIDS has come not from the futile attempts to attack HIV with toxic antiviral drugs like AZT but from treating the various AIDS-associated diseases separately. Predictions based on the HIV theory have been falsified or are supported only by dubious statistics based mainly on the theory itself. Yet the HIV establishment continues to insist that nothing is wrong and to use its power to exclude dissenting voices, however eminent in science, from the debate.
Like other leaders of the scientific establishment, Nature Editor John Maddox is fiercely protective of the HIV theory. He indignantly rejected a scientific paper making the same points as this article. When Duesberg first argued his case in 1989 in the prestigious Proceedings of the National Academy of Science, the editor promised that his paper would be answered by an article defending the orthodox viewpoint. The response never came. The editors of the leading scientific journals have refused to print even the brief statement of the Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis, which has over 300 members. The statement notes simply that "many biomedical scientists now question this hypothesis" and calls for "a thorough reappraisal of the existing evidence for and against this hypothesis."
Such a reappraisal would include the following elements: Genuinely controlled epidemiological studies of all the major risk groups: homosexuals, drug users, transfusion recipients, and hemophiliacs. The studies should employ an unbiased definition of AIDS. Too often we have been told that HIV always accompanies AIDS, only to learn that this is so because AIDS without HIV is named something else. The studies should be performed by persons who are committed to investigating the HIV theory rather than defending it. There is reason to suspect that properly controlled studies of transfusion recipients and hemophiliacs in particular will show that the incidence of AIDS-defining diseases is independent of HIV status.
An audit of the CDC statistics to remove HIV bias and thereby allow unprejudiced testing of the critical epidemiological evidence for the theory. Every effort should be made to determine how many AIDS patients were actually tested for antibodies and the testing method that was employed. Because even the most reliable antibody test generates many false-positive results, researchers should try to validate the tests by examining random samples of AIDS patients to determine whether significant amounts of replicating HIV can be found in their bodies. Statistics have been kept as if the purpose were to protect the HIV theory rather than to learn the truth.
Research focusing on the cause of particular diseases rather than the politically defined hodgepodge of diseases we now call AIDS. The cancer-like skin disease called Kaposi's sarcoma (KS) is one of the best-known AIDS-defining conditions, but leading KS and HIV experts Marcus Conant and Robin Weiss now say that dozens of non-HIV KS cases are under study in the United States and that KS is becoming much less frequent in gay male AIDS patients than it formerly was. Conant, Weiss, and other AIDS researchers now frankly attribute KS to an "unknown infectious agent" rather than to HIV, but KS is nonetheless still called AIDS when it occurs in combination with HIV. Duesberg attributes KS in gay males to the use of amyl nitrates (poppers) as a sexual stimulant. His theory is eminently testable, and it ought to be given a fair chance. Another example: Hemophiliacs in the age of AIDS are living longer than they ever did in the past, but they still often die of conditions related to receipt of the blood concentrate called Factor VIII. Research published in The Lancet in February confirms earlier reports that symptoms diagnosed as AIDS are best treated by providing a highly purified form of Factor VIII. Researchers should study the role of blood-product impurities in causing disease in hemophiliacs, without the distortion that comes from arbitrarily assuming that HIV is responsible whenever an HIV-positive hemophiliac becomes ill.
A critical re-examination of the statistics for AIDS and HIV in Africa and Asia. Researchers should perform new, controlled studies of representative African populations to test the relationship of confirmed HIV infection to the incidence of AIDS-defining diseases. It will not do to rely upon "presumptive diagnoses" or extrapolations from single antibody tests that are now well known to generate many false positives.
The HIV establishment and its journalist allies have replied to various specific criticisms of the HIV theory without taking them seriously. They have never provided an authoritative paper that undertakes to prove that HIV really is the cause of AIDS--meaning a paper that does not start by assuming the point at issue. The HIV theory was established as fact by Robert Gallo's official press conference in 1984, before any papers were published in American journals. Thereafter the research agenda was set in concrete, and skeptics were treated as enemies to be ignored or punished. As a result, the self-correcting processes of science have broken down, and journalists have not known how to ask the hard questions. After 10 yearsof failure, it is time to take a second look.
Charles A. Thomas, a biochemist, is president of the Helicon Foundation in San Diego and secretary of the Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis. Kary B. Mullis is the 1993 Nobel Prize winner in chemistry for his invention of the polymerase chain reaction technique, for detecting DNA, which is used to search for fragments of HIV in AIDS patients. Phillip E. Johnson is the Jefferson E. Peyser Professor of Law at the University of California, Berkeley.
Charles Thomas, Phillip Johnson and Karen Mullis June 1994

Dear Women, Please Read Carefully

2009-02-13T12:13:00.002-08:00

Dear Women, Please Read Carefully

Over 57,000 women in the United States have HIV. Most women get HIV from having sex with men and not using a condom. Women from all backgrounds and cultures can get HIV. However, increasing numbers of African American and Latino women have HIV. What is HIV?HIV stands for Human Immunodeficiency Virus. HIV is the virus that causes AIDS.
HIV is a virus that attacks your immune system. The immune system has "T cells" that help protect your body from disease. A person with HIV does not have as many "T cells" as a healthy person. HIV makes it hard for your body to fight off sickness.
A person with HIV is called HIV positive (HIV+).
How do you get HIV?You can get HIV by:Having sex with a person who is HIV + and not using a condom Sharing needles or syringes ("drug works") with someone who has HIV Getting blood from a person who has HIV You can't get HIV by:Being in the same room with someone who has HIV. Sharing a knife or fork, sheets, toilet seats, or phones with someone who has HIV Kissing a person with HIV Shaking hands with someone with HIV Getting bitten by a mosquito or other bug What are the signs?You cannot tell who has HIV just by looking at them. Most people do not show any outward signs when they first get HIV. A person can spread HIV even if he or she does not look sick. An HIV test is he only way to know for sure if you or someone else has HIV. It may take a few weeks or months for the HIV to show up on a test. This is called the "window period". This means that a person who was just infected may not test positive, even though they have the virus. During the "window period" a person can pass the virus to others. Always protect yourself from HIV.

How do you get tested for HIV? There are 3 main types of tests for HIV:

Blood -- a small amount of blood is taken. Oral -- a cotton swab is put in your mouth for about 2-5 minutes. Urine -- a small cup of urine is tested. How do you get treated for HIV?There is no cure for HIV. There are medicines that you can take to help stop the virus from building up in your body, so that you can stay mostly healthy. What should pregnant women know about HIV?When a woman is pregnant, she can pass HIV to her fetus through her blood. A pregnant woman can take medicine to lower the chance of giving her baby HIV. HIV can get into her breast milk. A woman can pass HIV to her baby during breastfeeding. What can you do if you are HIV+?See your doctor often. Take your medicine. Medicines must be taken regularly, or it will get harder to treat the virus with those medicines. Eat a healthy, balanced diet. Don't smoke or use illegal (street) drugs. Get regular exercise.

Aids And HIV Drugs To Help You

2009-02-13T12:07:00.002-08:00

Aids And HIV Drugs To Help You

HIV makes it hard for your body to fight off sickness. There are cells in your blood called "CD4 cells" or "T cells". These cells help protect your body from disease. HIV kills these cells. A person with HIV does not have as many of these cells as a healthy person.

There is hope.

There are drugs that can treat HIV and help people live longer. These medicines help to keep the virus from building up in your body. These drugs do not stop you from spreading HIV. You can still give the disease to someone else.

People with HIV may need to take 3 or more different medicines every day. You and your doctor will decide which ones are right for you. It is important that you take your HIV medicines every day. Do not stop taking your medicines without talking to your doctor. Over time, you can get very sick if you do not take your medicines.

Use this guide to help you talk to your doctor about the HIV medicines you are taking. This guide provides some basic facts about the HIV medicines that have been approved by the FDA.

There are many things you can do to help improve your health.
Work closely with your doctor to monitor your health.
Take your medicine.
Eat a healthy, balanced diet.
Quit smoking and using illegal drugs.
Get regular exercise.

Women and HIV
Women from all backgrounds and cultures can get HIV. However, increasing numbers of African American and Latino women have HIV.

Learn the facts about women and HIV. Educate yourself to help you live longer. Educate yourself so that you can teach other women how to prevent HIV and AIDS.

Did you know?
Most women get HIV from having unprotected sex with men.
A woman can pass HIV to her baby during pregnancy, labor, or delivery.
A woman can also pass HIV to her baby during breastfeeding.
A pregnant woman can take medicine to lower the chance of giving her baby HIV. Pregnant women should talk to their doctor about the pros and cons of taking medicines for HIV. Some anti-HIV medicines should not be taken during pregnancy because they can cause birth defects.
Babies born to women with HIV may need to take anti-HIV medicines after birth to lower the chance that they will get HIV. Talk to your doctor about the best way to treat your baby.
Women who are HIV positive should get regular pap smears and exams to test them for other health problems.
Women with HIV are more likely to have:
Vaginal yeast infections

Other infections such bacterial vaginosis

Pelvic Inflammatory Disease (PID)

Sexually Transmitted Infections like gonorrhea or HPV
Changes in the cervix that may lead to cervical cancer
Anti-HIV Medicines
The main drug treatment for people with HIV is Highly Active Antiretroviral Therapy (also called HAART). HAART drugs help to slow the growth of HIV in your body.

HAART is made up of different kinds of medicines:

1. Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
2. Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)
3. Protease Inhibitors
4. Fusion Inhibitors
5. Integrase Inhibitors
6. Entry Inhibitors
7. Combination Drugs

The seven different groups of HAART drugs are listed on the next few pages. The brand names and generic names are listed for each drug.

Risks and Side Effects
The drugs used to treat HIV can sometimes cause side effects. Side effects may be different depending on the person and the kind of medicine. Some people have no side effects. Others can have very bad side effects.

Tell your doctor about any side effects you are having. Do not stop taking your medicine without talking to your doctor. Your doctor may tell you tips to help you cope with the side effects. The doctor may also decide to have you take different drugs.

This guide does not give the specific side effects or warnings for each HAART drug. Check the drug label and ask your doctor for the side effects and warnings for the HIV medicines you are taking.

Nucleoside Reverse Transcriptase Inhibitors: What You Should Know
This guide does not give the specific side effects or warnings for each drug. Check the drug label and ask your doctor for the side effects and warnings for the HIV medicines you are taking.

Warnings
Women should not breastfeed while taking these medicines.
These medicines may cause lactic acidosis (too much acid in the blood).
These medicines may cause serious liver or pancreas problems.
People with liver problems including hepatitis and people with kidney problems should talk to their doctor before taking these medicines.
In some cases, people taking HIV medicines notice changes in body fat (like extra fat in the neck or upper back or loss of fat in the face or arms).
Warning Signs
Call your doctor right away if you have any of these signs:

Upset stomach
Vomiting
Feeling very weak or tired
Problems Breathing
Weakness in arms and legs
Tingling, numbness, or pain in feet or hands
Skin or eyes look yellow
Pain in the upper stomach area
Common Side Effects
Trouble sleeping
Headache
Feeling tired
Upset stomach
Mild nausea
Vomiting
Diarrhea
Dizziness
Do not feel like eating

Non-Nucleoside Reverse Transcriptase Inhibitors: What You Should Know
This guide does not give the specific side effects or warnings for each drug. Check the drug label and ask your doctor for the side effects and warnings for the HIV medicines you are taking.

Warnings
Women should not breastfeed while taking these medicines.
These medicines may cause serious liver problems or severe skin rashes.
People with liver problems including hepatitis and people with kidney problems should talk to their doctor before taking these medicines.
Women with CD4 counts higher than 250 should talk to their doctor about the risks of taking Viramune (Nevirapine).
In some cases, people taking HIV medicines notice changes in body fat (like extra fat in the neck or upper back or loss of fat in the face or arms).
Warning Signs
Call your doctor right away if you have any of these signs:

Flu-like symptoms
Feeling tired
Do not feel like eating
Dark urine (looks like tea)
Pale stools
Upset stomach/ nausea
Jaundice (skin or eyes look yellow)
Pain, aches, or sensitivity to touch on right side below your ribs
Also call your doctor right away if you have a severe rash along with blisters, swelling, pink eye, fever, muscle/ joint pain, or mouth sores.

Common Side Effects
Skin rash
Upset stomach
Dizziness
Problems concentrating
Feeling tired
Vomiting
Trouble sleeping
Headache
Diarrhea
Strange dreams

Protease Inhibitors: What You Should Know
This guide does not give the specific side effects or warnings for each drug. Check the drug label and ask your doctor for the side effects and warnings for the HIV medicines you are taking.

Warnings
Women taking birth control pills need to use another birth control method.
Tell your doctor about all medicines that you are taking. Protease Inhibitors may cause serious health problems or death if mixed with other medicines.
These medicines may cause serious liver problems.
These medicines may cause increased bleeding in people with hemophilia.
These medicines may make diabetes worse or cause people to get diabetes.
Some people taking protease inhibitors notice large increases in their cholesterol.
In some cases, people taking HIV medicines notice changes in body fat (like extra fat in the neck or upper back or loss of fat in the face or arms).
Women should not breastfeed while taking these medicines.
Warning Signs
Call your doctor if you have any of these signs:

Serious skin rash
Feeling very weak or tired
Unusual muscle pain
Trouble breathing
Stomach pain with nausea and vomiting
Common Side Effects
Rash
Diarrhea
Nausea (Upset Stomach)
Vomiting
Feeling Tired
Headache

Fusion Inhibitors: What You Should Know
This guide does not give the specific side effects or warnings for each drug. Check the drug label and ask your doctor for the side effects and warnings for the HIV medicines you are taking.

Warnings
People taking Fuzeon with other HIV medicines may be more likely to get pneumonia. Tell your doctor if you have a cough, fever, or trouble breathing.
Women should not breastfeed while taking Fuzeon.
In some cases, people taking HIV medicines notice changes in body fat (like extra fat in the neck or upper back or loss of fat in the face or arms).
Warning Signs
Fuzeon may cause serious allergic reactions. Call your doctor right away if you have any of these signs.

Trouble breathing
Fever with vomiting and a skin rash
Blood in urine
Swelling of the feet
Common Side Effects
Itching, redness, pain, bumps or swelling where the shot is given
Pain and numbness in feet or legs
Problems sleeping
Depression
Weakness or loss of strength
Muscle pain
Constipation

Combination Drugs: What You Should Know
This guide does not give the specific side effects or warnings for each drug. Check the drug label and ask your doctor for the side effects and warnings for the HIV medicines you are taking.

Warnings
Atripla may cause lactic acidosis (too much acid in the blood).
Atripla may cause serious liver problems.
People who have kidney or liver problems including Hepatitis B should talk to their doctor before using this medicine.
People who have ever had seizures and people taking medicines for seizure should talk to their doctor before using this medicine.
People who have ever had mental illness and people with bone problems should talk to their doctor before using this medicine
Women should not get pregnant or breast feed while taking Atripla.
Women taking birth control pills need to use another birth control method.
In some cases, people taking HIV medicines notice changes in body fat (like extra fat in the neck or upper back or loss of fat in the face or arms).
Warning Signs
Call your doctor right away if you have any of these signs:

Feeling very weak or tired
Unusual muscle pain
Trouble breathing
Stomach pain with nausea and vomiting
Feeling dizzy or lightheaded
Dark urine
Light colored stools
Loss of appetite for several days
Upset stomach (nausea)
Stomach pain
Jaundice (skin or eyes look yellow)
Common Side Effects
Dizziness
Headache
Trouble sleeping
Feeling drowsy
Problems concentrating
Unusual dreams

Integrase Inhibitors: What You Should Know
This guide does not give all of the specific side effects or warnings for each drug. Check the drug label and ask your doctor for the side effects and warnings for the HIV medicines you are taking.

Women who are pregnant or plan to become pregnant should talk to their doctor before taking Isentress (Raltegravir).

Women should not breastfeed while taking Isentress (Raltegravir).

Tell your doctor if you have any allergies before you start taking Isentress (Raltegravir).

In some cases, people taking HIV medicines notice changes in body fat (like extra fat in the neck or upper back or loss of fat in the face or arms).
Warning Signs
You should also see your doctor right away if you have any of these signs:
Unexplained muscle pain, tenderness or weakness
Signs of an infection
Common Side Effects
Diarrhea
Nausea
Headache

Entry Inhibitors: What You Should Know
This guide does not give all of the specific side effects or warnings for each drug. Check the drug label and ask your doctor for the side effects and warnings for the HIV medicines you are taking.

Warnings
People with liver problems including Hepatitis B or C should talk to their doctor before taking Selzentry (Maraviroc).

People with kidney problems or heart problems should talk to their doctor before taking Selzentry (Maraviroc).

Tell your doctor if you are taking high blood pressure medicines or if you have low blood pressure.

Do not drive a car or use heavy machinery if you feel dizzy while taking Selzentry (Maraviroc).

Tell your doctor if you have any allergies before you start taking Selzentry (Maraviroc).

Women should not breastfeed while taking Selzentry (Maraviroc).

In some cases, people taking HIV medicines notice changes in body fat (like extra fat in the neck or upper back or loss of fat in the face or arms).
Warning Signs
Selzentry may cause serious liver problems. Call your doctor right away if you have any of these signs:
Itchy rash on your body
Skin or eyes look yellow
Dark (tea- colored) urine
Vomiting and stomach pain
You should also see your doctor right away if you have any of these signs:

Nausea
Flu-like symptoms
Fatigue
Serious Side Effects
Possible chance of infection or cancer
Common Side Effects
Cough
Fever
Colds
Rash
Muscle and Joint Pain
Stomach Pain
Dizziness
Important Questions to Ask Your Doctor
What drugs am I taking?
What are the side effects of taking these drugs?
What do I do if I start having bad side effects?
What other prescription drugs should I avoid while taking my HIV medicines?
What herbs (like St. John's Wort) or over-the-counter medicines should I avoid?
When should I take each drug?
Should I take my medicines with food?
How should I keep my medicines when I go out of town?
How long can I stay on this regimen?
Ask your doctor to tell you what you should know about your HIV medicines. Write down the important facts in the space below.
My Regimen:
It is important that you take your HIV medicines exactly as your doctor tells you. Do not skip a pill. The medicines may not work correctly if you skip a pill.

Here are some tips to help you remember when to take your HIV medicines.
Use a schedule or planner
Set the alarm on your watch or clock
Find a friend to remind you
Use a pillbox to help you organize your pills

About HIV And AIDS

2009-02-13T12:04:00.002-08:00

About HIV And AIDS

AIDS is a disease that can be deadly. It is caused by a virus called HIV.

The most common ways to get AIDS are:

having sex with a person who has HIV or AIDS
sharing drug needles with someone who has HIV or AIDS.
You can also get HIV from a blood transfusion, if the HIV is in the blood. But that is rare. Strict rules about who can donate blood and tests on donated blood make transfusions very safe.

You cannot get HIV by donating blood. You cannot get HIV just by being in the same room with an infected person, or just by shaking hands or hugging an infected person.

In the last few years, AIDS has increased most among women, blacks, and Hispanics.

Sex, Condoms, And AIDS
If you or your partner has had sex with someone else, you both could get AIDS.

In the United States, women are more likely to get HIV from men than the other way around. Latex condoms are the best way to keep from getting HIV during sex. If you or your partner is allergic to latex, there are condoms made of polyurethane that can protect against HIV, too.

But natural membrane condoms, also called lambskin condoms, do not prevent HIV because the virus can pass through them.

If a man can't or won't use a condom, a woman can use the Reality female condom. It may protect against HIV, but it's not as good as the latex condom a man uses. Do not use a Reality female condom along with a male condom. Both condoms will not stay in place when used together.

Latex and polyurethane condoms are the only birth control products that protect against HIV. So even if you're using another kind of birth control -- like the Pill, IUD, cervical cap, Norplant, Depo-Provera, or diaphragm -- the man must still use a condom if you want protection against HIV.

Find Out If You Have HIV
You can find out if you have HIV at home with a test kit available at drugstores without a doctor's prescription. To use the test, you prick your finger to get a blood sample. Then you send the sample to the address given in the directions. You don't have to give your name. Be aware, though, that other tests, sometimes called rapid HIV test kits, have been advertised and sold over the Internet and elsewhere. These kits do not require you to send the tests to a lab. The FDA has not approved these tests and they may not be accurate.

Your doctor's office or clinic is a good place to get a test for HIV.

If the test says that you have HIV, ask your doctor or clinic:

Do I need more tests?
Do I need to start treatment?
Do I need to make any lifestyle changes at this time?
If you think you may be pregnant, find out right away if you have HIV.

Treatment early in pregnancy can greatly reduce the chance that your baby will have HIV.

The FDA has approved many drugs to treat HIV and AIDS. They can help people with HIV or AIDS feel better for a longer time. But there is nothing yet that will cure AIDS.

Guard Against Other Illnesses
If you are infected with HIV, tell your doctor or clinic if your symptoms get worse or if you get any new symptoms. They may try a different treatment. To avoid germs in food that could make you much sicker, follow these food safety rules:

When you handle food, wash your hands and kitchen utensils with hot water and soap.
Cook food thoroughly.
Make sure milk, dairy products, and juices are pasteurized.
Cook eggs and seafood well. Never eat them raw.
How To Use A Condom:
Make sure the condom package label says the condom can be used to prevent HIV.
Look for the expiration date on the condom package. Don't use the condom if the date has already passed.
Read the directions to make sure you know the right way to put the condom on and take it off.
Use a condom every time you have any kind of sex -- vaginal, anal, or oral.
Put the condom on as soon as the penis is erect, and remove it right after ejaculation.
Don't use a condom from a torn or open package.
Don't use a condom that's gummy, brittle, discolored, or has even a tiny hole.
Don't get oil-based lubricants, such as Vaseline, cold cream, or baby oil, on a condom. These could cause the condom to tear. If you use lubricants, make sure they're water-based, such as K-Y Jelly.
Watch Out For ‘Miracle Cures'
Some treatments for AIDS are advertised as miracle cures or as having some “secret ingredient.”

They are not approved by the FDA. They have not been scientifically tested. There is no proof that they work. They could even hurt you. Don't use anything to treat HIV or AIDS unless your doctor or clinic says it is OK.

Studies Of Unproven AIDS Medicines
Many medicines are being tested in scientific studies to see if they are safe and if they work against HIV and AIDS. Sometimes people with HIV or AIDS can get these experimental medicines by joining the studies. To find out about them, you or your doctor can call (800) TRIALS-A (874-2572).

Remember:
The best ways to keep from getting AIDS are:

Have sex only with one person who has never had sex with anyone but you. If you are a teen-ager and unmarried, the safest way is not to have sex at all.
Don't use illegal drugs.
Do You Have More Questions?
Ask your doctor. And ask the FDA. There may be an FDA office near you. Look for the number in the blue pages of the phone book.

If you have any questions about AIDS, call (800) 342-2437 or (800) 344-7432 (Spanish). For the hearing impaired, call (800) AIDS-TTY (243-7889).

You can also call the FDA on its toll-free number, (888) INFO-FDA (463-6332).

Source: Fda official web site.