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Tuesday, July 19, 2011

Isn’t It Ironic? More Musings from Paul Kawata (from the National Minority AIDS Council)

Here's a great article that discusses how HIV could potentially be ended worldwide and thoughts on how to do so:

http://www.nmac.org/index/news-app/story.618/title.isn-t-it-ironic-more-musings-from-paul-kawata

Isn’t It Ironic? More Musings from Paul Kawata

Wouldn't it be ironic if People with AIDS (PWAs) were the reason we stopped the epidemic?! After all of the blame, all of the discrimination, all of the judgment, there is something quite wonderful about the prospect of PWAs bringing an end to this devastating disease.


At the 6th International Conference on HIV Pathogenesis, Treatment and Prevention, you can feel the excitement as people talk about HIV Prevention Trial Network study 052 or Treatment As Prevention (TAP). At a panel this afternoon, a researcher called it the "light at the end of the tunnel."

TAP is about lowering a community's viral load to stop the spread of HIV/AIDS. It's about getting PWAs to an undetectable viral load as a way to support their individual health and end this epidemic. It's not without challenges, but as one of the speakers said "we may be at the beginning of the end." However, it's going to take PWAs leading the way.

There is something so perfect about this solution. Not only could it stop the epidemic, but it would also benefit individuals living with HIV/AIDS. Researchers also say the solution isn't just for wealthy countries. Treatment As Prevention should be a global goal. With the recent United Nations' commitment to provide HIV treatment to 15 million people by 2015, we may be able to end this epidemic in my lifetime.

However, it's not time to throw away behavioral interventions. The HIV community and researchers mostly agree that it's going to take a combination of approaches. We need to implement structural interventions like TAP and continue with proven behavioral interventions. However, these behavioral interventions need to be scaled up to impact large numbers. We're not talking hundreds of people; these interventions need to impact thousands, if not millions of people.

If I sound ecstatic, I am. However, we are years, if not decades away from solving this epidemic. This solution will require PWAs to be on drug therapy for the rest of their lives or until we find a cure. We still have to figure out how we are going to pay for treatment for millions of people around the world.

In the U.S., we need to:

•Identify HIV positive Americans who do not know they are HIV positive;


•Upon diagnoses, link these individuals into care as quickly as possible; and


•Ultimately, get HIV positive Americans on drug therapy and keep them on it.

At the end of 2008, the CDC estimated there were 1,178,350 Americans living with HIV. Approximately 236,400 people in the U.S. do not know they are HIV positive. Unfortunately, the majority of people living with HIV are not on drug therapy. In fact, the number is somewhere between 250,000 to 350,000 Americans who are currently on Antiretroviral Therapy (ART).

Researchers postulate that there is a benefit for individuals who can bring their viral load to undetectable soon after being infected. It is the time that the virus can do the most damage to your immune system. This is also the time when people are the most infectious and can pass the virus to others. Getting to undetectable viral load early can minimize the damage to the individual and stop the spread of HIV. However, more studies will need to be done.

It's no longer just about the individual, it is also up to PWAs to save their communities. This is a huge shift in our work. Before, we were talking about empowering PWAs -- now we're asking them to save us. That's why they need to lead this effort.

Given the uncertainty of the effects of long-term drug therapy, we may be asking PWAs to put their health on the line. They have reason to be skeptical. But maybe, just maybe, the leadership of people facing the same risks, with the same concerns, displaying the same willingness to risk it all to save their communities, will alleviate some of that skepticism. At the same time, the HIV community must continue to push a research agenda to ensure the long term safety of these drugs, the development of new medications, as well as a viral load test that is rapid and affordable. We must also remain committed to finding a vaccine and a cure for HIV/AIDS.

So how are we going to pay for the drug therapy necessary to stop this epidemic? We can't even get the funds to cover the 8,689* Americans currently on AIDS Drug Assistance Program (ADAP) waiting lists. From my perspective, we need to do the following:

1. Between now and 2014, ask the pharmaceutical industry to keep their patient assistance programs open for people who cannot get their drugs via private insurance, Medicaid or ADAP.

2. Enroll HIV positive Americans into PCIPs (Pre-existing Condition Insurance Plans). Depending upon the state, we may be able to use Ryan White funds to pay for the premiums. This could be one of our bridges to 2014.

3. Monitor implementation of the Affordable Care Act (ACA) to ensure that the benefit package covers drug therapy for HIV positive individuals.

4. Upon full implementation of ACA, ask the pharmaceutical industry to cut the price of their drugs based on economies of scale. For TAP to work, we will need to triple, if not quadruple, the number of people on drug therapy.

We need to continue our pressure to get everyone covered under ADAP, especially if we are going to increase the number of people on drug therapy. It's a national shame that we have so many Americans on waiting lists. Maybe if policy makers were educated about the connection between treatment of HIV and the prevention of HIV, we might see more funding for this important program.

This is a big plan that requires big leadership. It should be led by People with AIDS, but also must include the government, the HIV community and the pharmaceutical industry. If HIV has taught me anything, I've learned that you have to be bold, you have to be strong, and you have to be willing to compromise. I see a roadmap to end this epidemic. You're damn right I am excited, you should be too.

Yours in the struggle,

Paul Kawata
Executive Director
National Minority AIDS Council

Thursday, July 14, 2011

Things to know in July....

Hope you're all having a happy, safe summer! Some things to update you on:

1) There's a strain of the bacterial STD infection gonorrhea that is becoming resistant to antibiotics, making it harder to treat. Using condoms will help keep you safer from HIV (for which there is NO cure) and STDs like gonorrhea.


2) Many people don't know that HIV testing can be done with rapid tests that are ORAL swabs that use NO BLOOD OR NEEDLES! These tests are just as accurate as a rapid test with blood, plus they are pain-free! You can get results in just 20 minutes.

http://www.denverpost.com/ci_18365285

3) July's Safety Net message to share with your friends is:

"Learn your HIV status in 20 minutes-- it's a test of strength. Get tested, get answers. Confidential HIV & STD testing at Hartford Gay & Lesbian Health Collective. Call (860) 278-4163 or email info@hglhc.org "

Once you've shared this, take our quick survey and you could win a gift card to Dunkin Donuts! http://www.surveymonkey.co​m/s/3J6X2P8


Wednesday, July 13, 2011

July's Safety Net message!

Learn your HIV status in 20 minutes. It's a test of strength. Get tested, get answers. Confidential HIV & STD testing at your convenience: call HGLHC at (860) 278-4163 or email jamieb@hglhc.org


Share this month's Safety Net message with your friends by posting it on Facebook or Twitter, by texting or emailing it to them, and let us know that you did. You'll be entered to win a drawing for a $10 gift card to Dunkin Donuts so you can get your iced coffee fix on us!

Post this message for your friends or send it to them directly, ESPECIALLY  men who have sex with men. You'll be setting a great example and encouraging them to make a healthy choice. :) Thanks for pitching in to help keep our community safe and vigilant in the fight against HIV!

Email jamieb@hglhc.org or fill out our survey here to let us know that you shared the message: http://www.surveymonkey.com/s/3J6X2P8 

Pool Boys!

Just some pool boys for your entertainment!