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Opinion

HIV-Negative Men

By Mathew Rodriguez   Poz Magazine

Are Still Choosing Stigma

Over Science

​​According to a recent study in the Journal of the International AIDS Society, a disturbingly high amount of HIV-negative gay men doubt the veracity of the statement “Undetectable = Untransmittable (U=U).” If you haven’t heard that motto before, it’s pretty simple. People living with HIV who are on medication and whose viral loads have reached undetectable status cannot transmit the virus to their sexual partners. ​​

The motto arose after the PARTNER study showed in 2016 that, among over 1,100 mixed-status couples who had condomless sex, not one HIV-negative partner acquired HIV from their HIV-positive partner.

​The 2018 study on U=U ended up recruiting 12,222 eligible gay and bisexual men to share how they really felt about the slogan, which is gaining consensus among the medical and scientific communities, though that consensus has not extended to the general population. The men recruited were asked to give four possible answers on how accurate they believe the slogan to be: completely accurate, somewhat accurate, somewhat inaccurate and completely inaccurate.
An HIV-negative writer asks: Why does resistance persist to the “Undetectable = Untransmittable” message?

A recent study confirms that fear of HIV continues to trump scientific knowledge of the virus.  

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Treatment News

HIV and the Brain

“We knew HIV could cause neurological damage, but we did not know it happened so early in the infection,” Serena Spudich, MD, MA, a professor of neurology at Yale and a co–senior author of the paper, said in a press release.

“The findings emphasize the importance of identifying infected people early and treating them so we can halt its progression.”

HIV Quickly Starts Damaging the Brain, but Treatment Can Halt Progression

By Benjamin Ryan   Poz Magazine

Not long after an individual contracts HIV, the virus penetrates the brain and begins to cause progressive damage to the volume of the organ as well as cortical thickness. Antiretroviral (ARV) treatment apparently halts this progression and is able to dial back some of the damage.  This finding adds yet more weight to the imperative of treating HIV as soon as possible after infection.

Publishing their findings in Clinical Infectious Diseases, researchers studied 65 people who entered the study soon after they contracted HIV, in a period known as primary HIV infection. These participants, 30 of whom started ARV treatment during the study, received multiple MRIs of their brains over time.

The researchers compared the brain scans of the participants with scans of 16 people with long-term, or chronic, HIV infection as well as 19 HIV-negative individuals.

The study authors found that before participants began ARV treatment, a longer time spent with untreated HIV was associated with loss in volume in various parts of the brain, including the thalamus, caudate and cerebellum. More time living with untreated HIV was also linked with cortical thinning in the frontal and temporal lobes and the cingulate cortex.

After individuals started ARVs, the progression of such brain damage stopped, and there were some small increases in cortical thickness measures.

To read a press release about the study,  click here.​​

To read the study abstractclick here.

Scientists cautiously optimistic about HIV vaccine candidate

Because this phase of the trial was considered successful, the vaccine can be be tested in a wider patient population that is at higher risk of infection. That trial started in the fall and is underway in 2,600 women across sub-Saharan Africa.
Researchers caution that the results of the early trial do not mean a viable vaccine. The ability to induce HIV-specific immune responses does not necessarily mean the vaccine will protect humans from HIV infection.

"I would say that we are pleased with these data so far, but we have to interpret the data cautiously," said study co-author Dr. Dan H. Barouch, a principal investigator on the study, a professor of medicine at Harvard Medical School and the director of the Center for Virology and Vaccine Research. "We have to acknowledge that developing an HIV vaccine is an unprecedented challenge, and we will not know for sure whether this vaccine will protect humans."
 By Jen Christensen, CNN 
​July 7, 2018


(CNN)There may be a glimmer of hope in the fight to protect people from HIV-1, the most widespread type of the virus and the one that causes the most disease globally.

A new vaccine appears to be safe and induced an immune response in humans and rhesus monkeys in an early stage trial, according to new research published Friday in the journal The Lancet .

​That means it's safe enough to go into the next phase of testing, which involves a larger number of humans. It's one of only five experimental HIV-1 vaccine concepts that have gotten this far during the 35 years of the HIV pandemic.
With 1.8 million new cases of human immunodeficiency virus every year, according to United Nations estimates, and almost 37 million people living with HIV worldwide, the quest for a vaccine has been urgent -- and extremely difficult.

Being a 'superhero': The South African volunteers trialing a HIV vaccine

​​Only four vaccine concepts have made it to testing in humans, and only one provided any evidence of protection in an efficacy trial, but the effect was considered too low to make it available for use.

The new vaccine proved to be protective in monkeys, and while antibodies against HIV were generated in humans, it is unclear whether the vaccine will protect against infection.
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"It's a very interesting study. Obviously, the search for an HIV vaccine is very elusive," said Dr. Carlos del Rio, who was not involved with the study but has done similar research as the co-principal investigator of the Emory-CDC HIV Clinical Trials Unit. His unit is one of 37 clinical trials units responsible for implementing the scientific agenda of the National Institutes of Health's international HIV/AIDS Clinical Research Network.
"Despite all the advances we have had with HIV, we need a vaccine. It is critical, and this new vaccine, while there is a long way to go, it is nice to see robust evidence to move on to the next phase of testing."

Vaccine Fast Facts

Scientists use these initial phases of clinical trials to determine the best dosage to use and to see whether a vaccine is safe.
The new vaccine was tested in 393 healthy people considered at low risk for infection and 72 rhesus monkeys. The human trial participants came from 12 clinics in South Africa, east Africa, Thailand and the United States.


In addition to being well-tolerated by all the test subjects and inducing an immune response against HIV in humans, the vaccine provided 67% protection against infection from the simian-human immunodeficiency virus in the rhesus monkeys. It's unclear whether it would provide protection in humans.
Opinion, Huffpost
Phillip Eli

Too Many People Are Dying By Suicide 

​​ Bourdain died by suicide while in France to film his CNN show “Parts Unknown.”​​

Another week, we might be discussing the Centers for Disease Control and Prevention’s alarming new suicide report in abstract terms.

The CDC announced Thursday that suicide rates increased in all but one U.S. state from 1999 to 2016, and they rose by more than 30 percent in 25 of those states. The report also noted that nearly 45,000 Americans died of suicide in 2016, which, for perspective, is more people than Chicago’s Wrigley Field can hold during a sold-out baseball game. On average, 20 veterans die by their own hand daily. 

But this wasn’t a week in which suicide felt vague or far off. On Tuesday, we learned of the passing of beloved fashion designer Kate Spade, and Friday brought news that chef Anthony Bourdain too had died while in France to film his CNN show “Parts Unknown.”

Suddenly, we all knew someone who had taken their own life. And at least one mental health organization connected those celebrity stories to America’s broader suicide crisis. In its statement on Spade’s death, the American Association of Suicidology pointed out that 28 women die by suicide every day in the U.S. and that, for middle-aged women in particular, it’s one of the top 10 
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SLAVEN VLASIC VIA GETTY IMAGES

Invisible Life of HIV Made Visible

Written by: Kriti Varghese — [email protected]  April 22, 2018

UC Davis researchers discover how to disrupt HIV latency.

By lying dormant, HIV can dodge the body’s immune system and hide from treatments. UC Davis researchers might have just found the way to bring HIV out of hiding once and for all.

“HIV latency is a unique state of HIV during its life cycle when the virus goes into hiding from the immune system,” said Guochun Jiang, a UC Davis associate project scientist. “Although the virus is present in the cells, it does not actively produce viral proteins or infectious viral particles.”

The researchers have been working on making the virus visible to the immune system so it can be targeted by immunotherapy.

​“We were exploring the epigenetic mechanisms that could be exploited for disrupting HIV silence and target it for immune clearance,” said Satya Dandekar, a professor of microbiology and chair of the Department of Medical Microbiology and Immunology at UC Davis.
 “This led us to the identification of a new histone modification — histone crotonylation — by which HIV can be forced out of its latent state and out of hiding from the immune system. Histone crotonylation is a modification of the histone tails and occurs when  crotonyl coA gets added to lysine amino acid in histones.”

Histone modifications open up the DNA, enabling transcription factors to initiate gene expression. Histone crotonylation in particular leads to the active gene expression of HIV, making it more visible to the immune system.

“The next step is to find out if reversal of HIV latency by histone crotonylation will help the immune system to eliminate infected cells,” said Dennis Hartigan-O’Connor, a UC Davis associate professor in the Department of Medical Microbiology and and Immunology and the co-investigator of this project. “We need to know if reversal of latency can have a meaningful impact on the amount of HIV in the body.”

Courtesy - The California Aggie is an entirely student-run and independent publication. The Aggie publishes online daily at theaggie.org. Without a journalism program at UC Davis, The Aggie is the best hands-on experience for students interested in journalism, reporting and other aspects of newspaper design and production.

Achieving the 90-90-90 Target

The First Country to Achieve the
​UNAIDS/WHO 90-90-90 Target

In October 2014, the World Health Organization launched the 90-90-90 treatment goals. These goals proposed that by 2020, 90% of people with HIV will be diagnosed, 90% of diagnosed people will be in care; 90% of people receiving care will have durable HIV suppression. Achievement of the 90-90-90 targets will mean that at least 73% of all people with HIV have viral suppression, a large enough proportion to have a major impact on rates of HIV-related mortality and new infections.

With little fanfare, WHO announced that Sweden has become the first country to achieve the UNAIDS/World Health Organization (WHO) 90-90-90 target, as research published in  HIV Medicine  shows. At the end of 2015, 90% of HIV cases in Sweden were diagnosed, 99.8% of people were linked to care and 95% of people taking antiretrovirals for at least six months had a viral load below 50 copies/ml.

“We believe that Sweden is the first country to achieve the UNAIDS/WHO 90-90-90 goal,” comment the investigators.
Antiretroviral therapy (ART) has dramatically reduced rates of HIV-related illness and death and the infectiousness of people taking treatment.

For people to benefit fully from treatment they must engage with a multi-step care cascade: diagnosis, linkage to care, engagement with care, initiation of ART and viral suppression.

However, in many settings, even in richer countries, sup-optimal levels of engagement with HIV care mean that many people are not benefitting from ART (antiretroviral therapy), meaning there are avoidable HIV-related deaths and there continues to be high rates of new infections.  Information on people in care was obtained from the Swedish InfCare HIV Cohort Study. By the end of 2015, data on 6946 diagnosed individuals were included in the study’s database.

Surveillance data from the Public Health Agency of Sweden indicated that 90% of people with HIV living in Sweden have been diagnosed.

For more information, follow the link to HIV Medicine


Credit:  Michael Carter
Published: 14 September 2016

Treatment News

AIDSVu Releases State-by-State data-rich map detailing concentration of HIV epidemic 

AIDSVU.COM
AIDSVu Releases State-by-State data-rich map detailing use of PrEP 

Movie Review:   Pushing  Dead
From A&U Magazine
​by TJ Banks

Danny Schauble (James Roday of Psych) is a writer
who’s frequently at a loss for words—at least when it
comes to putting them down on paper.
In one-on-one conversation, he’s funny, quirky, and insightful. He lives with Paula (Robin Weigert), a massage therapist; holds poorly attended poetry slams at the bar where he works as a bouncer; and drinks coffee from a mug bearing the words “Wanted dead or alive” and a face suspiciously like his own.
His dead lover, Kevin, now shows up in his dreams with “an Uzi lobster claw” where one of his hands used to be.

Danny, the antihero of Tom E. Brown’s award-winning film Pushing Dead, has also been living with HIV for twenty-two years. Thanks to a birthday check from his mom, he now has too much money in his bank account, a technicality that essentially locks him out of his health care plan. He deals with this as he deals with most things—with help from a few tried-and-true friends, coffee, and constant caustic banter. 

At one point, he’s sorting out pills in the bar with the owner, his friend Bob (Danny Glover): Bob’s are “old man stuff,” whereas Danny’s are his HIV meds, of course. “I win,” Bob deadpans. “Eight bottles—you, seven.”
​Danny picks up the bottle. “This is a multivitamin,” he says with mock solemnity. “Multivitamins don’t count. Therefore, it is a tie.”

And there you have it: an entire scene about two men making cracks about the meds they need to make it through the day. It’s sad and funny all at once. 

There are a lot of moments like that in Pushing Dead plus some random quirky bits. A strange unsettling little girl who appears to Danny and others, spouting stale adages. A traveling nightmare about a “creepy faux puppet” with a bleeding face. And Snowball, a white toy monkey that Paula talks to.

This is a film about AIDS, and yet it’s not a film about AIDS. Brown, who was diagnosed back in 1985, has said that he “didn’t set out to make an AIDS movie or a dark comedy. I set out to make a movie about coping.” Danny is coping the best he can. Watching him, you find yourself laughing. Or wincing. Or both. It’s that real, even with all the quirky bits.



T.J. Banks is the author of Sketch People, A Time for Shadows, Catsong, Houdini, and other books. Catsong was the winner of the 2007 Merial Human-Animal Bond Award.
AIDSInfo
Ibalizumab (brand name: Trogarzo) is a new US FDA approved HIV medicine for adults who have limited treatment options. Check out the AIDSinfo fact sheet to learn more about this drug.
CDC Division of HIV Prevention
Despite advances, not all people living with HIV (PLWH) in the United Sates are receiving the necessary HIV care they need.

Let's work together to improve retention in care & treatment.

VAC-3S is an investigational therapeutic HIV vaccine that is currently being studied in clinical trials.