Tag Archives: antiretroviral drugs

STD Awareness: Is Withholding HIV Status a Crime?

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If your sexual partner had HIV and did not tell you about it, how would you feel? Most of us would feel betrayed, lied to. We might be scared that we’d contracted the virus, too. If we had known, maybe we would have chosen not to have sex, or might have taken different precautions. Perhaps we’d be angry that someone took away our ability to evaluate the risk for ourselves, and instead decided for us that the sex was worth the risk.

Disclosing HIV status can make someone vulnerable to risks, but open communication forms the basis of healthy relationships.

Many people think it should be against the law for someone with HIV to withhold their status from a sexual partner. To do so seems like a violation of someone’s right to make their own decisions about the sex they have, a denial of pertinent information that needs to be factored into one’s decision-making.

Then why are organizations like American Psychological Association, the American Medical Association, and the U.S. Department of Justice opposed to these types of laws?

Meet Nick

In June 2008 in Iowa, Nick met Adam on a dating website. They hung out at Nick’s apartment, spent a few hours getting to know each other, and eventually had sex. A few days later, Adam heard through the grapevine that Nick was HIV-positive.

The next month, three armed detectives stormed Nick’s workplace, took him to the local hospital, and ordered nurses to take his blood. Meanwhile, police were searching his house for drugs — not illicit drugs, but lifesaving antiretroviral drugs. Nick was arrested. His crime? Criminal transmission of HIV.

Even though Adam never got HIV. Continue reading →

STD Awareness: Can Gene Editing Cure HIV?

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For the first time in history, someone with HIV has been treated with cells edited in the lab. It was a bold attempt to try to replicate previous successes in “curing” HIV through bone marrow transplants, but the results were a mixed bag.

Your DNA is like a book, and each sentence is a gene. Imagine a word is misspelled. Sometimes, a misspelling won’t affect your ability to understand the sentence, but other times, it will be so bad that you’ll have trouble figuring out the intended meaning. Think of the difference between “I drive a car” and “I driv a car,” or “I like food” and “I like flod.” You might not be able to tell what that last sentence is even trying to say! Those misspellings are mutations, and sometimes mutations are relatively benign (“I driv a car”), while other times they can cause diseases (“I like flod”).

A mutated version of the CCR5 gene confers near-immunity to HIV — but increases susceptibility to other viruses.

CRISPR, pronounced crisper, is a powerful new technology that can edit genes. By cutting DNA at a specific location and replacing some of the letters in the genetic alphabet, CRISPR can edit genes like you can edit a document using “find and replace.” The hope is that, someday, CRISPR could be used to fight disease by tweaking faulty genes. Continue reading →

National HIV Testing Day: A Time to Empower Yourself and Get Tested

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The following post comes to us via Ava Budavari-Glenn, a political communications major and a nonprofit communications minor who is entering her sophomore year at Emerson College. She is a writer whose work focuses mainly on advocacy, and a community organizer who has worked for nonprofit organizations and political campaigns. She is a media and communications intern at Planned Parenthood Advocates of Arizona.

It was the 1980s. All of a sudden, seemingly out of nowhere, thousands and thousands of people were dying from an illness that had never been seen before. The diagnosis was a death sentence. As soon as you had it, you would die painfully and quickly. The disease was AIDS, caused by a virus called HIV.

In the United States, this disease ravaged the LGBTQ community; gay and bisexual men were the hardest hit. The Reagan administration failed to acknowledge the disease, until Ronald Reagan’s press secretary laughed about it and called it the “gay plague.” Tired of the government’s inaction, the people decided to take matters into their own hands and formed the grassroots organization ACT UP (AIDS Coalition to Unleash Power) in 1987.

With modern medical treatment, people with HIV can live pretty normal lives.

They protested, made targeted demands, and created poster campaigns. They formed a network of community organizers in cities across the country, and employed radical protest strategies, such as the AIDS Memorial Quilt, which covered the National Mall with names of people who had died from the disease. They focused their targeted efforts on specific politicians, as well as the Food and Drug Administration and the Centers for Disease Control and Prevention. They did such an extensive amount of research that the activists essentially became scientists themselves. They were able to lower drug prices and get the FDA to approve experimental drugs for HIV at a quicker pace. They educated, diminished social stigma, and perhaps most important, supported medical advances that reduced AIDS-related deaths.

And finally, in 1996, scientists discovered the treatment that turned HIV from a death sentence to a chronic illness. Finally, after 15 years of tragic deaths, obsessive scientific research, and fiery activism, patients could live long and happy lives with a drug “cocktail” that could suppress the virus. Continue reading →

STD Awareness: Can HIV Be Cured Now?

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In 1991, when Timothy Ray Brown was in his 20s, he moved from the United States to Europe in search of adventure. His travels brought him to Berlin, where he put down roots and became a translator — but this newfound stability was quickly disrupted. A former boyfriend told him he had been diagnosed with HIV, the virus that causes AIDS, and suggested Brown be tested as well. The results were positive. Brown calculated he had about two more years left to live.

His fortunes changed the next year when antiretroviral drugs transformed HIV from a death sentence to a manageable chronic disease. Life went on. But 10 years later, in 2006, he started noticing changes. While he usually made a 14-mile round trip on his bike to and from work, a quick ride to a café one mile away left him so winded he had to stop halfway through.

We still don’t have an HIV cure that works for everyone.

He was diagnosed with leukemia, a type of cancer that affects certain types of blood cells. He immediately began chemotherapy, a taxing regimen that nearly killed him when an infection forced his doctors to induce a coma. And when the cancer came back, his doctors recommended a bone marrow transplant, which involved wiping out his immune system with drugs and radiation. A year later, after his leukemia came back, he received a second bone marrow transplant. Recovery was grueling. He descended into delirium, nearly went blind, and was temporarily paralyzed. He had to undergo physical therapy to relearn how to walk and talk.

Miraculously, he came out of this near-death experience in full remission from leukemia. But the bone marrow transplants hadn’t just gotten rid of his leukemia. They had gotten rid of his HIV infection, too. The media dubbed him the “Berlin patient.” Continue reading →

STD Awareness: The Good, the Bad, and the Ugly

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Sexually transmitted diseases (STDs) have been with us since the dawn of time — or at least since the dawn of sex. And, as we continue to hone our approach to preventing and treating them, STDs will always grab headlines, whether the news is bad or good.

The Good

Can the HIV epidemic be stopped?

For more than a decade, AIDS, the illness caused by HIV, was seen as a death sentence. It wasn’t until the mid-’90s that antiretroviral drugs kept the virus in check, prolonging lifespans for people with access to these medications and transforming the infection into a chronic disease. Now, those dreaming of an end to HIV are seeing reasons for optimism. No, a cure isn’t in the works — but many researchers believe we can end the epidemic through prevention.

Ending HIV transmission will take money and an efficient health care infrastructure, but we have the tools to do it. It starts with expanding access to HIV testing — an estimated 15 percent of Americans with HIV are unaware of their status. The next step is to ensure that everyone testing positive has access to antiretroviral drugs. When used correctly, these medications keep viral levels so low that the chances of transmission are virtually nonexistent. More recently, medications called PrEP — pre-exposure prophylaxis — enable people without HIV to protect themselves from infection. Condoms, of course, are a time-tested prevention tool. Gathered together, we have a pretty mighty arsenal. Here in the United States, we could stop HIV transmission in its tracks in just a handful of years. Of course, people all around the world will need access to testing and treatment to halt this scourge on a global level. Continue reading →

STD Awareness: The HIV Epidemic at Home

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In the United States, we understand HIV — the virus that causes AIDS — using a common narrative, one that gives us the impression that its deadliest chapters belong in decades past or distant places. It goes like this:

The disease emerged in the 1980s, cutting down young gay men in their primes and blindsiding scientists as they scrambled to unravel the virus’ mysteries. While AIDS initially whipped up mass hysteria among the general public, LGBTQ folks demanded equality, pushing to find treatments and a cure. AIDS activism and scientific research eventually led to the development of antiretroviral drugs, which tamed the plague by turning a death sentence into a chronic disease. Now, with the right medication, people with HIV can live long, healthy lives. The hysteria has died down, as most people realize viral transmission is preventable, and the infection is manageable.

One thing hasn’t changed, however: Just as it was in the 1980s, AIDS is still thought of as a disease of the “other.” Back then, it was a disease of gay men, a population cruelly marginalized by the general public. Today, it’s thought of as a disease of sub-Saharan Africa, where HIV prevalence is highest.

That narrative, however, doesn’t tell the whole story. Right here in our own backyards, the HIV epidemic continues to spread in the face of chilling indifference from those not affected. African-American MSM — men who have sex with men, who may or may not self-identify as gay or bisexual — have an HIV prevalence that exceeds that of any country in the world. In Swaziland, for example, 27 percent of adults are living with HIV/AIDS, but if current transmission rates hold steady, half of African-American MSM are projected to be diagnosed with HIV in their lifetime. Instead of taking this projection as a wake-up call to invest in lifesaving health policies, however, state and federal responses are poised to let it become a self-fulfilling prophecy.

Contrary to racist and homophobic stereotypes, data show that black MSM aren’t more likely to engage in risky sexual behavior, use drugs and alcohol, or withhold their HIV status from partners. So why are they burdened with higher HIV rates? The answer lies beyond mere behavior, embedded in policies and practices that disproportionately harm people based on race, sexuality, and geography. Continue reading →

STD Awareness: HIV Testing

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HIV testIt’s often been said that young people view HIV as a chronic disease rather than the “life sentence” it was before there were effective treatments. The fact that an HIV infection can be managed with antiretroviral drugs is a boon from modern medicine, and there are hopes for better treatments on the horizon.

But HIV is only a manageable infection if you, well, manage it, and most Americans with HIV aren’t being treated with the medications we have in our arsenal. Only 3 out of 10 Americans who are infected with HIV are controlling the virus with medication — but when you zoom in on that population and look specifically at young people, the numbers are even more dismal, with only 13 percent of youth, ages 18 to 24, receiving treatment.

Knowing your HIV status is easier than it’s ever been.

Much of this problem is due to a lack of access — without adequate health coverage, these medications can be out of reach for many. But that’s not the whole story — it’s estimated that nearly half of 18- to 24-year-olds with HIV don’t know it. If they haven’t been diagnosed, they can’t know to seek treatment; if they don’t seek treatment, they can’t manage their infection; if they can’t manage their infection, their risk of health problems and early death increases — as do the chances of transmitting the virus to someone else.

So, if a 20-year-old tests positive for HIV and begins antiretroviral treatment right away, he or she can expect to live another five decades — to age 71, not bad compared to the average life expectancy of 79. But if that 20-year-old does not take antiretorvirals, he or she can only expect to live another dozen years — to age 32.

That’s why it’s so important to get tested and know your status. Continue reading →