HIV/AIDS

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Future of Program for Low-Income HIV/AIDS Patients Unclear After Obamacare

Sharon Wilson, 53, picks up her weekly allotment of produce from the AIDS Project of the East Bay. Wilson, who has HIV, says without help, she couldn't afford to buy fresh vegetables. (Angela Hart/KQED)

Sharon Wilson, 53, picks up her weekly allotment of produce from the AIDS Project of the East Bay. Wilson, who has HIV, says without help, she couldn’t afford to buy fresh vegetables. (Angela Hart/KQED)

By Angela Hart

Several times each week, Sharon Wilson, a 53-year-old HIV-positive retired caregiver, takes an hour-long bus ride from her Berkeley home to her clinic in downtown Oakland. Wilson doesn’t mind making the trip, because she says the care she has received there since her diagnosis has saved her life.

Wilson says multiple chronic diseases, including HIV, have made it impossible for her to work. Ensuing financial struggles make managing her disease increasingly difficult.

“I can’t afford healthy food and all the medications I need to take,” Wilson said as she described her strict antiretroviral drug regimen. “It’s not easy to learn a new way of living. I take a handful of pills when I wake up in the morning, a handful of pills with lunch, and another handful before I go to bed.”

For people like Wilson, the AIDS Project of the East Bay — one of Alameda County’s six HIV specialty clinics — is a place of refuge. There, Wilson has received primary care for her HIV and specialty care since 2006. She’s been referred to Oakland’s Highland Hospital multiple times to treat other chronic conditions, including congestive heart failure and arthritis. Continue reading

Doctors Fear HIV Patients Will Fall Through Cracks As Obamacare Rolls Out

Public health implications as people who stop taking HIV medications can quickly become infectious

Dr. Kathleen Clanon talks to patient Andrew Solis about keeping his HIV under control. Clanon worries her patients will have disruptions in their care if they don't navigate the changes coming under federal health reform. (Mina Kim/KQED)

Dr. Kathleen Clanon talks to patient Andrew Solis about keeping his HIV under control. Clanon worries her patients will have disruptions in their care if they don’t navigate the changes coming under federal health reform. (Mina Kim/KQED)

A major goal of the federal health care law is that millions of people who currently do not have health insurance will have improved access to care. But the massive overhaul is also expected to be widely disruptive, and doctors worry that many people with chronic illness could suffer during the changeover, as KQED’s Mina Kim details today on The California Report.

Kim tells the story of 33-year-old Andrew Solis who stopped taking HIV medications more than a year ago after becoming addicted to methamphetamine while in a “rocky relationship.” He resumed treatment at the Oakland Highland Hospital HIV clinic last October after ending the relationship.

Solis has been able to get back in to treatment fairly easily, Kiim reports. But changes coming under the Affordable Care Act could complicate care for clinic patients, says Kathleen Clanon, chief medical officer at Highland Hospital. Continue reading

Researchers Report First Cure of HIV in a Child; Reaction in California

Antiretroviral medicines are used to treat HIV/AIDS. (SONNYTUMBELAKA/AFP/Getty Images)

Antiretroviral medicines are used to treat HIV/AIDS. (Sonny Tumbelaka/AFP/Getty Images)

A baby born with HIV, the virus that causes AIDS, appears to have been cured, scientists announced at a meeting on Sunday in Atlanta. They described the case of a child — as yet unnamed — from Mississippi who is now 2 1/2. The child has been off medication for about a year and appears to be free of infection.

From AP:

There’s no guarantee the child will remain healthy, although sophisticated testing uncovered just traces of the virus’ genetic material still lingering. If so, it would mark only the world’s second reported cure.

Specialists say Sunday’s announcement, at a major AIDS meeting in Atlanta, offers promising clues for efforts to eliminate HIV infection in children, especially in AIDS-plagued African countries where too many babies are born with the virus. Continue reading

Rethinking Unprotected Sex for HIV-Positive Men

By Mina Kim

Deon Brimmer, 32, is HIV positive and expecting a daughter.  He’s being treated by a new San Francisco program that helps men with HIV safely realize their dreams of being dads. (Photo: Ryan Anson)

Deon, 32, is HIV positive and expecting a daughter. He’s being treated at a new San Francisco program that helps men with HIV safely realize their dreams of being dads. (Photo: Ryan Anson)

The public health message around unprotected sex for those with HIV has always been the same: Don’t do it. Even with huge strides in medical science that’s changed HIV from a death sentence to a chronic but manageable disease, that directive has not changed.

Now, a new program based in San Francisco is challenging this long-held campaign, and helping HIV-positive men have babies — the conventional way. The program run by San Francisco General Hospital, called PRO Men, teaches men about a range of reproductive options, from adoption to in vitro fertilization — where an egg is fertilized in a lab dish — to carefully timed intercourse.

“I would say as an HIV provider community, we have really failed these men,” says UCSF professor Deborah Cohan, who runs the hospital’s Bay Area Perinatal AIDS Center or BAPAC. “We really have not created programs to help them realize those goals and do so safely.”

“It is one of the last big remaining hurdles that I think many heterosexual men and women have to what they would consider living a normal, ordinary life.”

With the discovery of drugs to treat the virus, Cohan said people with HIV are living long, healthy lives. And for those who want to start families, having “safe” sex, Cohan said, can mean foregoing condoms when a female partner is ovulating. Women can also take HIV drugs, which some studies show can protect against the virus. (BAPAC has helped HIV-positive women who adhere to their medications have healthy babies for years.)

“We know that if the person who is positive takes antiretrovirals and their viral load is suppressed, meaning the medication is working at killing all the HIV in the blood, that the likelihood of them passing HIV to a sexual partner is essentially zero,” Cohan said.

Continue reading

Homeless Young People Find Help at Larkin Street Youth Services in SF

The news this week from the Centers for Disease Control about HIV and young people may have startled some, but to people who work at San Francisco’s Larkin Street Youth Services, it was a spotlight on what they see every day.

More than a quarter of all new infections every year are in young people between ages 13 and 24 — and more than half of those youth infected don’t know it. Hardest hit are African Americans — 57 percent of people in this young age group.

In advance of World AIDS Day on Saturday, The California Report’s host Rachael Myrow visited Larkin Street Youth Services, which helps homeless teens get off the streets and get tested for HIV. She talked to two women who manage programs at the organization.

Here is an edited transcript of their discussion:

LARA TANNENBAUM, Larkin Street’s housing programs: The majority of our youth have experienced a severe amount of abuse or neglect in the home, parental substance use, perhaps a lot of poverty in the home where families weren’t able to care for them. Many of our clients are LGBT and their parents asked them to leave because of their sexual orientation. So people really become homeless for a variety of reasons.

RACHAEL MYROW: How do you start a conversation with a teenager about HIV/AIDS?

RAE SUBER, Larkin Street’s HIV testing & prevention program: Getting a client to consider testing is like getting them to consider medical care in general. Usually there’s a crisis. They think they might have a sexually transmitted infection. They think they might be pregnant. They think their partner might have an infection or be pregnant, and they’re concerned. So they come in and, if testing is indicated, we’ll recommend it. Continue reading

Is AIDS Still A Critical Concern to the Gay Community?

Private AIDS funding drops, while new HIV infections among African American men rise dramatically. (Mark Ralston: AFP/Getty Images)

Researchers, doctors, advocates and general attendees at this year’s International AIDS Conference were awash in enthusiasm that a cure to the AIDS epidemic is actually within reach, largely due to advances in treatments and improved prevention.

But to actually reach the cure takes money. And right at this moment, private funding is down.

Dramatically.

Funders Concerned About AIDS, a philanthropy dedicated to ensuring the end of the epidemic, says both the number of grants from private foundations and actual dollars given have dropped by about one-third.

While the new infections are among people at the intersection of race and poverty, the traditional funders of HIV/AIDS … look around at their friends and may get the sense AIDS is “solved.”

At first blush, it would seem that a down economy would be a big driver, but Daniel Tietz, Executive Director of the AIDS Community Research Initiative of America (ACRIA), sees something else at work. He spoke with KQED’s Rachael Myrow on The California Report Friday morning and said that the downturn in funding predated the downturn in the economy. Continue reading

AIDS 2012: Research, Yes … and also Performances & Protests

By Alvin Tran

Service Workers in Group, "SWING," a foundation that provides information and support to  sex workers and transgender men in Thailand, performs at the International AIDS Conference. (Photo: Alvin Tran)

Service Workers in Group, "SWING," a foundation that provides information and support to sex workers and transgender men in Thailand, performs at the International AIDS Conference. (Photo: Alvin Tran)

As a public health student for the last seven years, I’ve attended my share of research conferences. But the moment I arrived in Washington for the 19th International AIDS Conference, I knew instantly that this one would be different.

Unlike other conferences I’ve attended, the history of the International AIDS Conference is filled with controversy. I could pick many different starting points, but how about the travel ban? The International AIDS Conference had not been held in the U.S. in 22 years because HIV-positive individuals were barred from entering the United States. Congress voted to lift the ban in 2010, and D.C. was promptly chosen as the host city for this year’s conference.

But as the conference began and American speakers took pride in finally having the opportunity to be the hosts, I quickly learned that the travel ban was still in force for some people. HIV-positive sex workers from outside the U.S. are still prohibited from traveling to the U.S.

Activists from across the country, including many from San Francisco, carried red umbrellas and signs, and interrupted sessions in protest of the travel ban and arrest risk from carrying condoms. Continue reading

Stigma An Apparent Barrier in Achieving AIDS-free Generation

By Alvin Tran

Researcher Glenn-Milo Santos of Oakland's Global Forum on MSM & HIV presents data on homophobia at the 19th International AIDS Conference. (Photo: Alvin Tran)

Researcher Glenn-Milo Santos of Oakland's Global Forum on MSM & HIV presents data on homophobia at the 19th International AIDS Conference. (Photo: Alvin Tran)

Research presented this week at the 19th International AIDS Conference shows how homophobia may be a major barrier to achieving the “AIDS-free generation” — the optimistic tagline underlying much of the conference.

A new survey of young men who have sex with men (MSM) shows that “experiencing homophobia” may put them at greater risk of contracting and spreading HIV, the virus that causes AIDS.

The study was conducted by Oakland’s Global Forum on MSM and HIV (MSMGF). Researchers surveyed more than 5,000 MSM globally. Nearly 1,500 were age 30 or younger, with about two-thirds of these young men from Asia and six percent from North America. According to the study, young MSM who experienced homophobia more frequently said they had less access to a variety of services including free HIV testing and condoms. Experiencing higher levels of homophobia equated with less access to medical treatment for HIV-positive gay men.

Young MSM who experienced homophobia more frequently said they had less access to a variety of services including free HIV testing and condoms.

“Our findings really underscore the importance of also addressing the larger structure and social factors that are associated with HIV infection especially among young men who have sex with men,” said Glenn-Milo Santos, an epidemiologist and MSMGF researcher.

In addition to highlighting the possible relationship between experiencing homophobia and having less access to HIV preventive services and care, Santos also presented results about respondents’ overall experiences with homophobia. Continue reading

Carrying Condoms Brings Arrest Risk for Sex Workers

Report presented at International AIDS Conference shows “chilling effect” of police policies

By Alvin Tran

Condoms with a political message, handed out at the International AIDS Conference by St. James Infirmary, a San Francisco health clinic for sex workers. (Photo: Alvin Tran)

Condoms with a political message, handed out at the International AIDS Conference by St. James Infirmary, a San Francisco health clinic for sex workers. (Photo: Alvin Tran)

Police officers in San Francisco and Los Angeles may be undermining public health efforts to prevent the spread of HIV among sex workers.

That’s according to the findings of a new Human Rights Watch report “Sex Workers at Risk,” presented at the 19th International AIDS Conference in Washington, D.C. this week.

Researchers interviewed more than 300 people, including current and former sex workers in four major U.S. cities — San Francisco, L.A., Washington, DC and New York. They found that police officers were either confiscating or taking photographs of sex workers’ condoms as evidence of prostitution, putting sex workers at risk.

“Sex workers on the street are telling us that they are having unprotected sex with clients as a result of this practice,” said Megan McLemore, Senior Researcher at Human Rights Watch.

In L.A., New York and Washington, police confiscated the condoms and used them as evidence, but San Francisco police instead photographed the condoms before giving them back to sex workers.  Continue reading

FDA Approves First Drug to Help Prevent HIV Infection

(Justin Sullivan: Getty Images)

(Justin Sullivan: Getty Images)

The Food and Drug Administration has approved Truvada, the first drug shown to reduce the risk of HIV infection in people who are at high risk of acquiring HIV, the virus that causes AIDS.

Truvada was already approved as a medication for treatment of people already infected with HIV.

Truvada is to be taken twice a day in what is known as pre-exposure prophylaxis, or PrEP.

From the FDA’s press release:

As part of PrEP, HIV-uninfected individuals who are at high risk will take Truvada daily to lower their chances of becoming infected with HIV should they be exposed to the virus. A PrEP indication means Truvada is approved for use as part of a comprehensive HIV prevention strategy that includes other prevention methods, such as safe sex practices, risk reduction counseling, and regular HIV testing. Continue reading