VAGINAL RING: MICROBICIDES AT TIPPING POINT RING NOW: JOIN THE START STUDY RING A BELL? HIV STIGMA JULY 2010. ISSUE 4 Pick me up. I am free. IS IT TWO RED AND ONE GREEN, OR THE OTHER WAY ROUND?
If you don’t take it, talk about it. Anti-HIV medication can be complicated, but that shouldn’t stop you taking it properly. Your doctor or nurse can help you deal with problems or make changes to your prescription. Find out more at www.yourstoryyourscript.co.uk
August 2009, HIV/0509/2906
HIV compl meds A5.indd 1 25/05/2010 10:32 Ringing in the changes Shortly before leaving office, the outgoing Labour administration lit the torch paper for the removal of the ring fence around the AIDS Support Grant which has funded the vital work of many HIV charities since 1989. The ring fence was to go next year, giving those charities a time to seek alternative funding.
The new coalition government went a step further; on June 10 Communities Secretary Eric Pickles announced the AIDS Support Grant ring fence would go during this financial year.
NAT (National AIDS Trust) has urgently sought assurances from the Government that steps will be taken to ensure local authorities continue to meet the social care needs of people living with HIV/ AIDS. But, the loss of the ring-fence means they are under no duty to do so.
On June 22 the Chancellor announced that Disability Living Allowance (DLA) will be reformed from 2013/14. Making it more difficult to be awarded this support will undoubtedly make life harder for many people with HIV/AIDS.
Now is the time to contact your local authority and remind them about the vital work your local HIV organisation does.
Thanks to all the clinics who have agreed to distribute free copies of BASELINE; if you’d like more next time send us an In this issue email to editor@baseline-hiv.co.uk 04 bylines 05 drop-us-a-line Please join our facebook group (BASELINE) 06 jabs and gels: and follow us on twitter (Baselinetweet). TM Microbicides & vaccines 10 headline: UK Editor: 14 start study Robert Fieldhouse 19 headline: global Associate Editor: 22 starting HCV treatment Jane Phillips 26 BASELINE at BHIVA News Editor: 28 myline: Julie Musonda Chris O’Connor 30 thick as thieves: HIV & stigma 34 hotline Sub Editor: 36 headline: treatment Joanne Russell 38 introducing AIDS orphan UK Editorial Support: 40 romania in focus Tom Matthews 44 Q & A i-base 46 myline: Joel Korn Design & layout: 48 NAT fundraiser: pics Meryl Media - 0161 235 7279 50 positive action for children Publisher: Courtesy 52 myline: Tim Baros Fieldhouse Consulting Limited www.ipmglobal.org 55 myline: JD Bailey 56 lancashire in focus Email: [email protected] 58 punchline: kope 60 lifeline: HIV Phone: 0121 449 4405 or 07886 159735 62: headline: healthy living Copyright of all images and articles remains with the publisher. All other rights recognised. Views expressed by individual contributors are not necessarily 63: volcanic ash insurance those of the publisher. The mention, appearance or likeness of any person 64 headline: hepatitis or organisation in articles or advertising in Baseline is not to be taken as any 66 fineline and numbers indication of health, HIV status or lifestyle. 03 deadlines for the next issue
Copy 01/09/2010 Advertising 10/09/2010
Rob Fieldhouse is an extremely busy and Simon Collins is a leading HIV advocate. He lucky man who travels the world reporting and heads up HIV i-base. presenting about all things HIV. Jay Obrecht lives, eats and breathes Jane Phillips has been Rob’s software advisor, cartoons, believing they are a powerful tool manager and personal calming therapist for some to teach, persuade, impress and entertain. His time now and is really happy to be doing it. Maybe first cartoon appeared in The Sun. heading back to the UK from rural France... Tim Baros pays the rent by working in Chris O’Connor covers issues from the wine the City. In his spare time, he writes film trade to the trade in counterfeit medicines and reviews and some feature articles for has reportedly widely on HIV. www.hereisthecity.com and has written for Pride Magazine, thebody.com and Body Gareth Williams splits his time between a Positive Magazine, and he was recently graphic studio creating artwork and walking vast featured in FS Magazine. and beautiful areas around the UK – seems like an ideal plan. Alex A is an HIV positive journalist living in Romania. Joanne Russell is a Reuters-trained journo who put down the pen to become an English teacher. J.D Bailey was diagnosed at 2 years of age but found out she was HIV positive aged Tom Matthews has just quit a 15 year long early 11. Now twenty years old, she is currently a retirement to return to work a Birmingham’s World student of English at the University of Surrey. AIDS Day Co-ordinator. Joel Korn is the support and development Julie Musonda works for Leicestershire AIDS worker at River House Trust, a fund raiser at Support Service and a volunteer member of the JAT - (Jewish Action and Training for Sexual LhivE user-led peer support group. Health), and a facilitator of Living Well’s Positive Self-Management Programme. Ian Govendir has been involved with HIV organisations for the past 14 years. He is Chair Katherine Sladden is the Communications of AIDS Orphan, a trustee of CARA, and Head of Manager for the National AIDS Trust (NAT) individual giving at the Soldiers Charity. His desire to set up a Charity focusing on Children orphaned by HIV/AIDS came out of the time he spent with the British Red Cross as Head of the fundraising department.
BASELINE: Great to see you at BHIVA JD Bailey’s excellent column was kindly forwarded Dr Tristan Barber to me through Magda Conway at CHIVA. She writes in an incredibly clear, accessible and emotive way Jane. The issue looks absolutely stunning; about many of the issues faced by our younger attractive, topical, well written, positive engaging adolescents as they transition from paediatric to and really is a stunner. You’ve got such a great adult services. I would really like to print off her team and are doing a brilliant job. Well done lovey. column to give to our younger patients as I think it Phil – London would really help them to hear her voice – we do get BASELINE here in the adult service but for the Hi Robert, younger adolescents a one page print out would Just to let you know that our Monday night Gay be much more accessible. I wonder if that would Men’s Group continues to flourish, 20 members be possible? with the BASELINE logo and details if last night, plus 2 guest speakers. We have had that too is possible. If JD Bailey and BASELINE are several new members and enquiries from guys happy I would really like to circulate her column who saw our advert in “BASELINE” Many thanks for to the other transition clinics through HYPNet (the your continued support. HIV Young persons Network). Martin and the GMG team xxxx Dr Caroline Foster Imperial College, London Jane. Nice new issue dear, picked it up at Chelsea & Westminster! Like the article on liver, however Dear Editor Errol nearly set fire to the kitchen the other night I am a community development worker with by burning liver he was cooking for the dogs... Yorkshire MESMAC sexual health project in York coincidence? and your magazine would be of interest to our B in London service users/groups accessing our offices. It’s a great publication with news, views and interesting We are an HIV support organisation and will soon articles. be running a PSMP (Peer Support Management Thanks in advance and keep up the great work. Programme) for clients. Would it be possible to Pete Blackburn have a batch of copies of BASELINE to distribute to MESMAC our clients? Kind Regards Liz Bayley - Project & Funding Coordinator www.worcesteraidsfoundation.org.uk I picked up a copy from Rochdale GUM clinic whilst visiting there recently. I will notify our Director Tom Doyle regarding putting together some contributory articles for you and articles from our service users. Keep well and best wishes – Anon
First of all let me compliment you on your magazine. Baseline is a truly useful and welcome medium for all of us living with HIV. Thanks especially for the life stories and updates on treatments. Both for content and graphically, the magazine is - in my view - a success. Kindest regards, Simon - London 05 But a subset of antibodies, known as ‘broadly jabs and gels neutralizing antibodies’ (bNAbs), could hold clues to the design of potentially powerful HIV vaccines. Until recently, only four relatively weak antibodies had been isolated from HIV positive individuals in Chris O’Connor the developed world.
Progress on new HIV prevention technologies That changed last year when IAVI researchers (NPT) is at a tipping point BASELINE reports discovered two new and highly potent antibodies from NAT’s recent expert think tank. from a volunteer in Africa - as well as the site on HIV to which they attach. Since then, still more ‘Good news-bad news’ moments could see the bNAbs have been identified - and more are being development of vaccines and microbicidal gels discovered each month. In combination, these stride ahead or stagnate. antibodies neutralize virtually all strains of HIV, according to IAVI CEO Seth Berkley. Exciting news “2010 is crucial. There have been so many but a far cry from being a useable vaccine. disappointments to date - donors and policy makers are fatigued,” according to Sheena Long-term funding for these technologies has to McCormack, senior scientist, at the Medical be immune from political fluctuations, say IAVI. Research Council (MRC). In the UK, NAT and its parliamentary partner Whitehouse Consulting are monitoring the new May 18th was World AIDS Vaccine Day, thirteen Government’s position on AIDS research. years to the day since President Bill Clinton challenged the world to find an AIDS vaccine. To ‘NAT is monitoring the new UK mark the day the National AIDS Trust gathered government’s position on AIDS international agencies to review the innovations research.’ in the fight for HIV protection. Microbicide - back on-side? Vaccine initiative gets a shot in the arm The need for an effective microbicide is desperate. Fresh impetus has been shot into the vaccine The highest burden of HIV infection in Africa initiative following the results of the Thai Vaccine is on young women who are often unable to trial, RV144. The vaccine, using a combination of convince their male partners, especially husbands two compounds provided some protection after and regular partners, to use condoms. Poverty, the failure of two previous large scale vaccine concurrent relationships and gender-based trials. However, the protection level of 30% is too violence increase women’s vulnerability. low for an effective vaccine. Even a partially effective microbicide could “A second generation of vaccines, targeting cellular have a profound impact on the dynamics of immunity are going into human trials in the next HIV transmission. According to mathematical few years,” says Hester Kuipers of the International modelling, say CAPRISA (Centre for the AIDS AIDS Vaccine Initiative (IAVI). More importantly, say Programme of Research of South Africa), 2.5 IAVI, is the quest to design vaccines that harness million HIV infections could be averted over 3 the antibody response - to date every time the years if a microbicide with 60% effectiveness was body figures out how to target and neutralize HIV used in 73 low-income countries. the virus simply changes its structure. Akin to the vaccine experience, microbicides
06 are looking for a success after a series of failures using a gel, ‘generally women raved about it, there including the hugely disappointing PRO 2000 gel was a sense of more control, anticipation and trial (MDP-301). Hope is now pinned on the trial of pleasure when using the gel - they were actually the ‘next generation’ tenofovir gel - CAPRISA 004, disappointed when the trial ended.’ due to report its findings at the International AIDS Conference in July 2010. See our interview with “Long-term funding for these lead researcher Salim Abdool Kareem on the next technologies has to be immune page. from political fluctuations.”
Meanwhile, the Microbicide Trials Network’s VOICE PrEP – focus on high risk groups study (MTN- 003) is underway and evaluating Giving HIV drugs to HIV negative people in the a tenofovir vaginal gel or a daily tablet as pre- hope of preventing them acquiring HIV, known exposure prophylaxis (PrEP). This trial will involve as pre-exposure prevention (PrEP) is being looked up to 5,000 women who will be split one of five at in the VOICE trials due to report this year. Both study groups: trial the approach in people at higher risk of HIV -three tablet groups; acquisition: in Peru and Ecuador men who have tenofovir, Truvada or oral placebo sex with men and in Thailand injecting drug users -and two vaginal gel groups; will trial tenofovir as pre-exposure protection. tenofovir or placebo Despite the immediate need of these technologies, VOICE participants will use the microbicide gel there is longer term fear of potential ARV every day unlike in CAPRISA 004 when it is only (antiretroviral) resistance. If oral PrEP and ARV used before and after sex. Results are expected in microbicides show good effect and are rolled out, 2012. there is a danger (should an individual become HIV positive) that tenofovir-resistant viruses could Further down the line, the International Partnership circulate. for Microbicides (IPM) is looking at testing a gel of the investigational NNRTI dapivirine, although ‘Without monthly testing’, as is the case in the some researchers are concerned that it is not trials, says Sheena McCormack, ‘individuals with different enough from Truvada to attract funding. very high viral loads could be on monotherapy An IPM initiative to test a new approach, the for some time. As tenofovir is the backbone of ‘dapivirine vaginal ring’ may demonstrate high treatment programmes in South Africa, where acceptance among women. Quick dissolving there are far fewer drugs to choose from and many anti-HIV films are also being developed and rectal unpleasant ones such as d4T, there is a danger of tenofovir gel is being researched for use by gay resistance ‘screw up’.” men. “It’s a hypothetical but reasonable assumption The acceptance of gels by women continues to be that by taking tenofovir when infected, a small evaluated by the IPM and the MRC. According to proportion of people will become resistant,” says Celine Mias of the IPM, an acceptability trial (PAS1) Salim Abdool Kareem. “The concern is about showed good acceptance. New studies are looking people’s therapeutic options three-to-five years at the acceptability of vaginal gel rings. down the line. If five years ago you had said Truvada would a first-line therapy in South Africa it Sheena McCormack reports that one Ugandan would have been hard to believe - five years from MRC trial showed only a 5-10% negative rating in now, who knows?” 07 top microbicide researcher speaks to.. Chris O’Connor
Salim Abdool Kareem is the Director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and lead investigator of a number of clinical trials investigating microbicides, vaccines and HIV/TB co-infection. Salim spoke to BASELINE from the University of KwaZulu- Natal, Durban.
Their CAPRISA 004 trial will be the ninth microbicide study he has been involved with since 1994. Salim has staying power.
Salim and the team are currently finalising the results of this trial; involving 889 women from KwaZulu-Natal who received either tenofovir vaginal gel or a placebo gel. “If the results are not positive, we have to ask ‘At stake is the protection of women from why not? It works in reducing mother-to-child HIV transmission - at the moment they are transmission and in animal studies. We have to defenceless,’ says Salim, “98 of our women have look at adherence, did we use enough of the drug? become infected with HIV during the trial, despite Should we use a combination of drugs?” the preventions we offered, this is the incredibly high background of HIV prevalence for young In 2008 South Africa recorded an overall HIV women in the community.” prevalence of 29% in antenatal clinics; four districts had a rate in excess of 40%, three of these were in If tenofovir gel shows good protection levels KwaZulu-Natal. of around 50% it would be a groundbreaking moment, according to Salim; “This will be the “The problem is so acute and the need so great,’ first time there is evidence that an ARV is able says Salim, ‘we just have to persuade funders to to prevent HIV transmission in humans. It would back us – what can we say to a young woman who open up a whole new field – then it would be comes to us; she has a partner, working away in the critical to have confirmation studies in different mines, he is not faithful and he wants kids - what populations and different settings, like the VOICE can we say to her? Be faithful? At the moment we trial.” can offer her nothing.”
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Future Dates: November 19th - 21st 2010, The Lake District - Only 9 places left March 19th - 20th 2011, Snowdonia, North Wales - Only 18 place available largeOutdoors.com news: UK
Chris O’Connor
Kids take centre stage at CHIVA Young people living with HIV were prominent at the recent 4th Annual Conference of the Children’s HIV Association (CHIVA). Opening the session, 18 year old Mathilda Mudyavahu, a voluntary worker at Positively UK (formerly Positively Women), talked about the role of peer support for “hard-to-reach” HIV adolescents, and shared her experiences of moving into adult services.
A recurring theme of the day was neuro-cognitive functioning. Indeed the CHIVA Debate was ‘This house believes that antiretrovirals should be started in all HIV-positive children immediately to protect the confounded observers when it showed that tablets child’s brain.’ were preferred by mothers and children as well as being one sixth of the cost of syrup formulations. Dean Krechevsky, clinical psychologist from St Mary’s London conducted a case note review One presentation by Bhanu Williams surprised and measuring cognitive learning in primary school concerned many at CHIVA. Research from Imperial aged HIV positive children - 70 children; 80% of College and the Institute of Child Health looked at them had African parents, showed evidence of the first generation of women infected with HIV ‘some learning vulnerability…requiring extra from birth who are now becoming pregnant. Of support at school.’ The study reported more 36 pregnancies, 27 were unplanned with a median specific measures of neuro-cognitive functioning maternal age of 18. A “worryingly high number”, and learning are needed. say the researchers. The conference was closed by the CHIVA youth Dr Saye Khoo, Liverpool University, looked at the committee, comprising seven young people living pharmacology of antiretrovirals in children. He with HIV who shared their ideas for increased lamented the ‘shocking lack of effort’ in producing involvement in transition from child to adult HIV data and trials in this field. Tenofovir, for example services. They also outlined their development of he said was not available in a child formulation. a summer camp for young people with HIV. For Di Gibb of the Medical Research Council reported presentations see http://chiva.org.uk/health/ that the Arrow acceptability trial in Africa had conferences/previous/4th-annual
10 Walk for Life celebrates 21st Birthday Over 2000 walkers took to the streets of London on June 6th, raising over £250,000 so far with sponsorship money continuing to roll in until September. On the 21st anniversary of Europe’s biggest HIV charity walk the theme was fancy dress and the 10 kilometre Walk for Life dragged up and high kicked its way through the capital. On their return, the walkers danced into the evening to ‘The Feeling’, aptly supported by Four Poofs and a Piano. Obituary: Jim Smith Obituary: Haydn Lewis Jim Smith, a tireless and selfless worker with HIV Haydn Lewis passed away on 21st May 2010. positive people, passed away recently. He will be Haydn was an inspirational campaigner for the greatly missed. Whether as an advocate or carer, rights of people with haemophilia and their his kindness and endless generosity was always families whose lives have been devastated by there. contaminated blood products. Haydn contracted Jim worked with St Stephens Volunteers and with HIV and hepatitis C from contaminated blood the Chelsea and Westminster Hospital, the Patients and unknowingly passed the HIV virus to his Forum and at The River House Trust. wife Gaynor. To hear Haydn in his own words and his search for truth and justice, please see the Goodbye Tracy Barnes interview from BBC’s Newsnight. Hillingdon AIDS Response Trust (HART) says goodbye to its much-loved manager Tracy Barnes www.bbc.co.uk/blogs/newsnight/ this month. Tracy is heading to a new life in South susanwatts/2010/05/ America.
11 news: UK
Chris O’Connor
Hep C rates soar in the North Positively Women is now West Positively UK Cases of hepatitis C (HCV) in the North West of Positively Women is embracing men. After a review England increased by 30% in 2009 compared to of strategy and consultation with service users 2008. Since 1999, the North West has consistently Positively Women is now Positively UK (PosUK). had the highest HCV rates across England. In 1997 there were 110 cases. This has increased year on Positively UK will extend its remit to reach both year, with 2195 cases identified in 2009. men and women living with HIV. PosUK says the organisation will retain its core ethos of peer According to the Health Protection Agency (HPA) support, with people living with HIV developing injecting drug users are the ‘key risk group in the and delivering services. Services for men will be region and HCV in this group is the highest in the created under the new banner of ‘Positively Men’. country.’ It is critical that awareness campaigns are sustained and enhanced so that more people at Positively UK say ‘specialist’ HIV agencies have risk can be tested and treated,’ say the HPA. recently lost contracts, and at the same time there is a lack of agencies to deliver peer-led work, It is thought that up to 500,000 people in the UK particularly after the closure of groups such as have been infected with hepatitis C. Positive Place.
Increasing reports of newly acquired HCV among According to a statement from PosUK replacing HIV positive men who have sex with men (MSM) ‘Women’ in the title was a difficult decision to have led the HPA to establish an enhanced make and the charity acknowledges many people surveillance system in London, Manchester and will feel a sense of loss that the organisation is no the South East. In the first 17 months up to May longer called Positively Women. However, current 2009 there were 109 newly acquired HCV cases. support groups will remain women only and the 96% had been diagnosed HIV positive with a mean charity will continue support for lesbian, bisexual of four years between diagnoses. Injecting drug and transgender women. Positively Women use was reported in 17 cases. magazine will also remain women focused.
According to the HPA, the higher HCV viral load PosUK is developing a new service to support among coinfected men compared to men living women through pregnancy and ante natal only with HCV, may account for the enhanced care over the next year. A new website transmission rates although the rates observed www.positivelyuk.org will be launched to were lower than expected. coincide with the change of name.
12 Crusaid merges with THT Terrence Higgins Trust (THT) has merged with the fundraising and grant-making HIV charity Crusaid. Since its inception in 1986 Crusaid and its ‘Walk for Life’ have been a vital part of the HIV landscape in the UK raising over £33 million and releasing 45,000 hardship grants.
Jordan Hay, Chief Executive of Crusaid, told BASELINE, the major factor behind the merger had been the economic downturn which had affected the charity’s ability to fundraise.
The Crusaid Hardship fund has been closed for six months, “I didn’t want to just survive as a charity, we had to continue the Hardship fund’ said Hay. Law now protects people with It made sense, he says to merge with a more HIV from hate crime robust charity. “It’s a good fit; someone calling THT A clear message that HIV-related hate crime will Direct, could be put through to the Hardship Fund. not be tolerated has been issued by the Crown It will be more cohesive. At the end of the day Prosecution Service (CPS). The CPS has issued this is about helping people with HIV forced into revised guidance to make it clear that people with poverty, the move will be beneficial for everyone. HIV have the same protection as other victims of As a positive man I just wanted Crusaid to survive.” disability hate crime.
Debbie Holmes, Director of Fundraising at THT, The National AIDS Trust and the Equality and is clear the Crusaid Hardship Fund had to be Human Rights Commission, raised concerns retained, although no definite date has been set with the CPS that disability hate crime guidance to reopen the Fund for grants. Crusaid spent 40% excluded people living with HIV. The stigmatised of its income on its hardship fund and charitable nature of HIV means it is vitally important that grants. THT’s spends 89% of its income on its from the moment of diagnosis people living with charitable activities. HIV are afforded the same protections as other disabled people. Current commitments to Crusaid’s overseas projects will continue to be honoured but no Nadine Tilbury, Senior Legal Advisor for the CPS, decision has been made about the future. On the said: “Crimes against people living with HIV - fundraising side Holmes is a huge fan of the Walk motivated by hostility towards their status - have for Life, citing its diversity as “inspirational.” “We no place in our society and we will prosecute those will have consultations on changing the brand responsible robustly and, where there is sufficient name but we don’t want to alienate anyone,” she evidence to do so, we will apply to the court for added. more severe sentences.” 11 is your CD4 count over 500 off therapy?
Simon Collins, HIV i-Base
An important new study is enrolling in the UK What are the potential benefits for me? and needs your help. . The first benefit is that you will be contributing to research that will expand our The START study (Strategic Timing of AntiRetroviral knowledge about HIV. Therapy) will look at when to start treatment and . If you join one of the sub-studies, you may be many other aspects of HIV. monitored with tests that are not currently part of routine care, including looking at What is the study for? brain functioning, bone health and heart and The START study will randomise people to start lung health. HIV treatment when their CD4 count is above 500 . Monitoring and care in a study are usually or to wait until it reaches 350. more intensive than in the general clinic. You will have the chance to speak more to the The study will look at the risks and benefits of doctors or nurses, if you need this. earlier compared to later treatment. . You could get earlier HIV treatment if you are randomised to this group. Why is START so important? . Whether you start treatment immediately or Because no other study has researched this. when you CD4 count reaches 350, you may have a wider choice of drugs to choose from. Starting earlier may help your long-term health. Why else would I want to start treatment so We do not know whether this is at 350, 500, 700, early? 900 or just when you are diagnosed. This study will . The main reason is the believed benefit this show us this. could have on your long-term health.
Which treatment can I use? . Your CD4 count will stay higher – because The choice of meds is entirely up to you and your this is always related to how high it is when doctor. Because all drugs are provided free in the you start. study, when you come to start treatment, you may It may only mean starting a year or two have the options to choose newer meds that are earlier rather than waiting until 350. not routinely available. . Other benefits include reducing your risk of
14 The Strategic Timing of AntiRetroviral Treatment study THANK YOU for START compares the risks and benefits your interest in this of starting HIV medicines at CD4+ cell counts over 500/mm³ important study! compared to waiting until CD4+ cell counts drop to 350/mm³ in people who are well. Once treatment has started, the goal is to
Local contact information keep taking HIV medicines to keep the virus undetectable. When is the best time to start taking We know that HIV medicines prevent AIDS- HIV medicines? related illnesses. These illnesses are rare when your CD4+ cell count is greater than 350/mm³.
Recent research, however, suggests that HIV-positive people who aren’t taking HIV medicines may develop cancer or other illnesses affecting the heart, liver, Timing is or kidneys more than usual, even at higher CD4+ cell counts.
everything. We need to understand whether it is better to start taking HIV medicines as soon as you know that you have HIV or to wait and follow the current guidelines. transmitting HIV because an undetectable viral When will the results be known? load makes you less infectious. The study is planned to run for five years. ThisWould starting HIV medicines earlier — length of time is thought to be needed because that is, before CD4+ cell counts What are the benefits if I am in the deferred the differences between the two groups may onlydrop to below 350/mm³ — prevent serious illnesses group? This international study, funded by the National Institutes ofbe small. Health and other collaborating organizations, is being conduct- of the heart, liver, or . ed by INSIGHT (International Network for Strategic Initiatives kidneys? Deferring treatmentin Global HIV may Trials) give in conjunction you a with year the Copenhagenor two HIV Programme (CHIP) in Denmark; the Medical Research Council longer to prepare(MRC) inbefore the United you Kingdom; have the National to get Centre your in HIV However, a similar sized study, also planned to last The START study Epidemiology and Clinical Research (NCHECR) in Australia; the Would earlier head around treatmentWashington International and the Coordinating importance Center in the of United over five years, in fact answered the study questiontreatment States; and the sponsor, the University of Minnesota. wants to answer adherence. Although this may only be a year or much earlier - within two years. prevent more two difference for many people. If the results are seen sooner, the study might be deaths? these questions. shorter. START . You may also have the choice of newer medications when you come to start treatment, Where are the study sites? and may benefit from more recent research Your have to visit one of the sites in London, about the best drugs to start with. Brighton or Leicester. Your travel costs can be reimbursed if you decide you want to take part. . Starting at 350 is the current standard of care in the UK and most European countries. If you Many more clinics across the country will join next need to start treatment earlier for any medical year, but getting this first phase enrolled is critical reason, this is of course allowed. for making sure the study continues.
Which is the ‘best’ group to get in? For further information, talk to a doctor or nurse at This is the crucial question. And it is why we need your clinic, or, in confidence, email: the study. [email protected]
Some experts might think one thing and others If you would like to talk about START or any other another. There is a lot of discussion and opinions treatment issue with an independent community but little solid evidence. treatment advocate, call the i-Base phoneline: 0808 800 6013. This will only come from a large randomised trial – Mon, Tues, Wed: 12.00–4.00pm and START is enrolling 4000 people in 30 countries. 15 US move to very early treatment
Chris O’Connor
Professor Brian Gazzard speaks to BASELINE about the recent US decision to recommend “In the past BHIVA has largely HIV treatment at 500 CD4 count. been proved correct on treatment decisions – a better The United States federal health panel has changes record than in the US.” its guidelines on when to start HIV treatment. They now advise starting at CD4 counts of 500 and In the search for firm evidence most experts below - instead of waiting until you CD4 count including the federal health panel endorse the reaches 350. The panel decision, carried by a START trial which will look specifically at this issue. narrow majority, puts the US guidelines out of step “I am in favour of START, we have a big obligation, with many other countries. Many clinicians and we don’t know for certain which is the best route treatment advocates - inside and outside the US – to take. These are not different opinions on how remain adamant that there is insufficient evidence best to get to the pub. When to start taking meds to justify this change. for the rest of your life or feel like you are missing an opportunity to control the virus – these are big So is the UK treatment start line in the right decisions.” place? Professor Brian Gazzard, Chair of the British HIV Association (BHIVA) Guidelines Committee; The city of San Francisco health authority has told BASELINE, “The US guidelines are based on a taken the US guideline changes a stage further US cohort study NA-ACCORD – people in the US to pursue a policy of universal HIV treatment on are not entitled to free care, so the study looked at diagnosis - regardless of CD4 cell count. This ‘Test the middle classes if you like. All the health issues and Treat’ approach will try and reduce the HIV poorer people face are discounted. If you look at community’s collective viral load and reduce HIV similar studies done in Europe - where we largely transmission. have free care – there is no evidence to change.” Local HIV advocacy group Project Inform has Guidelines are just that, say treatment advocates broadly backed the initiative, after wavering now and each HIV positive person has the right to advocate treatment in line with US guidelines at decide his/her best treatment path with his/her 500 and below. Dana Van Gorder, Project Inform’s clinician. However national guidelines can be Executive Director said, ‘For me there are far too persuasive. many people in the US and around the world Brian Gazzard points out, “In the past BHIVA has who are positive and not in care, never mind in largely been proved correct on treatment decisions treatment. There is a lot of pushback on this but – a better record than in the US – for example it is incumbent on us to ask how are we going to guidance on AZT monotherapy, efavirenz as first- help the 220,000 undiagnosed in the US?’ line treatment. Traditionally BHIVA guidelines have been pretty good.”
16 Blackburn Choice of HIV and your BODY SHAPE, HEART, LIVER OR KIDNEYS 17th August 6pm PROVIDED AS A SERVICE TO MEDICINE BY GILEAD THRIVINE @ The Jarman Centre, 53 James Street, BB1 FREE workshops this summer on 01254 263525 HIV and your HEART, KIDNEYS, BONES, Manchester LIVER and BODY SHAPE HIV and your KIDNEYS 5th July 1pm Speaker: Choice of HIV and your LIVER, BONES, BODY Robert Fieldhouse,Editor SHAPE or HEART 6th September 1pm Zion Community Resource Centre 339 Stretford Rd, Hulme Manchester, M15 4ZY Birmingham HIV and your LIVER 13th July 7pm Choice of HIV and your BONES, BODY SHAPE, HEART or KIDNEYS 10th August 7pm ABPlus, 29-30 Lower Essex Street, B5 0121 622 6471 www.abplus.org.uk Leeds HIV and your BODY SHAPE 8th July @ 6pm Choice of HIV and your LIVER, KIDNEYS, HEART or BONE 5th August @ 6pm Skyline, 4th Floor, Gallery House The Headrow, LS1 0113 244 9767 www.leedsskyline.org.uk Newcastle HIV and your HEART For information on the workshops 7th July 3.30pm or more details about the venues, contact 07886 159735 or email Choice of HIV and your LIVER, KIDNEYS, BONE or BODY SHAPE [email protected] 4th August 3.30pm Body Positive North East, 12 Upper Princess Square, NE1 This meeting is funded and 0191 232 2855 supported by Gilead Sciences www.newcastle.gov.uk/hivservices.nsf/a/bpne Be Part of something hUgE… JAT (Jewish Action and Training for EMIS: EuropeAN sexual health) is the only charity in the UK providing sexual health MeN’s Sex survey programmes for the whole of the Jewish community.
JAT supports Jewish people living with HIV and their carers socially, emotionally and in some circumstances, financially. JAT aims to enable and ensure that Jewish people with HIV are able to live life in the way they wish.
JAT runs education workshops nationally in schools, youth clubs, summer camps and also trains youth workers from all the major Jewish youth organisations. The main aim of these education programmes is to empower young people to make safe and informed life choices.
JAT is currently looking for sessional workers who will be involved in awareness-raising by working with DO IT Now At Jewish young people, parents and www.emis-survey.eu educators. If you need any assistance, would EMIS will be the biggest survey of gay men like to support our work or would and bisexual men in the world! It is happening in 25 languages across 31 European countries like to know more about JAT please in the summer of 2010. In the UK the survey is go to the website: co-ordinated by Sigma Research and incorporates the Gay Men’s Sex Survey, www.jat-uk.org also known as Vital Statistics. The survey is completely anonymous. or call 0208 952 5253
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emis-baseline.indd 1 02/07/2010 16:45 China lifts HIV entry ban The International AIDS Society (IAS) has applauded China’s announcement that their 20-year-old HIV news: global entry and immigration ban is to be lifted. “With this announcement, China’s entry and Jane Phillips immigration policy relative to HIV will be rooted in science and sound public health practices, rather than reflecting the fear and bigotry that drove this policy for so many years,” said Julio Montaner, President of the IAS.
“Removing these types of laws around the world is crucial to combating stigma and discrimination against people living with HIV and we hope other Activist jailed for raising HIV nations with such laws and policies in place will awareness soon follow suit.” Maxim Popov, an HIV educator has been sentenced to seven years imprisonment in Tashkent In the Asian region, many countries have HIV- (Uzbekistan). He was jailed for the promotion of specific entry or immigration laws. Singapore has HIV prevention via leaflets and workshops. a complete ban on all HIV positive non-nationals for entry and immigration. The IAS launched a campaign against his imprisonment and called for his immediate release. Brunei targets and deports HIV positive foreigners, Mr Popov, 29, has been jailed for attempting to while Australia requires HIV testing for permanent address his country’s growing HIV epidemic with visa applicants over the age of 15. South Korea effective, evidence-based approaches. He is the announced changes to its entry and immigration author of brochures which discuss the use of policy on January 1, 2010, but clarification on its condoms in HIV prevention, the need for sterile amended laws is still awaited. needles for injecting drug users, and education on HIV within same-sex relationships. Worldwide, some 66 countries have some sort of HIV-specific laws that restrict the entry, stay or In his training workshops with school teachers, residence of people living with HIV. Popov used a text-book published in Kazakhstan with the support of USAID and UNDP. The Uzbek For more information on countries with HIV entry, government said that the book constituted stay and residence restrictions, go to: an “assault on minors without violence” and www.hivrestrictions.org ordered the book be incinerated and barred from circulation.
According to UNAIDS, Uzbekistan has one of the world’s fastest-rising HIV infection rates. About 16,000 cases of HIV were reported in 2009 — more than an eleven-fold increase from 1,400 cases in 2001. 19 PROVIDED AS A SERVICE TO MEDICINE BY GILEAD South London AAEGRO FREE workshops this summer on 14 Willis Road HIV and your HEART, KIDNEYS, BONES, Croydon CR0 0DY LIVER and BODY SHAPE 26th June 2010, from 1pm 3rd July 2010, from 1pm For more information contact Mark Mpungu- 07828 114256. Facilitators: Miles Stones Peer Badru Male & Support Elias Phiri (AAEGRO) St Winefride’s Church Hall Bridges Road South Wimbledon London SW19 1SB 5th July 2010, from 6pm 9th August 2010, from 6pm For more information contact: Eric Simpson Tel. 07881 943324 Hope Gate Trust Bridge Park Community Leisure Centre Harrow Road Stonebridge Park London NW10 0RG 8th & 29th September 2010 AT 18:00 GMT For more information contact: Fitzgodfrey Chilfya: Tel.: Telephone: 02080900424/5-6 Email: [email protected]
For more information about the HIV and Body, please contact: Community Badru Male: [email protected] or Development Tel: 07956047596 Organisation (formerly African Families Elias Phiri: Support Services) [email protected] 1-3 The Pavement Tel: 07914855206 Grovehill House Grovehill Road Redhill, RH1 6TW This meeting is funded and 6th August 2010, from 5pm supported by Gilead Sciences 3rd September 2010, from 5pm For more information contact: Mark Mpungu- 07828 114256 Put a ring on it The AIDS Foundation of Chicago’s new campaign promotes the FC2, the new female condom. But it’s not just for the single ladies—men who have news: global sex with men can use it too.
Jane Phillips During the National Women and Girls HIV/ AIDS Awareness Day, a coalition of AIDS service organisations, launched the Chicago Female Condom Campaign’s “Put a Ring on It!” (taken from Beyonce’s hit song, “Single Ladies”).
While female condoms are not new, the FC2 is an improved version. It is seamless, made of a hypo- allergenic synthetic rubber, which can be used HIV epidemic emerging in the with any kind of lubricant (as opposed to male Philippines latex condoms which can only be used with a Low condom use, needle sharing and a rise in water-based lube). casual sex and prostitution may unleash an HIV epidemic in the Philippines, according to a new Female condoms are open-ended tubes but have study published in the Journal of the International two rings—one on each end. Before sex, the AIDS Society (JAIDS). receptive partner inserts the smaller of the two rings into the vagina or anus so that the outer ring Unlike surrounding countries, the spread of HIV protrudes. The inner ring can be removed for anal in the Philippines has been seen as “low and sex. slow” because of the geography, low intravenous drug use, sexual conservatism and high male “Our campaign has an explicit section [describing] circumcision rates. how the female condom can be used for anal But, authors said “...a large, increasing and intercourse and among gay men...” generalised epidemic HIV was possible now www.ringonit.org because of the presence of many factors. “ These include a low rate of condom use; unsafe practices among intravenous drug users; large migration rates; increasing trends in extramarital and premarital sex; a lack of education and common misconceptions about HIV/AIDS.” The report also focused on the 7.5 million Filipinos working abroad in 170 countries (who make up make up 30-35% of all HIV cases reported in the country) and the likelihood of Filipino workers being a high source of new HIV cases upon their return home. The Philippines has the lowest rate of condom use in Asia - just 20 to 30% among groups at higher risk of HIV infection such as sex workers. 21 starting hep C therapy
Jane Phillips
Topline:
. Starting HCV therapy can be a daunting prospect . Unlike HIV, HCV treatment will be a short course . Unlike HIV, some people are cured with current hepatitis therapy . Starting HCV therapy soon after you contract HCV may offer you the best chance of a cure
Hepatitis C was first identified in 1989. It is spread through blood-to-blood contact and it may take “Life’s challenges are not many years for symptoms to develop. It may also supposed to paralyse you; be contracted sexually. Unlike hepatitis A and B they’re supposed to help you there is no vaccine to protect you, but treatments discover who you are.” are available. Unlike HIV it is possible for you to cure hepatitis C with a short course of treatment. People who complete hepatitis C treatment and have no measurable hepatitis C virus in their blood six months after completing the course are called sustained viral responders. These people are said and Australia. These strains respond to treatment to be cured. more easily and require a shorter treatment course.
There are six different forms or genotypes of HCV. Genotype 4: found most often in the Middle East Whilst the genotypes do not predict how serious and Africa – like genotype 1 it requires longer your disease may be, they can predict how long treatment and is less likely to be cured with current you will need to be treated for and how likely you treatment. are to get a cure from treatment. Genotype 5 and 6: are much rarer (6 is often seen Genotype 1: found mainly in Europe and North in Egypt) and requires longer treatment is needed America, usually needs a longer course of in chronic (established infection). treatment and is less likely to respond to current treatment. Typically, people who have chronic hepatitis C genotype 2 or 3 will need treatment for 24 weeks. Genotype 2 and 3: found mainly in Europe, North People who have genotype 1, 4, 5 or 6 will need America but also widely throughout the Far East treatment for 48 weeks.
22 People vary widely as to how quickly their Ribavirin (tablets or capsules) are taken twice a liver condition worsens, and it is difficult to day. Ribavirin alone does not work against HCV, it predict.Some factors have been linked to faster needs to be taken alongside interferon. progression: There are two licensed pegylated interferon . The older you are at infection injections, and 2 types of ribavirin tablets: . Being HIV positive Pegasys (peginterferon alpha-2a) – a prefilled . Being male weekly injection and Copegus (ribavirin) 200mg . Drinking alcohol tablets (dosed between 800mg to 1200mg in two . Co-infection with hepatitis B (HBV), hepatitis D separate doses). (HDV) . Being overweight PegIntron Redipen (peginterferon alpha-2b) is a . Having diabetes weight-based injection pen, and Rebetol (ribavirin . Smoking tablets) 200mg (dosed from 800mg – 1400mg in two separate doses.
Treatments for HCV If you are given interferon alone it is likely that you cannot tolerate ribavirin or your hepatitis has There are two types of drugs to treat HCV – been picked up very soon after infection. If you interferon and ribavirin. are uncertain about any aspect of the medication you are prescribed it is always best to discuss this Interferon is a natural protein which is made by with your healthcare team. You can always get your body to fight viruses (but we do not produce advice from a community treatment advisor at a enough by ourselves to combat HCV). Interferon voluntary sector agency. It is important to avoid needs to be injected subcutaneously, (that means pregnancy before, during and 6 months after your under your skin normally into the fat in your treatment. stomach). For some people the side effects of hepatitis Standard interferon doesn’t last long in the body C treatment can be very hard to live with. At so needs to be given at least three times a week. worst you may experience extreme tiredness, A new longer lasting pegylated interferon became depression, weight loss, flu-like symptoms. available a few years ago. Pegylated interferon has Some people benefit by also taking anti- been modified so it lasts longer in your body – it depressants or medication to treat anaemia (low has to be injected once a week subcutaneously. red blood cells).
Genotypes Genotypes
Treatment Treatment
23 starting hep C therapy What if I am HIV positive and just diagnosed with hep C? Jane Phillips If you are living with HIV and have contracted HCV recently (in the last six months) you have a window of opportunity to take interferon and ribavirin treatment for a shorter period than people who Monitoring Tests have established (chronic) HCV.
Alongside a range of liver function tests you may Taking treatment soon after infection with HCV need a liver biopsy (where a small amount of may also increase the chance that you will clear liver tissue is removed to see how much fibrosis the virus completely. One European study found (or scarring) is present. More hospitals now have no additional benefit to hepatitis C treatment access to a fibroscan which measures the stiffness longer than 24 weeks if people with HVI started of your liver. This may avoid you needing to have within six months of infection. a liver biopsy. Many people with HIV have had acute (recent) You will need a blood test to identify which HCV infection picked up by abnormalities in their genotype of HCV you have as well as a HCV viral regular blood work (your liver function is often load test to measure the amount of HCV in your measured alongside your CD4 count and viral blood before you start treatment. Anyone starting load). A rise in liver function can suggest recent interferon therapy should have an eye test HCV infection. (especially if you are diabetic). If you find yourself in this situation, think seriously about HCV treatment. At 12 weeks you will be tested to see how well you are responding to treatment. Ideally your HCV Baseline: viral load should be undetectable at this time. If you have not had a good enough response your . Be prepared for the side effects doctor may advise you to stop therapy. . Commit to lots of hospital appointments . Eat well, rest and have a good support system At six months you will have a HCV viral load test to in place see if the virus has been cured. . Have questions and notes ready to take with you each time you visit the clinic New medications Lifeline: New HCV drugs, currently in late stage clinical trials, may be available in the coming years. For further information see: These will have to be taken alongside existing www.hepctrust.org.uk treatments. Right now we don’t know very much www.hcvsupport.org about how well these new treatments will work in www.beincharge.com people living with HIV and HCV. www.pegassist.com
24 GD: 17208 Printing Process: Offset Process: Printing
One hundred per cent dedicated to HIV medicines and research, focused on the needs of those affected by HIV, and committed to innovation.
UK/HIV/0066/10 June 2010 www.viivhealthcare.com Y K +(4 Colors) C M 1 Colors: 14.8x21 Pages: Size: Distiller 8.0 in: Acrobat Indesign CS3 Generated File: Native
GSKEDC-UK-2010_2060_Viv Ad A5_D1.indd 1 6/28/2010 7:28:59 PM The BASELINE team attended the Second Joint Conference of the British HIV Association (BHIVA) with the British Association for Sexual Health and HIV (BASHH) in April at the Manchester Central Convention Complex. Around one thousand medics, HIV journalists and community advocates attended the four day meeting. View the presentations online at: www.bhiva.org/AnnualConference2010Presentations.aspx We would like to thank Gilead Sciences Limited, Bristol- Top Nurse Nicky Perry with Myers Squibb and Merck Sharp & Dohme Limited for Robert Fieldhouse making our attendance possible.
BASELINE’s Jane Phillips & Chris O’Connor
Crusaid’s Ian Leckie with Robert Fieldhouse
Top nurse Sheila Morris with Gilead’s Stephen Head and Debbie Flanagan
ViiV Healthcare’s Kyle Patel Veronica Oakeshott APPGA
Viiv Healthcare’s Anna Lawson and Mortimer Market Centre’s Dr Tristian Barber
Robert Fieldhouse with Ben Cromarty, The stand looked great. Thanks Myck North Yorks AIDS Action
26 * Providing specialist and peer * Promoting positive attitudes and support, advocacy and information equitable access to health
* Promoting involvement, voice * Campaigning against and visibility discrimination
A national charity providing www.positivelyuk.org peer led support to people email: [email protected] living with HIV call: 020 7713 0444
Registered charity number: 1007685 347-349 City Road, London EC1V 1LR the journey... part 3
Julie Musonda
Life, for the last five years, has been like the biggest suddenly brought home to me, that even in my and fastest rollercoaster at Blackpool Pleasure sheltered life, I’d taken stupid risks whilst on my Beach. The lows were deep, dark and raining and travels abroad. Risks, I’m sure we’ve all taken at one the highs were warming, with blue skies and time or another. pretty flowers. Disclosure was one of the biggest issues of my illness. Who can I tell? Who needs to ‘I’ve come a long way from the know? days of carrying spray bleach.’
I’ve come a long way from the days of carrying I eventually confided in my very best friend and to spray bleach with me when I went to stay in a this day she has been my rock. For that, Michelle, I hotel for the weekend or washing fresh foods thank you and love you for the support you have with sterilising fluid as I didn’t want to die of given me over the past five years. Slowly I told food poisoning! The internet was a minefield of key members of my family who have all remained information, some true and some absolute crap faithful to me. But my parents, well that’s another but all very believable when you’re vulnerable. story. I strived all my life not to disappoint or bring shame on my parents and here I was about to blow A year after I got diagnosed I married my their world apart. I chickened out and to this day perpetrator; for love I thought at the time. But in they don’t know. They don’t need to know. My only hindsight I’d now say it was for security and out of wish is I could be honest enough to tell everyone, anxiety about dropping this particular bombshell however, you wouldn’t introduce yourself as to a prospective new beau. It was hard enough, at “My name’s Julie. I’m a diabetic.” So actually why my age to mention to a new sexual partner that does anyone need to know? All those who are he should use a condom. I was sterilised when important to me know my diagnosis, and to the I was 23 years old and condoms never seemed rest of the world…… it’s not important and none necessary. Hindsight is such a beautiful gift. It of their business. 28 You WANT To geT oN BuT PeoPLe WoN’T LeT You let’s talk HIV STIGMA
The person depicted in this advert is a model.
Talking to people who understand your concerns can really help. Contact one of the groups below (or your local HIV community organisation) A Promise for Life for friendly confidential advice.
w: nat.org.uk t: 020 7814 6767 w: tht.org.uk t: 0845 122 1200 w: ahpn.org t: 020 7017 8910 w: positivelywomen.org.uk t: 020 7713 0222
Date of preparation: September 2009 AXKAL092647
A5_LETS_TALK_HIV_STIGMA_BOY_v1.indd 1 26/02/2010 15:07 thick as thieves: HIV and stigma
Chris O’Connor Yet only 14% of respondents felt that HIV positive The Stigma Index may sound like the latest women should have children, despite the fact that thriller from Dan Brown but ‘The People Living medication exists to prevent mother-to-child HIV With HIV Stigma Index’ is far from a light read transmission. and has been received as a damning report into the stigma and discrimination many positive The inside view people in the UK face today. So what do HIV positive people in the UK say about being on the receiving end of stigma and The community research known as Stigma Index discrimination? During 2009 the Stigma Index comes at a time when the consequences of interviewed 867 people living with HIV in the UK HIV stigma are increasingly being recognised. about their experiences over a 12 month period. Despite advances in antiretroviral treatment, late diagnosis is still common and a significant, stable One in five had been threatened, harassed or proportion of people are still not coming forward verbally abused according to the Index. The for HIV testing: with stigma playing a big part. same amount said they had been denied medical treatment because they had HIV, with GPs, and Recent surveys in the US and Australia made dentists being identified in particular. Almost for shocking reading. A survey in March 2009 60% per cent of participants had doubts that their by GMHC in New York compared attitudes now medical records were being kept confidential. to those a decade ago. Many perceptions have not changed at all - many Americans still do not Sigma on stigma want to work with an HIV positive person, share Research in this area is nothing new. In the UK, an apartment with them or have an HIV positive Sigma Research has produced a raft of data into individual teaching their children. stigma and discrimination over the years, mostly using questionnaires and online ‘self completion’ When the focus is more specific the results can be research models. even more depressing for positive people. A study from 2007 by the American Foundation for AIDS So what is so different about Research (amFAR) captured the attitudes of five the Stigma Index? thousand Americans on HIV and women. Kevin Osborne, Senior HIV Advisor, International Planned Parenthood Federation (IPPF), one of the In response to the question; should a woman with Index partners, argues, “It’s unique; people with HIV the following conditions have children? 59% said have never been asked directly and systematically women with cancer should, 47% said women with about the stigma they face and the questions were depression should, 37% said women with multiple put by other HIV positive people. We are asking sclerosis should, 20% said women with hepatitis the same questions in 17 other countries, this will C should and 19% said women with Down’s give us a baseline monitoring tool to analyse and syndrome should. compare changes to stigma over time.”
30 The process of gathering this information is as Giving the index finger to important as the end product say Stigma Index. stigma launch They championed a community research model, and trained 35 positive people to interview Annie Lennox, singer songwriter and activist; the participants in the Index. “It is HIV positive Professor Jane Anderson, Homerton Hospital people saying ‘I am involved in the process,” the and David Borrow MP, then Chairman of the All- researchers are HIV positive, the analysts are Party Parliamentary Group on AIDS, launched the positive - this way people feel they have a much Stigma Index report at the House of Commons. bigger buy-in,’ says Osborne. The UK Secretary of State for Health at the time, “1 in 5 had been denied medical Andy Burnham MP, was due to address the launch treatment” but was detained by ‘unavoidable parliamentary business.’ The overwhelming majority of the 867 participants were people living with HIV who are accessing HIV In a statement to BASELINE Burnham said: ‘I service organisations, and not those outside the welcome this report…tackling HIV stigma is support system. A criticism of previous studies has everyone’s business. We will carefully consider been that groups such as women and migrants are this reports’ findings.’ A subsequent meeting with often under represented. the DH was requested by the Stigma Index. This did take place but ministers have all since been Stigma Index say their interviews included hard to replaced in the General Election. Burnham is now reach groups such as ex-prisoners, men who have running for the Labour leadership. sex with men, sex workers, migrants documented and un-documented, “Did we reach all corners? Stigma Index want to see the current orientation of No - we didn’t get to some people, we need more UK HIV services realigned - although 88% per cent people in rural areas for example. However, we feel of participants knew of organisations to access there has been a word of mouth effect - we will get help, only 28% had actually sought their help. HIV more next time.” and criminalisation is another area that crystallises prejudice and discrimination and has to be fought. The initiative is a partnership of two international groups, the IPPF, the Global Network of People Not all the data was bad news, the report Living with HIV (GNP+) and the International highlighted that people living with HIV are ready Community of Women with HIV/AIDS (ICW) to take responsibility - over 60% of people in the together with UNAIDS. Funding the initiative is Index said that they felt they could change attitudes the M.A.C AIDS Fund (M.A.C Cosmetics) who have if they themselves challenged discrimination. committed £300,000 to producing the Stigma Index in the UK.
31 thick as thieves:
HIV and stigma civil partnerships and the Disability Discrimination Act of 2005 have all helped to address HIV-related stigma. Most observers agree that much HIV Chris O’Connor stigma can be homophobic in origin and the recent legislation can undoubtedly change attitudes. So what’s been going on in the UK? The HIV stigma faced by migrants to the UK, within In 2001 the UK government published the first ever their own community and outside appears to be strategy for sexual health and HIV; The National lower on the DH agenda. Although the mantra Strategy for Sexual Health. One of its five key aims ‘attitudes are slowly changing’ is often cited by was reducing stigma around HIV and sexually observers, dedicated money and focussed strategy transmitted infections. Apart from reducing social is wanted by positive people and representatives exclusion, the strategy acknowledged that stigma who spoke to BASELINE. hindered access to services, HIV diagnosis and The protection offered by the law under the Hate fuelled onward transmission. Crime category by the Crown Prosecution Service It took a while but in 2006 the Department of Health has been widely welcomed. (DH) launched a specific action plan to tackle The area where the DH might directly effect HIV-related stigma. The DH spent £250,000 with change in attitudes could be in employment. National AIDS Trust (NAT), Terrence Higgins Trust Many people who contacted BASELINE spoke of (THT), NAM, MedFASH and the African HIV Policy the understanding and professionalism of workers Network (AHPN). Through these organisations in the NHS when dealing with people living with stigma would be tackled in the media, workplace, HIV. However, some noted attitudes, as identified education of health care workers, gay men and in by the Stigma Index, that left them feeling African communities. marginalised. With 1.3 million employees the NHS The Tackling HIV and Discrimination programme could start fighting stigma far closer to home. of work ran until 2008. Since then the DH has taken an ad hoc approach to challenging HIV Stigma index latest stigma, funding AHPN to develop two toolkits to It’s been fairly quiet on the Stigma Index front help Christian and Muslim faith leaders tackle HIV since the high profile Parliamentary launch last discrimination – launched in 2009. year. Activity is expected to peak again in August once the raw data have been put together with The DH has supported projects where stigma people’s stories. and discrimination are addressed incidentally to the major aims of the organisation project; for The Stigma Index hopes that making the complete example by funding a number of community- data sets available to HIV community groups may based HIV testing services. Recently the DH funded help organisations bid for funds to challenge HIV a publication by MedFASH aimed at clinicians to stigma. For information contact Lucy Stackpool- support them offering HIV testing in a range of Moore at the International Planned Parent hospital settings, as well as the ongoing work of Federation. Email: [email protected] THT and NAT. A 45-minute film based on the experiences of the The DH has also supported a reprint of NAM’s HIV Stigma Index’s HIV positive researchers is soon to and Stigma booklet. be previewed on YouTube and the Stigma Index website: Recent legislative changes are laying the foundations against HIV prejudice: the repeal of www.youtube.com www.stigmaindex.org Section 28, the equalisation of the age of consent, This article was sponsored by Abbott Laboratories 32 launches online August 1 www.baseline-hiv.co.uk Got an event or product you’d like us to promote? Email [email protected] Models Needed THT is looking for under 21’s who identify themselves as lesbian or bisexual to model for a new website called Talksafe. The website is where young people can go for advice on all aspects of growing up. Under 16s will need parental consent. If you are interested contact: tel: 020 7812 1626, or email: [email protected]
Please complete GP survey Funk for Life The HIV Forum Link Project is seeking the help Swedish funk and jazz trombone player Nils of positive people to shape future medical care Landgren’s project to inspire and nourish children services. Just complete a five minute online with music making has already seen some survey about GP services and how you want them incredible results and one euro from each CD to develop. sold will be donated to the aid organisation for This information will help equip patient groups this unique project in Kibera, Nairobi, one of the consulting the NHS on the future delivery of biggest slums in Africa. Primary Care services. Buy it at www.amazon.co.uk The survey is one of the first ventures undertaken by the new HIV Positive Link Forum Project, an umbrella organisation to support HIV positive Positively – Courtney Sheinmel patient groups across the UK and to help people Captured with honesty and perception, the start new patient groups. complicated thoughts of thirteen-year-old Emmy The website is at www.forum-link.org Price as she navigates her life during difficult months following her mother’s death from AIDS. The survey is at: Emmy, who’s HIV-positive, not only must deal www.forum-link.org/research/gp/survey with the loss of the person she loved the most, but must face her own illness with a new sense of More info is available from Paul Decle on 020 7738 heart-wrenching reality. 0258, 07919 554 635 or at: [email protected] Buy it at www.amazon.co.uk
34 Canary – ETT English Touring Theatre Written by the multi award-winning Jonathan Harvey (Beautiful Thing, Gimme Gimme Gimme, Hushabye Mountain & Coronation Street), Canary is a deeply moving, funny, uplifting and often magical story about love, honesty and being brave enough to sing out at the top of your voice - with style. Dates throughout UK during June and July. www.ett.org.uk/Productions/2010/Canary
The Spider and the Fly Adrienne Seed’s autobiography The Spider and the Fly is a moving love story with a terrible twist to the tale. Spanning continents and decades, this is the voyage of a young girl to a woman, entangled in the web of a fascinating but ultimately destructive relationship. Told with humour, poetry and pathos, this is a true story that you won’t forget, and one which may even save your life. Buy it at www.lulu.com
35 Shift from AIDS to non-AIDS deaths continues Death rates among people living with HIV fell dramatically after the introduction of antiretroviral news: treatment therapy in the mid’ 1990s. Over the past 10 years the most common causes of death have shifted Robert Fieldhouse from AIDS-related opportunistic infections such as pneumocystis carinii pneumonia and Kaposi’s sarcoma to non-AIDS conditions such as heart and First maturation inhibitor in liver disease, and non-AIDS-defining cancers such development halted as lung cancer, according to the findings from the Myriad Genetics has announced it is suspending large Antiretroviral Therapy Cohort Collaboration. its HIV drug development programme. The Overall, 5% of the patients in the study died. Whilst company says it is taking this step “for strategic, AIDS accounted for almost half of all deaths, the business reasons; and a reduction in workforce.” most common non-AIDS deaths were caused by Myriad had been developing a maturation non-AIDS cancers (11.8%); non-AIDS infections inhibitor called bevirimat (MPC-4326, PA-457) (8.2%); causes related to violence or drug use after purchasing the rights to the drug from (7.7%); liver disease (7.0%); heart disease (6.5%). Panacos Pharmaceuticals in 2009.
ART cuts HIV transmission 90 per cent in heterosexuals People living with HIV taking antiretroviral therapy (ART) are 92% less likely than untreated individuals to transmit HIV to their heterosexual sexual partners, according to an African study reported in The Lancet. Among untreated partners, greater transmission risk was associated with lower CD4 cell count and higher HIV viral load. The researchers concluded that ART could be an effective strategy for achieving population-level reductions in HIV transmission. Morphine may offer protection against HIV-related brain impairment End of the road for Apricitabine Morphine, a pain-relieving drug derived from On May 10, the biotechnology company Avexa opium poppies may help protect the brain from announced that it is halting development of its HIV-related damage by interfering with HIV’s investigational nucleoside reverse transcriptase ability to enter cells, according to a study in mice. inhibitor (NRTI) ‘apricitabine’ after failing to find The researchers were keen to emphasise that a licensing partner. Apricitabine demonstrated people should not use morphine or similar drugs potent antiviral activity, good tolerability, and like heroin to protect their brain, but suggested minimal resistance in clinical trials , but its twice- these findings may offer clues for designing daily dosing placed it at a disadvantage compared future drugs to prevent neurocognitive to currently available once-daily NRTIs. impairment in people with HIV. 36 Gene linked to long-term non Second generation “Atripla” on progression identified the way People with HIV who naturally maintain a very Gilead Sciences recently announced that it is low HIV viral load without taking antiretroviral moving ahead with the development of a once- therapy and don’t experience disease progression- daily single-pill coformulation of their nucleoside/ known as “elite controllers” are likely to carry a nucleotide reverse transcriptase inhibitors gene variation, HLA B57, that is associated with tenofovir and FTC (Emtriva) -the 2 drugs in the a stronger and more effective immune response Truvada combo -plus Tibotec’s investigational against HIV, according to a study recently non-nucleoside reverse transcriptase inhibitor published in Nature. rilpivirine (TMC278), which recently demonstrated On emergence from the thymus (where CD4 T cells promising efficacy in a late stage clinical trial. mature), T-cells of elite controllers appear to be Rilpilvirine is Tibotec’s second NNRTI. The new primed to recognise and respond strongly to HIV coformulated drug should be available in Europe proteins. at the end of next year. The companies are also working toward an Frequent drinkers lose CD4 agreement to make the fixed-dose combination of cells Truvada and TMC278 available in the developing People with HIV who drink alcohol frequently (two world. or more drinks per day) are almost 3 times more Sideline: likely than infrequent or non-drinkers to have their cell count fall to 200 cells/mm3 or less. Protease inhibitor: a class of HIV drugs that inhibit HIV’s protease enzyme The risk was 7-fold higher among people not taking antiretroviral therapy. Frequent drinkers HIV viral load: the amount of the virus’ genetic also had higher HIV viral loads on average. The material (RNA) in a tiny amount of your blood researchers suggested this was likely related to CD4 count: the amount of immune system co- their poor treatment adherence. ordinating cells in a tiny amount of your blood Antiretroviral drugs: drugs which inhibit HIV, which is a retrovirus High homocysteine levels NRTIs or nucleoside analogues: a class of HIV common among people on HIV drugs that inhibits HIV’s reverse transcriptase meds enzyme which translates viral RNA into DNA. People with HIV taking antiretroviral therapy often Maturation inhibitor: a drug class which binds experience increased levels of homocysteine -- an to the HIV protein gag and renders the resulting amino acid that may damage blood vessels and virus particles incapable of infecting other cells. contribute to increased cardiovascular risk after Neurocognitive impairment: a brain disorder in six months of HIV treatment, according to research which thinking abilities are mildly impaired. published in JAIDS. Kaposi’s sarcoma (KS): a tumour caused by It currently remains unclear if lowering human herpes virus 8 (HHV8) homocysteine levels can prevent heart attacks Pneumocystis carinii pneumonia: a form of and strokes. The researchers suggested that pneumonia. Pneumocystis is found in the lungs treatments to lower homocysteine levels should be of healthy people but being an opportunistic evaluated in people with HIV. But, they concluded, infection causes a lung infection in people with studies of various approaches (such as vitamin B lowered immunity. supplementation) in the HIV negative population Thymus: the place where T-lymphocytes or T-cells have shown ‘...variable degrees of success.’ (immune cells) are produced. 37 Aids took their family
…don’t let it take their future too.
Eight-year-old twins, Lily and Isaac lost their mother to AIDS. Isaac escaped the virus. Lily didn’t. Despite her age and poverty their grandmother tried to care for them. But it was too much and she had to hand her daughter’s babies over to an orphanage. There are 33,000 AIDS orphans just like Lily and Isaac in Mombassa, Kenya. Please help us to help them. Please give online now at: www.aidsorphan.net
Aids Orphan UK Trust is a company limited by guarantee in England 7034018. Registered charity number 1133364. Registered office: Hanover House, 14 Hanover Square, London, W1S 1HP. introducing AIDS Orphan (UK Trust)
Ian Govendir
AIDS Orphan became a registered charity in There are huge issues to be overcome: December 2009. The organisation was established in response to the growing AIDS epidemic .Telling the children they are HIV positive worldwide. UNAIDS estimates by 2015 there will .How to deal with stigma be more than 25 million children who face being .How to be able to disclose their status in a orphaned by HIV. This must count as one of the confident way biggest humanitarian disasters the world has ever .How to act as responsible sexually mature adults known. The children usually live with their extended A group of concerned people decided that family who struggles to feed an extra mouth. something had to be done so we set up AIDS Because they are seen as AIDS orphans they often Orphan as a UK-based NGO. AIDS Orphan is a grant become neglected and sometimes do not eat and making organisation that works with partner are sent out to work. Even when attending school organisations in the developing world where the they often cannot afford to have school uniforms problem is more predominant. or a meal. As a last resort some children become abandoned and they end up in an orphanage. While we are in our infancy we believe that there is room for another charity that dedicates all of The children are faced with enormous its work to helping children who have lost their psychological challenges around abandonment. parents. As such, it was decided to concentrate Our first programme is based in a major slum our work on the psychological support of children. area of Mombasa where we are setting up a programme to train local children’s home staff to Our initial project is in Mombasa, Kenya, where it is deliver counselling to the children. This is being estimated there are 33,000 AIDS orphans. We have done by sending out qualified psychologists from a network of people and partners on the ground the UK to train up home staff. We are also training who deliver much needed help. We are currently nurses from Mombasa hospital to deliver courses working with an established children’s home and of counselling to the affected children. Mombasa hospital. We will work with children in homes to identify When setting up the charity it soon became very the neediest children in the surrounding slum evident that 80% of children who have been areas where we feel the greatest need is. For more orphaned by HIV/AIDS were HIV positive. information on the charity and ways to help, please All of the children face enormous challenges in go to www.aidsorphan.net or their life, not having parents and having HIV. call Ian on 020 7 624 3011
39 my fight for universal access
Alex A from Romania
Disruption to the antiretroviral treatment supply in Romania due to lack of funding has recently made headlines within the country and abroad. The local NGOs have put up an unprecedented campaign to raise awareness of this situation and to make the local authorities take responsibility for their actions.
Most of those affected by these decisions were powerless in the face of the inevitable.
As a person living with HIV in Romania for ten years and who has been on medication for seven years without interruption, I faced a crucial decision.
Here is the story of my journey within the intricate maze of a rotten medical system.
40 I was diagnosed HIV positive in the year 2000. But the main building of the infectious diseases That year the world did not come to an end. hospital wasn’t an architectural marvel either. For Nevertheless my own little universe did start to years it made me think of scenes from movies about crumble to pieces. It took me more than a decade World War II. I kept remembering the day when the to reconstruct the puzzle and I am still not done. new windows were put in. Everybody was in awe. Not one person seemed to be bothered about the To those who think that there is nothing worse falling coating or the smoked down façade. For than receiving a death sentence at 19, I suggest them, those were just minor details, but I couldn’t they think twice. In my case, the place where I disagree more. live gives the story a whole new twist; being HIV positive in Romania is no walk in the park. The main building of our infectious diseases hospital did not see any major refurbishment in Romania became a member of the European Union years. in 2007. Everybody looked upon that event with the eyes of a child receiving a Christmas present. However during my time spent abroad, even I For me, as a person living with HIV it meant not became less sensitive to those shortcomings. only freedom, but the promise of a future. The Distance, both spatial and temporary did its opportunity to take my whole life to the next level healing magic on me and I began to think that I came with a scholarship that I won the following was finally living my dream. I was away from the year. Within the nine months that I spent abroad past, well grounded in a present that fulfilled me the only thing that kept me connected to the old and that made me able to envisage a better future. Romanian reality was my HIV treatment. Unfortunately this state of balance didn’t last for too long. When the scholarship ended and I had Babies get their vital fluids through the umbilical to go back home, it felt like being diagnosed all cord. I got my ARVs through the mail system. Every over again. After nine months of absence, home two months my mother made it possible for me to sweet home welcomed me with a crooked smile see my survival kit arrive safely at its destination. and plenty of disappointments. I had to restart my As soon as the parcel was in my hands I felt blessed. visits to the clinic and the old depression kicked back in stronger than before. Still, every now and then images from home kept haunting me. Among the hardest to forget was Each time I entered the hospital yard I saw the the anti-rabies facility where our blood would be same picture. It was the desolating image of a cold drawn. Strangely enough this did not take place metal fence placed where a clinic for HIV positive in the main building of the clinic, but in a smelly patients was supposed to be built by a local NGO basement covered in damp. using external funding. 41 my fight for universal access
Alex A from Romania Global Fund. Now that we were left on our own, the lives of so many PLWHA were in great danger. I couldn’t even remember the year when they We were simply the victims of a very defective began the construction. It was so long ago that resource management plan which together with hardly anyone knew the reason why the project the international economic crisis had turned into had been abandoned. Nowadays only the fence a disastrous cocktail. and some construction material scattered on an empty ground remain; the silent witnesses of the With my head bursting from all the turmoil inside, repeated failures of our beloved medical system. I kept talking to everyone I could think of and I got pretty much the same answers. In Romania, as But these failures were not my own. Sure I was PLWHA we were not important enough to matter directly affected by them, but I still thought I could in the big economic equation. Our lives were do something to turn things around. That is why simply dismissed. I decided to try to leave the country again as a volunteer. Little did I know at that moment that the Call me an incurable idealist or even naïve, but I system had yet another blow prepared especially just couldn’t accept this approach. This attitude for me. and my constant effort to contact as many people as possible did pay off in the end. Telling my story Ironically enough I got hit right in the face on April and fighting for my rights brought me not one, Fool`s Day 2010 when my doctor announced, but two life-saving donations. Now that I had without any ceremonial undertone, that I was not my treatment secured for three months ahead I going to receive my treatment for that month due should have felt relieved. Instead of that, I got even to a delay in the payments to the drug distribution more apprehensive about the future; It no longer company. Apparently I had absolutely no say in looked promising, but gloomy and dark. this. Immediately it became crystal clear to me that I couldn’t stay put and let others play with my What use is my own comfort, when so many other life. So I decided right there and then that I must people living with HIV in Romania don’t have their take the whole matter in my own hands. Instead treatment secured? For how long can I count on of constantly worrying about the effects of the the generosity of strangers to ensure my survival? treatment interruption on my general health, I took immediate action. Through putting all my All these questions made the puzzle of existence energy into research, within only a few days, I got harder than ever to solve. However, I am to the core of the entire mess. determined to keep on trying. Between the flight or fight responses to this life- threatening situation I found out that our government had actually I chose to stand up for myself and for my human been covering ART with domestic resources for rights. the past few years. This information contradicted my previous knowledge that the funding for ARVs One could say I won my first battle, but I know that in our country came from external sources like the the real war has only just begun. 42 ABplus is a Birmingham-based charity for people living with and affected by HIV. Established in 1996 our membership has grown to over 500 members.
We offer practical and emotional support both to people living with HIV and their partners, close friends and family.
Our services: • Weekly debt advice surgery in partnership with Birmingham City Council • Assistance with grant applications or benefit forms • Counselling • Monthly gay men’s and women’s peer support groups • Free complementary therapies • Drop in Monday and Friday 10.30am-3.30pm • Hot Meal Service • Food bank for people in need • HIV & STI testing Wednesdays 2.30pm-6pm – no appointment needed • Positive Steps Training programme for people thinking of returning to work
Contact 0121 622 6471 or email [email protected] 29-30 Lower Essex Street, Birmingham, B5
Are you a 50+ gay man who lost friends and/or partners to AIDS during the 1980s and 1990s?
The Lost Generation: The Social Worlds of Older Gay Male Survivors of the AIDS Epidemic Principal Investigator: Dana Rosenfeld, PhD. Senior Lecturer in Sociology, Keele University Aims of the Research: To interview 30 self-identified gay men, currently aged 50 and older, who lost friends and partners to AIDS between 1982-1996, to find out about their lives and how the AIDS epidemic affected them in their early years and afterwards, up to and including the present. The research will seek to understand how the AIDS epidemic of the 1980s and 1990s affected your social networks, and how you rebuilt them in the aftermath of the epidemic. The research will also look at how the AIDS epidemic has affected your personal lives and identities. For more information about taking part, contact [email protected] i-base with other HIV-positive men. This doesn’t sound Q & A healthy unless it was your choice. While HIV knocks everyone for a while, it can also make you more isolated and less confident and if this continues can lead to depression and other problems. Simon Collins In the context of anonymous sex where your partner is unknown, then the risks support you using condoms every time. When you can talk to your partner about treatment, resistance, and other infections including hepatitis C (HCV), then sero-sorting can be an amazingly powerful and liberating aspect of life for many people. Question: But you need to talk, and then trust the information. If I have unprotected sex with other HIV positive people will I get resistance? The more you talk, the easier it gets. Many people find it easier to be out about their HIV status Hi, I’m an HIV-positive gay male aged 31 and I was online than in bars, so that can be a good place diagnosed and infected in 2008. My CD4 count is to practice. 670 and viral load is 31,000. My health is good and I’m not on meds. In general, anyone who has an undetectable viral load for 6 months or so will be less likely to I’ve been scared to sleep with other positive men transmit HIV than someone not on treatment. Viral through fear of catching treatment resistant strains load is probably the most significant risk factor. or worse. I am a passive partner and I’m afraid my question relates to unprotected sex. I am aware of But you also need to balance the clinical the risks - it got me in this situation! implications if reinfection occurs. Based on current evidence, the main risk from reinfection, If I were to sleep with an HIV positive guy, is it is resistance. The more resistance either of you better for me if he is on meds and undetectable has, the more drugs that could be wiped out if or would that put me more at risk of developing that strain is transmitted. If neither of you has resistance? resistance, and have never taken drugs, then even if reinfection occurs, it is unlikely to have any Now I can ‘sero-sort’ I’d like to know what’s likely to impact on future treatment. be the safest way to prevent my situation getting any worse, be it developing drug resistance, Have you had a resistance test? Most HIV positive superinfection or other hard to treat infections? people will have had a resistance test and will know the general results. Your potential risk to I am also immunised against hepatitis B (HBV). Am other HIV positive partners is as important as their I truly safe against this if I were to unknowingly risk to you. come into contact with it? If either of you has resistance, you need to balance the risk again. Multi-class resistance is very Answer: serious – it is like catching HIV in 1985. The clinical implications are that none of the resistant drugs Thank you for your question. Lots of people are in will work. Resistance to one class is serious too. If a similar situation to you so taking time to go into you lose the NNRTI family, you will be taking more the details is important. pills when you do start treatment. Sex is an essential part of life for most of us. HIV The risk from STIs (sexually transmitted infections) complicates this, but it should not stop you having should be lower if you know your partner. HCV is a healthy sex life. I interpret your question as if sexually transmitted among HIV positive gay men, you have stopped having sex, because you talk though how this happens is less clear. As a blood- about sero-sorting and are worried about risks borne virus, rougher sex, where there is a risk of
44 being exposed to blood is probably one of the key factors. Group sex and shared toys or lube are also potentially risky. HBV vaccines can protect against HBV for many years. You should also have a vaccine for hepatitis A. The level of immunity you have can and should be checked by your HIV clinic every year. This is cheap and easy and will tell you whether the vaccine is still protective or whether you need a booster. So in summary, the safest way to protect your health is to talk and be honest. The coalition government Most HIV positive people are very happy to discuss their health and how they are doing, or to support is to produce a White someone else who is new to this. This is where we paper in July on prevention can all support each other. and public health 4:55 PM Jun 10th via Echofon Whatever you decide as an acceptable risk for you, the most important thing is to feel in control about your health from now on. Lot of uncertainty about where HIV and sexual health fit in the new government’s agenda according to DH spokesman at conference in Leeds 4:47 PM Jun 10th via Echofon BASELINE would like to thank Debbie Maiden at HGL in Birmingham for all her help getting the magazine distributed across the West Midlands 12:02 PM Jun 9th via web
Well done Gilead and NAT walkers for being in top ten highest fundraisers last Sunday at CRUSAID W.F.L http://www.walkforlife.co.uk 7:28 AM Jun 8th via web
Aids denialist Pete Duesberg, under investigation by Uni of California, after paper to ‘Medical Hypotheses’ forces publisher to peer review 2:10 AM May 3rd via web
TM
Follow Charlie, the BASELINE cat who tweets at www.twitter.com/baselinetweet45 happy HIV birthday!
Joel Korn
On 23rd April 1984, scientists in America announced HTLV-3 as a variant of a known human Joel Korn cancer virus that had the same scientific make- decade I know that there are some organisations up as the LAV virus first identified in France. doing great work in HIV prevention and sexual This marked the discovery of the virus which health. But it frustrates me that three decades on later became known as causing AIDS. To avoid the general population, which has been indirectly confusion it was later renamed human immuno- affected by HIV, still think it will never affect deficiency virus or HIV. them. It amazes me that people who grew up in the 1980s, who are now parents, still believe it Coming from a fairly sheltered conservative is someone else’s responsibility to provide sex background in the Jewish community in north education information to their children – it is all London at the time, this new piece of information our responsibility. escaped my world. When I reached secondary school, sex education consisted of a group of When is our ‘monumental breakthrough’ going rowdy boys going through puberty, watching an to happen in preventing sexually transmitted badly recorded 1970s VHS tape showing a flower infections (STIs) across the age spectrum? becoming pollinated. The teacher could not even say the words “sex” or “sexual health” without Even the new radio campaign for hepatitis C does getting embarrassed. not mention sex.
‘Sex education consisted of a group of Our communities want to know and need access to rowdy boys going through puberty, more effective and hard-hitting health promotion watching an badly recorded 1970s messages. VHS tape showing a flower becoming pollinated.’ The Global Network of People Living with HIV reported, ‘an estimated 33.2 million people are My brother, who was five years older than me, living with HIV worldwide, of whom, 5.4 million are was given a Department of Health leaflet from young people. 40% of new infections are amongst my parents entitled: ‘Boys – all you need to know!’ 15-24 year olds, most of them female. However, in Later in life I was fortunate to have a worldly-wise the global response to HIV there is a massive gap older sister to educate me and we took it on as in the support and the meaningful and engaged our duty to educate our parents. Because my participation of youth living with HIV’. education took place during the Section 28 years, and I went to Jewish schools, sexual orientation In West London, where I work, in 2009 alone, was never spoken about. there were 10 people aged 24 or younger newly diagnosed HIV positive -this is only the tip of the Working in the sexual health sector for the last iceberg. 46 If there is a way to optimise your HIV management, how will you know?
Get informed. Talk to your doctor. Speak to your friends.
©2010 Bristol-Myers Squibb & Gilead Sciences VIEMEA10NP001 177/UKM/10-02/MM/1175 Date of preparation: April 2010 National AIDS Trust’s (NAT) Spring Awakening 2010 fundraiser took place at the Design Museum on May 13, raising over £50,000 for the charity. BASELINE’s Susan Cole won a prize in the Tombola. If you’d like to be come along to a future NAT event, email Jo Murch at [email protected] with the title ‘Event Registration’ in the subject heading, along with your name and postal address in the body of the email. It really was a fantastic night.
Photos Credit: Dean Ashton Richard Brierley, Auctioneer
Andre Rafael Dos Santos, Mohammed Amr Badreldin Hamdy and Gilson Batista Aggie MacKenzie, Martin Dibben, Deborah Jack
HIV writer Susan Cole, BASELINE editor Robert Fieldhouse and Kat Sladden, Communications Manager, NAT Crowd scene
Howard Charmon, Remi Saget and Tim Gutteridge The NAT Fundraising Events Committee
Silent Auction Pieces from the Broad Gallery 48 Get your own copy delivered to your door
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positive action for children
Robert Fieldhouse commitment to communities affected by HIV and AIDS: £50 million is being invested in the fund over the next ten years.
Back in 2001, the United Nations General Assembly set a target for 80% of pregnant women Dominic Kemps, Director of ViiV Healthcare’s and their children to have access to essential HIV Positive Action programme speaks to prevention, treatment and care by 2010 in the BASELINE. hope of reducing the proportion of infants born infected by 50%. If you had £50 million to spend on HIV, what would you spend it on? “UNAIDS is leading efforts around the reduction of mother to child transmission (MTCT) and ViiV Healthcare, the new HIV-focussed pharma together with the Global Fund has called for the company set up by GlaxoSmithKline (GSK) and ‘virtual elimination’ of MTCT by 2015. The PACF is Pfizer put this question to a number ofkey aligned to these goals, targeting at least eighty stakeholders- from the workers of multi-lateral percent of the money to be spent in Africa, at a companies to community groups of people living local community level where the need is greatest,” with HIV. Kemps tells me.
“We ended up with 17 priorities from 40 ”AIDS is now beginning to reverse conversations,” Dominic Kemps, who heads up decades of steady progress in child Positive Action, tells me. survival in Africa.“
For the past 18 years GSK’s Positive Action So what makes this different to the host of other programme has funded sustainable grass roots pharma-led initiatives to support people living projects in more than 50 countries. with HIV?
But a year ago GSK’s CEO Andrew Witty announced “This is something divorced from commercial a new and additional initiative, the Positive Action interest, but sits alongside what ViiV is doing to for Children Fund (PACF) “targeting NGOs (non- improve access to medicines in low- and middle- governmental organisations) and others working income countries. at a grassroots level to prevent mother-to-child HIV transmission (PMTCT).” “Remember these are women who are already accessing care to some extent, so by implication Responsibility for the development and they are accessible.” implementation of the fund was transferred to ViiV Healthcare following the company’s launch 77 per cent of women (70 million) in low- and last November and is now a key component of its middle-income countries access at least one 50 antenatal care appointment. This provides the There are a number of existing large-scale opportunity for all these women to have access international initiatives to prevent mother-to- to PMTCT and sexual and reproductive services. child transmission of HIV. These include: But, this remains a missed opportunity for most .The President’s Emergency Plan for AIDS women. Relief (PEPFAR) - (It is estimated that PEPFAR programmes averted almost 240,000 infant Every day, 1.4 million women give birth in low- and infections between 2003 and 2008) middle-income countries. In 2008, 430,000 infants were born HIV positive. .The Call to Action Project (set up in 1999, by 2008 had reached 5.2 million women with .Without treatment, about half of these positive access to PMTCT services) children will die before their second birthday. .Without intervention, the risk of MTCT ranges .The UN Interagency Task Team on MTCT from 20% to 45%. (In 2008, 45% of the estimated HIV positive .With specific interventions in non-breastfeeding pregnant women in low- and middle-income populations, the risk of MTCT can be reduced to countries received at least some antiretroviral less than 2%, and to 5% or less in breastfeeding (ARV) drugs to prevent HIV transmission to their populations. child, up from 35% in 2007 and 10% in 2004.)
Effective prevention of mother-to-child .MTCT-Plus (implemented through 14 clinical transmission requires a four pronged strategy. programmes based in nine countries throughout sub-Saharan Africa and Asia. Treatment and care 1. Preventing HIV transmission among prospective provided to 13,000 adults and children between parents - making HIV testing and other prevention 2002 and 2007) interventions available in services related to sexual health such as antenatal care. .The Global Fund (790,000 HIV positive pregnant women received PMTCT treatment up 2. Avoiding unwanted pregnancies among to November 2009) HIV positive women - providing appropriate counselling and support to women living with HIV “If we focus our efforts, we can make a difference,” to enable them to make informed decisions about Kemps stresses. The first round of Positive Action their reproductive lives. projects were being announced as we went to press. We hope to report on some innovative 3. Preventing the transmission of HIV from positive programmes in an upcoming issue. mothers to their children during pregnancy, labour, delivery and breastfeeding. www.viivhealthcare.com
4. For those women detected and for their families; Read the WHO’s PMTCT Strategic Vision 2010-2015 integration of HIV care, treatment and support. at: www.who.int/en 51 Tim Baros
I feel like I am carrying around a stigma. Not a through my mind: I had my evening dosage of physical one like a spot on my face or a really bad HIV pills in my bag and they were in an obvious haircut, but a stigma. My stigma is spelt “HIV.” small pill box. Yes, of course, this was the first thing that the bouncer grabbed out of my bag. He made ‘Lots of positive people are ashamed me open the pill box and explain. I told him that and fearful about their HIV. ‘ they were HIV pills (I came clean then about the pills being HIV medication as I didn’t want him So what is stigma? Stigma is defined as the and my new friend to think I had illegal drugs). phenomenon whereby an individual with an There was an awkward silence for a good painfully attribute, which is deeply discredited by his/her long 30 seconds and the bouncer then mumbled society, is rejected as a result of the attribute. something as I was trying to think quickly of what to say next. Eventually my friend and I both agreed Lots of positive people are ashamed and fearful not to go into the bar, but the damage was done. about their HIV. I ask myself ‘Do I feel that way?’ I have to say that at times. I do. I had been forced to come out as being HIV positive to my new friend and also to a complete The last time I came out to someone about stranger! Talk about going public, (even though it me being HIV positive it was in an extremely was accidental). I felt a little ashamed but luckily awkward situation. It was not even during a sexual my friend and I talked about it some more and encounter, unfortunately! actually had a very nice evening anyway.
My new friend and I (we had met a few months Did I feel rejected and discredited that night? Yes prior at a drinks party) were about to walk into a and no. Yes because of the awkwardness of the straight bar when the bouncer asked if he could moment, and no, because my friend accepted me look inside our bags. The first thought flashed for who I am.
52 You WANT PEoPLE To sEE ThE rEAL You let’s talk HIV STIGMA
The person depicted in this advert is a model.
Talking to people who understand your concerns can really help. Contact one of the groups below (or your local HIV community organisation) A Promise for Life for friendly confidential advice.
w: nat.org.uk t: 020 7814 6767 w: tht.org.uk t: 0845 122 1200 w: ahpn.org t: 020 7017 8910 w: positivelywomen.org.uk t: 020 7713 0222
Date of preparation: November 2009 AXKAL092992
A5_LETS_TALK_HIV_STIGMA_WOMAN_v1.indd 1 26/02/2010 15:15 Confidential Support & Advice Confidential Barnsley’sSupport 1st & local Advice support group, supporting people +ve +ve Barnsley’s living 1st with local HIV support in +ve group, Confidential supporting our Borough people Support living with & Advice HIV in our Borough Barnsley’s 1st local support HIV +VE PEER SUPPORT in SOHO group, supporting people www.GMG.org.uk living with HIV in WHAT WE DO: our Borough mpositive aboute change . Offer diverse, non-judgmental peer advice . Provide space to relax and express yourself with other HIV +ve gay men mpositive aboute change . Check-in, followed by discussion on common themes or urgent topics Telephone us on: . Discuss living with the virus and living as +ve gay men . Non-funded, independently run and facilitated Telephone us on: by established members 012mpositive26 about32014e change8 WHY DO WE MEET? 01226 320148 . Let off steam about, and help find self- Email: [email protected] acceptance for being +ve Telephone us on: . Combat isolation of dealing with HIV by ourselves Email:www [email protected] . Talk about medications (starting/taking) and 01226 320148 coping with side effects www.plusme.org . Discuss stigma or experiences of disclosure . For friendship and fun, and socialise/network with other HIV +ve gay men Email:me [email protected], for you WHERE & WHEN? . Every Monday 5.30-8pm in Soho, London (apart www.plusme.org from Public Holidays) Companym No. 067727e10 here, Charity for No. you 1129248 WANT TO ATTEND A MEETING?
Company No. 06772710 Charity No. 1129248 If you’re an HIV +ve gay man, we would be delighted to welcome you at one of our meetings. Use the contact form for meeting details at our me here, for you website:
www.gmg.org.uk/contact.php Company No. 06772710 Charity No. 1129248 am I better than you?
J. D Bailey
It has been clear to me for many years, but seems even more obvious now as I have grown older, that there is a hierarchy among those of us who are HIV positive! Let me explain; I’ve noticed that when charities try and implore supporters to give money towards HIV/AIDS they use people who have contracted HIV from their mothers, not those who have contracted it through sexual acts or bodily fluids. This, I would argue is to heighten supporters’ emotions. Occasionally, they may mention someone who has had a dodgy blood transfusion, but still the message is that the ‘true’ victims of HIV are the ones who had no control over it.
Worse still, even when I’ve gone to social groups or camps/conferences for people who are HIV positive, the inevitable question ‘How did you get it?’ would arise. As soon as this question comes up there seems to be a divide between people who contracted it from birth, rape or a dodgy transfusion and those who contracted HIV from sexual acts or by using infected needles.
‘It shouldn’t be about how we got HIV, but more how we can deal with it...’
So my question is: am I better than you? I contracted HIV from my mother. it will never be known whether it was during the pregnancy, birth or whilst breast feeding, but that’s how I got it. Once upon a time I, myself, felt like I deserved more sympathy because I was ‘innocent’.
Now I may stand alone on this matter, but I believe that there is a major problem with this train of thought. I was conditioned to feel as though I had a right to receive more sympathy. I’m going to assume that none of us chose to have this immune deficiency, but it’s our lot in life. If we turn against each other, when we should in fact be able to empathise, then how do we expect those who are HIV negative to respond positively towards any of us? It shouldn’t be about how we got HIV, but more how we can deal with it and help others to do so, because at the end of the day it is no one else’s business other than yours and mine.
55 lancashire HIV services
Peter Channon
Peter Channon looks at HIV in England’s Undiagnosed HIV and late diagnosis are higher Northwest in Lancashire than the national average. The lack of a visible LGBT community and infrastructure in Lancashire is one of the largest counties in most areas and wide variations in the ethnic mix England. It’s stunningly beautiful, but presents of our communities can sometimes lead to fear numerous challenges in the provision of social of homophobia or racism and make people even care for people living with HIV. harder to reach.
For the past three years I’ve led the development The geographical spread of our residents can of HIV social care services here. enforce isolation. Providing specialist services is challenging in itself due to the physical size of the Our population is dispersed over a wide and county. predominantly rural area with small towns and cities such as Lancaster in the North, Blackburn Three years ago, Lancashire relied heavily on a and Burnley in the East, Preston in the Centre, single specialist social worker and on the major Chorley in the South and Blackpool in the West. regional HIV voluntary agencies based some distance away in Manchester. HIV prevalence in Lancashire is relatively low, with around 800 diagnosed people. HIV prevalence Over the last three years I have worked with varies quite significantly from area to area. partners to develop a local infrastructure. Our specialist HIV social worker returned to generic North Lancashire has over 130 people living with duties, but rather than simply lament her loss HIV. In total 70% are men who have sex with men we tried to turn a negative into a positive and (MSM). There are over 170 people diagnosed HIV reviewed the way in which we organised social positive and living in Central Lancashire; they are services. relatively evenly split between heterosexual and MSM. Two hundred people live with diagnosed From local needs assessments we knew that HIV in East Lancashire; 60% of them heterosexual. people prefer to use voluntary sector agencies, rather than social workers for the majority of their “The lack of a visible LGBT care needs. The reliance on a single social worker community can make people even for the whole county meant that there was poor harder to reach.” continuity of service if that social worker was off work, due to sickness or annual leave. Blackpool is a separate unitary authority, with a high LGBT population, and has one of the highest We devised the role of HIV Champion social HIV rates outside of the major English cities with workers using the countywide drug and alcohol over 300 people living with HIV. team of nine social workers. We provided training 56 and information and a specific care pathway to Lancashire still relies on the HIV services based in enable access. This scheme is closely monitored to Manchester, which include: ensure it meets the needs of our HIV client group • George House Trust (GHT) and so far seems to be working well. • Body Positive North West (BPNW) • Barnardos We developed crucial local voluntary HIV These are able to support our local agencies to services. In North Lancashire, and more recently deliver specialist courses. in neighbouring Cumbria, this is provided by a generic agency called ‘Signposts Multi Agency In the past year courses have been developed for Resource Centre’ which provides a wide variety of delivery on a local level within Lancashire. GHT services including case work, information, advice with support of the Elton John AIDS Foundation and a local social group. deliver the yearly gay men’s newly diagnosed course and gay men’s residential weekend. BPNW One of the advantages of this service, is that people has trained local agencies to deliver the Positive accessing the service aren’t disclosing their status Self Management course and is also working with by doing so; disclosure being a concern among Signposts to deliver community based instant many people living with HIV and particularly so in HIV testing. THRIVINE is soon to start delivering the small communities of that area. its positive picture art therapy course and Robert Fieldhouse from BASELINE has been delivering the Fylde and Wyre residents are within easy travelling HIV and your Body programme here. In the coming distance of Blackpool. Some services there are months I will be delivering the BEST programme, a provided by SHIVER, a sister project of the CLASS training course to raise awareness of the benefits service based in Preston which covers Central of starting HIV treatment. Lancashire. They provide information, advice, counselling and a wide variety of health promotion For more info about Lancashire’s HIV services and social support services including case work or comments and suggestions, please contact and social groups. [email protected] or call on: 01772 253 840. In the East of the County, advice sessions are offered within the HIV clinics in Blackburn and Signposts: 01524 419 021 Burnley by specially trained staff from the Citizen’s SHIVER: 01253 311 431 Advice Bureau. Specialist HIV advice and support CLASS: 01772 825 684 is provided by George House Trust. There is also CAB Hyndburn: 01254 304 110 the addition of a new and very popular peer-led GHT: 0161 274 4499 group, THRIVINE, which provides regular peer THRIVINE: 07890 147 806 support and social spaces, as well as courses and BPNW: 0161 882 2200 events including art therapy. Lancashire Social Services: 0845 053 0000 57
running low..?
Living Proof Residential Weekend
2010 9-11 July 24-26 September 17-19 December
National Long-Term Survivors BM LTSG LONDON WC1N 3XX for people living with HIV/AIDS E: [email protected] for the past 5 years or more W: www.nltsg.org.uk Jane Phillips
1. HIV-AIDS Carers & Family Service Provider Scotland 10 Elderpark Workspace 100 Elderpark Street Glasgow G51 3TR Tel: 0141 445 8797 6. Body & Soul Out of Hours phone support: 07778 117900 99 – 119 Rosebery Avenue London 2. Summit House Support Ltd EC1R 4RE Martins Hill Street Tel: 0207 923 6880 Dudley www.bodyandsoulcharity.org DY2 8RT Tel: 01384 243 220 7. Yorkshire MESMAC www.summithousesupport.co.uk PO Box 549 01 York 3. Body Positive Somerset YO30 7GX Creetown House, Tel: 01904 620400 Albermarle Road, Email: [email protected] Taunton www.mesmac.co.uk TA1 1BG Tel: 01373 836121 8. Terrence Higgins Trust Email: [email protected] 04 07 43 Pembroke Street 10 Oxford 4. CLASS, Drugline Lancashire Ltd OX1 1BP 2 Union Court, 05 Tel: 01865 243 389 www.tht.org.uk Union Street, 02 Preston PR1 2HD 09 9. DHIVERSE Tel: 01772 253840 08 Office B Email: [email protected] 06 Dales Brewery www.druglinelancs.co.uk Gwydir Street Cambridge 5. Body Positive Cheshire & North Wales CB1 2LJ Tel: 01223 508805 PO Box 321, 03 Crewe, Email: [email protected] Cheshire http://www.dhiverse.org.uk/ CW2 7WZ Tel: 01270 653150 10.Yorkshire MESMAC Email: [email protected] PO Box 417 www.bpcnw.co.uk Leeds LS1 5PN This reflects a small number of the valuable groups providing Tel: 0113 244 4209 support to people living with HIV. If you can recommend a local HIV Fax: 0113245 8233 or hepatitis support group email: [email protected] Email: [email protected] 60 Straight and HIV+? You are not alone Peer support, social contact, advice, workshops First and third Wednesdays 6.30pm-8.30pm Email: [email protected] 61 healthy living news Jane Phillips
“A vacation: Two weeks in the sun - and the rest of the year on the financial rocks”.
It’s important to have fun on holiday. You need it, The Tan you’ve earned it – but being positive you also need Protect yourself against the sun and use a good sun to be a little organised before you take off. block. Some meds (like Septrin) are extra sensitive to the sun. Half an hour in the sun without sun . Make sure you take your meds with you (and screen will increase your vitamin D levels and keep a few days extra supply in case of stirring your bones healthy. volcanoes etc). Pack them in your hand luggage – if your luggage goes missing you don’t want to Food and Drink be without your drugs. Food can often be the source of infections. Only drink boiled or bottled. Do not have ice unless you . Always carry your drugs in their original know it’s from boiled water. packaging, and take a copy of your prescription and/or a letter from your doc. Avoid raw shellfish, any raw and ready prepared fruit and vegetables/salads (unless you peeled it . If you are travelling to a country with entry yourself) and food from street vendors. restrictions on people with HIV you could send them on ahead. Sex Take your own supply of condoms, femidoms and . Do you need to store your meds in a fridge? lube – not all countries have easy access and they Check beforehand if there is one where you are might be of inferior quality. staying. Language . Never travel without insurance. Use a dedicated It might be advisable to find out what HIV and HIV insurer. Fill out the European Health AIDS are called in the country you are travelling Insurance Card (EHIC) at the Post Office. This will to in case you there’s an occasion (such as an also cover you for some medical emergencies emergency) where you need to let people know within Europe. www.ehic.org you are HIV positive. www.hivtravel.org 62 Has Iceland’s volcano really quietened down? No!
Kevin Waite
Following Iceland’s Eyjafjallajökull volcano Eyjafjallajökull volcano will not erupt again. There erupting in April, thousands of people’s holidays are still tremors and seismic activity, which could were delayed. foretell another eruption.
When they claimed on their travel insurance, Furthermore, scientists have warned that many were surprised that the claim was declined. Iceland’s Katla volcano, which is much larger than They were left with bills to pay for things like Eyjafjallajökull, may be about to erupt. Research by accommodation and car hire. the University College of London, analyzed the last decade of seismic activity around Katla and found Why? there is a strong possibility it will soon erupt. Historically, Katla has followed Eyjafjallajökull’s Travel insurance isn’t designed to cover any and eruptions within days or months. every situation. Policy wording exists, detailing what is covered and what isn’t. Is cover available? There are a small number of travel insurance Unfortunately, many people don’t read the policies that will provide ash-related cover. wording and assume that all sorts of things will be covered they just aren’t included in the policy. The HIV specialist insurer It’s So Easy Travel Insurance was highlighted on Radio 4’s You & Yours In the case of the volcanic eruption, the relevant programme on 31 May as being one such provider. section of travel insurance policies is trip delay Although the insurer behind our HIV policy won’t and abandonment. This is where you can claim an meet ash-related claims, luckily, we work with amount of money for each block of, usually, twelve more than one insurer! It’s possible to buy an hours that you’re delayed. If the delay is longer additional, very basic and inexpensive policy that than 24 hours, you can abandon your trip (if you will provide trip delay and abandonment related haven’t left the UK) and cover is up to the limit of to volcanic ash. Our HIV-inclusive policy will the cancellation section. cover any HIV-related claims including obtaining extra medication if someone’s delayed (the other, However, again, as with any insurance, claims basic policy won’t cover HIV claims). However, are met only under certain circumstances, one a policy must have been purchased before the of which is if the delay was caused by ‘adverse announcement of the closure of the airport to weather conditions’. Many insurers took the stance which someone was travelling to or from and any that the wind on which the ash was being carried ban on airspace in which they were due to fly. So was not adverse – it was just a normal wind. If it don’t leave it too late! had been a gale force wind that had caused delays, claims would have been accepted. The policy can be bought online, following the link on the www.hivtravelinsurance.com website. Could it happen again? Certainly! A geophysicist in Iceland, Magnus Tumi www.itssoeasytravelinsurance.com Gudmundsson, says it’s too early to say that the 0844 357 1314
63 Breakthrough in liver transplantation success Receiving a liver transplant may be the last chance at survival for someone whose HCV has progressed to end-stage liver disease. However, nearly all liver news: hepatitis transplant recipients become re-infected a few Jane Phillips days after their surgery.
Veggie burgers liver warning Researchers from Hiroshima, Japan have devised A new investigation in the US highlights the a novel strategy to prevent this.They extracted common misconception that veggie burgers are immune cells (lymphocytes) from the donor a liver-friendly food. livers before the transplant. They activated the lymphocytes in test tubes, then injected the Many people with HCV in the US make veggie activated lymphocytes into the patient three days burgers a staple part of their “safe” diet. However, after they had received their transplant a non-profit company investigation found that some veggie burgers are made with a toxin The researchers found this worked by keeping (Hexane) which is known to put an additional virus levels low in most of the patients. burden on the liver. More research is required to investigate injecting Hexane is a toxic chemical made from crude oil; activated lymphocytes to suppress HCV. But it is used in the manufacture of some soy-based researchers believe they have made a major foods. Soybeans are immersed in a “hexane breakthrough which may positively impact the bath” before they are processed into soy protein future success of liver transplantation. - common ingredients in traditional non-organic veggie burgers. Experimental drug drops HCV The US senior researcher said, “If a non-organic viral load by nearly 100% product contains a soy protein isolate, soy protein Early results from a Phase II study suggest that concentrate, or texturised vegetable protein, you Bristol-Myers Squibb’s experimental drug BMS- can be pretty sure it was made using soy beans 790052 has unrivalled potency against HCV. that were made with hexane.” The drug may well be one of the most potent yet The US Dept. of Agriculture (USDA) organic at treating HCV. An earlier phase in the research standards strictly prohibit the use of hexane. But, found it was highly effective at blocking the that rule doesn’t apply to foods labelled “made protein NS5A, a new target that might provide with organic ingredients.” a new weapon against a virus that can quickly develop drug resistance. The study is in the US and involves both male and females, treatment naive, chronically mono-infected HCV patients with genotype 1.
Although results are looking very promising, it could be another five years or more before we get to see it used in clinics. 64 HCV and diabetes: A deadly Prescribe heroin on the NHS, combo says nurse leader Having hepatitis C greatly increases your risk of The NHS should offer heroin to drug addicts and developing type 2 diabetes, and diabetes may provide open “consumption rooms” for supervised worsen the prognosis of hep C (HCV). injecting in order to cut crime and keep the public free from dirty needles, said the head of UK’s One potential explanation for this increase in biggest nursing union. disease progression is that HCV promotes the accumulation of fat inside your liver. A fatty liver Dr Peter Carter, general secretary of the RCN said is not able to absorb excess glucose from the giving heroin on the NHS would cut crime rates bloodstream; potentially forcing your blood sugar and help wean addicts off the drug. He said ‘It level to rise. might take a few years but people will understand’. His statement provoked an immediate reaction Many people with HCV develop insulin resistance. from the nursing profession; however, there is This means their liver and muscles are not able research from first studies at King’s College’s to absorb glucose (sugar) from the bloodstream national addiction centre to suggest that allowing and use it for energy. Instead, the glucose is users to inject heroin under medical supervision converted into fatty acids and gets stored as could cut local crime rates by two-thirds in six body fat, particularly in the abdominal region. Fat months. also accumulates in the liver and promotes the development of fatty liver disease. Some nurses at the RCN conference agreed:, Claire Topham Brown, said this plan could cut the HCV increases the risk of liver cancer and people transmission of viruses such as HIV and hepatitis...”. with both HCV and diabetes appear to be are at far Other experts said money should be spent on higher risk of developing liver cancer. addiction therapies instead. 65 HIV in numbers: women
33 million: the number of people estimated to be living with HIV worldwide
“Stigma kills people with HIV.” ½ are women Angelina Namiba, Positively UK at the NHIVNA conference in Brighton
75% of 15-24 year olds living with HIV in sub-Saharan Africa are “Tenofovir is now the drug of women choice for pregnant women with hepatitis B.” Dr Doug Dieterich, at the HIV-hepatitis coinfection meeting in Tel Aviv 2876: the number of women who are estimated to contract HIV every single day
“Shut up and take an HIV test 19,303: the number of (and keep wearing nice hats).” women accessing care in the UK in Silvia Petretti, Positively UK, after hearing of 2008 who acquired HIV from hetero Lady Gaga’s celibacy vow. sex.
138: the number of women who died with AIDS in the UK in 2008
66 You WANT To be AccepTed for Who You Are let’s talk HIV STIGMA
The person depicted in this advert is a model.
Talking to people who understand your concerns can really help. Contact one of the groups below (or your local HIV community organisation) A Promise for Life for friendly confidential advice.
w: nat.org.uk t: 020 7814 6767 w: tht.org.uk t: 0845 122 1200 w: ahpn.org t: 020 7017 8910 w: positivelywomen.org.uk t: 020 7713 0222
Date of preparation: November 2009 AXKAL093181
A5_LETS_TALK_HIV_STIGMA_GAY_MAN_v1.indd 1 26/02/2010 15:09 Community award ad A5:Layout 1 28/6/10 09:29 Page 1
UK AND IRELAND HIV COMMUNITY AWARD 2010
Integrity. Teamwork. Excellence. Do you know someone who’s always ‘Putting Patients First’?
At Gilead, we are focused on advancing the care of patients living with life-threatening diseases. But we believe that caring for patients extends beyond the research lab and the doctor's office. In essence, we believe in “Putting Patients 1st”. The aim of the award is to recognise a community group working within the UK in the field of HIV who through their practice has made a significant or unique contribution to people living with HIV. All UK community groups who are providing a supportive environment for people living with HIV are eligible to apply. The award will consist of two grants of £5000 each to fund the core activities of the project or the group nominated and will be in line with the ABPI Code of Practice. To enter please contact us at [email protected]
Date of preparation: April 2010 001/UKM/10-03/MM/1638a