ALL ABOUT AIDS

ALTERNATIVE AND COMPLEMENTARY THERAPIES

2006-10-30T17:40:00.000-08:00

WHAT ARE ALTERNATIVE THERAPIES?
A health treatment that does not fit into standard western medical practice is called "alternative" or "complementary". This includes many different therapies:
• Traditional healing practices such as ayurveda, Chinese acupuncture, and Native American healing
• Physical therapies such as chiropractic, massage, and yoga
• Energy work such as polarity therapy or reiki
• Homeopathy or herbs
• Relaxation techniques, including meditation and visualization
• Dietary supplements, such as HOW MANY PEOPLE USE ALTERNATIVE THERAPIES? Alternative therapies are very popular. In the United States, over 70% of people with HIV have used some kind of an alternative therapy. Many people use them regularly. Some health insurance plans pay for therapies such as chiropractic or acupuncture.

ARE THEY SAFE?
Alternative therapies can have dangerous side effects. The words "natural" or "non-drug" do not guarantee safety. The FDA (Food and Drug Administration) does not approve dietary supplements or monitor their safety or contents. Some herbs can lower blood levels of ARVs. Consumers need to be careful when using alternative therapies.
The FDA recently proposed new rules that would reduce the risk of contamination of dietary supplements and would require that their labels clearly indicate their identity, purity, quality, strength and composition.

DO THEY REALLY WORK?
It is difficult to find good information on alternative therapies. Get as much information as you can before using them. Try to find out:
o When and how was this therapy developed?
o How does it work?
o Are there any articles or studies of this therapy?
o Are the therapists trained, certified, or licensed?
o Are there any known side effects or other risks?
Sometimes this information is truly not available. However, if it seems like people don't want to answer your questions, be extra careful. You might be dealing with a health fraud.

WHY AREN'T THERE MORE STUDIES OF ALTERNATIVE THERAPIES?
Most research tests treatments for a particular disease or condition. Every patient gets exactly the same treatment. Sometimes alternative therapies are not standardized, making them more difficult to study.
Alternative therapies aren't always designed to treat a particular illness:
Some alternative therapies treat the whole person, not an illness. They might restore harmony, balance, or normal energy flow. Acupuncturists, for example, use the pulse to see if your body's energy is out of balance. Acupuncture for people with HIV is based on their individual energy pattern, not on their HIV. Therapies like this might help people with HIV, but they are not designed to treat HIV.
Few alternative therapies are standardized:
Few alternative therapies are standardized. Different brands of herbs can have different amounts of the active ingredient, although more standardized products are being made. Chiropractic, acupuncture, and other therapies are not standard. They are adjusted for each patient. Research is very difficult when treatments are not standardized.
Basic Safety Studies Haven't Been Done:
The FDA wants to know that a therapy is safe before they test how well it works. Even if a treatment has been used for many years with no reports of health problems, the FDA requires a scientific study to show that it is safe. There are no careful safety studies for many alternative therapies.
StudyStudies are expensive:
Scientific research is very expensive. The makers of alternative therapies often cannot afford to pay for scientific studies. The government prefers to pay for studies of western medical drugs because they appear to be more effective. Patents allow manufacturers to make large profits that help pay for research. However, most alternative therapies cannot be patented.

Despite these barriers, some alternative therapies have been carefully studied. Often, this research has been conducted outside the US and might not be considered by the FDA. The Fact Sheets for each alternative therapy mention research that has been done.

WORKING WITH YOUR HEALTH CARE PROVIDER
Tell your health care provider as much as possible about how you want to deal with your HIV infection. Tell your health care provider about all the therapies you use. This is very important if you have any kind of bad reaction to a medicine that you are taking. There could be some alternative therapies that you should not use together with your ARVs. For example, some herbs lower the levels of ARVs.

Check your health care provider's attitude and knowledge on alternative therapies. Ideally, your health care provider can keep an open mind and help you evaluate alternative therapies that interest you.

THE BOTTOM LINE
Most people with HIV use some kind of alternative or complementary therapy. Some alternative therapies can be dangerous. Others are safe to use. Some have been carefully studied and can improve your health.

It is difficult to study alternative therapies. Find out as much as you can before you start using an alternative therapy. Let your health care provider know about the therapies you are using. For more information see the web site of the National Center for Complementary and Alternative Medicine at http://nccam.nih.gov.

source:aidsinfonet.org

FDA Approves New HIV Treatment for Patients Who Do Not Respond to Existing Drugs

2006-10-29T16:40:00.000-08:00

The Food and Drug Administration (FDA) today approved Prezista (darunavir), a new drug for adults whose infection with the human immunodeficiency virus (HIV) has not responded to treatment with other antiretroviral drugs. Prezista, a new HIV protease inhibitor, is approved to be co-administered with a low-dose of ritonavir and other active anti-HIV agents. Ritonavir, a protease inhibitor approved in 1996, slows the breakdown of Prezista in the body thereby increasing the concentration of Prezista in the patient's system.

Infection with HIV causes AIDS, which results in more than 15,000 premature deaths each year in the United States and more than 2.8 million deaths each year worldwide.

"This approval offers new hope to HIV patients who too often urgently need new therapies in order to maintain their health," said Andrew C. von Eschenbach, MD, Acting Commissioner of Food and Drugs. "This drug is not a cure, but when combined with other standard therapies, it presents one more major step in our effort to help patients combat the effects of the disease."

Today's accelerated approval is based on evidence from two randomized, controlled studies comparing the safety and effectiveness of a Prezista-ritonavir combination with other ritonavir-boosted protease inhibitor combinations. Patients in both arms of these trials also used other anti-HIV agents (nucleoside reverse transcriptase inhibitors) with or without enfuvirtide, a fusion inhibitor that inhibits the virus from entering the cell. In these studies, patients on a Prezista-ritonavir combination experienced higher rates of reduction of their HIV viral load than patients on other ritonavir-boosted protease inhibitor combinations. Seventy percent of treatment-experienced patients achieved a virologic response, improving the treatment outcome, with Prezista-ritonavir in combination therapy compared to 21 percent in control group at week 24.

The most common side effects reported by patients on the Prezista-ritonavir regimen included diarrhea, nausea, and headache. About seven percent of patients on this combination therapy experienced skin rashes ranging from mild to serious.

The risks and benefits of Prezista have not been established for adults who have not been previously treated for HIV, or for children.

As a condition of the accelerated approval, the manufacturer is required to conduct post-marketing trials to verify and describe the clinical benefits of Prezista. Other postmarketing studies that the manufacturer has committed to conduct include studies in pediatric populations, studies to better define certain drug-drug interactions, and to evaluate the drug in patients with varying degrees of liver impairment to identify appropriate dosing for this patient population.

Patients are advised to take Prezista and ritonavir with food, and not to use the combination therapy together with St. John's wort or various other drugs, including certain anticonvulsants, antihistamines, sedatives and a few of the protease inhibitors.

Prezista is manufactured for Tibotec, Inc., Division of Ortho Biotech Products, L.P., Raritan, N.J., by JOLL, Gurabo, Puerto Rico.

source:fda.gov

New Study Shows More Convenient HIV Treatment As Effective As More Complex Regimens

2006-10-28T19:20:00.000-07:00

Regimens to treat HIV infection that are based on a non-nucleoside reverse transcriptase inhibitor (NNRTI) are at least as effective as treatment with a protease inhibitor but require patients to take fewer pills each day, according to a new study funded in part by HHS' Agency for Healthcare Research and Quality.

The study, published in the October 28 online issue of the Lancet, found that disease progression was similar for both regimens, but NNRTI-based treatment appeared more effective at decreasing the amount of virus in the blood. The number of patients who stopped treatment because of adverse events was similar for both medications.

The new study is the first to review all published research that directly compares the two classes of antiretroviral drugs used in highly active antiretroviral therapy (HAART). NNRTI-based regimens were found to be up to 60 percent more likely to suppress the amount of virus in patients' blood than protease inhibitor-based regimens. The percentage of patients who died or experienced disease progression were similar between the two treatments, and the number of patients who stopped taking the medications because of side effects or adverse events was also similar.

While some protease inhibitors require four doses each day, one NNRTI, efavirenz, can be taken in one daily dose. This convenience could increase the likelihood that patients will adhere to their HIV regimens.

Publication of the study follows the July 12 approval by the Food and Drug Administration of the first once-a-day medication to treat HIV. The drug contains emtricitabine and tenofovir, two nucleoside reverse transcriptase inhibitors, plus efavirenz. The components of the drug were previously available, but it is anticipated that the new combined formulation will simplify treatment and improve compliance.

"A simpler regimen offers the potential of improved adherence and better patient outcomes. Combined with the approval of new dosage formulations, this information could improve the management of patients in this country and in regions of the world where access to medical care and treatment compliance can be challenging," said AHRQ Director Carolyn M. Clancy, M.D. “These findings highlight the need for additional research that evaluates the extent to which improvements in markers of a disease, such a viral suppression, lead to improved clinical outcomes."

The Centers for Disease Control and Prevention estimates that between 1 million and 1.2 million people in the United States are living with HIV, and at least 40,000 new infections occur each year. Worldwide, approximately 40 million individuals are infected with the virus.

Researchers, led by Roger Chou, M.D., at Oregon Health & Science University in Portland, completed an analysis of 26 trials, including 12 head-to-head trials comparing NNRTI-based regimens with protease inhibitor-based regimens. Fourteen other trials compared two-drug regimens with either NNRTI-based or protease inhibitor-based, triple-drug regimens. Among 3,337 patients analyzed in the head-to-head trials, NNRTI-based regimens were better than protease inhibitor-based regimens by 20 percent to 60 percent in their ability to achieve viral suppression.

Dramatic decreases in the rate of HIV-related illnesses and deaths have occurred since the introduction of HAART therapy in which three or more antiretroviral agents are used. However, until now, comparisons of head-to-head trials were not available to support selection of a protease inhibitor or an NNRTI as part of that combination therapy. Researchers concluded that earlier analyses may be unreliable because their results differed dramatically from the analysis of head-to-head trials, even after excluding patients who had previously received HIV therapy and those who had received older NNRTIs, such as delaviridine, that are now used infrequently because they are less effective than newer NNRTIs. Prior antiretroviral treatment can cause drug resistance and treatment failure.

The study was completed as followup to an evidence review prepared by Dr. Chou and a team of researchers at AHRQ's Oregon Evidence-based Practice Center in Portland. The EPCs were established to synthesize existing scientific literature about important health care topics and promote evidence-based practice and decisionmaking.

source:
ahrq.gov

Tips for Teens: HIV/AIDS

2006-05-31T21:39:00.000-07:00

Tips for Teens: HIV/AIDS

Get the Facts…

AIDS--Acquired Immunodeficiency Syndrome--is caused by HIV, the Human Immunodeficiency Virus. HIV weakens your body's immune system, making it less able to fight against diseases and infections. HIV passes from one person to another through contact with the bodily fluids of someone infected with the virus. Most often, the virus spreads through oral, vaginal, or anal sex during which a condom is not used, or by sharing a needle. Mothers can pass the virus on to their babies during pregnancy or birth or by breast-feeding.

It's not a "gay thing." Many persons who become infected are heterosexual. In a recent study by the Centers for Disease Control and Prevention, more females than males ages 13-19 tested positive for HIV.1 The most common source of infection for females of all ages is heterosexual sex.2

Using alcohol and drugs increases your risk. Alcohol and drugs affect your judgment and lower your inhibitions. As a result, drinking or taking drugs can lead you to take risks you are less likely to take when sober, such as having unprotected sex.

Injected drug use was the cause of at least 11 percent of infections for young people ages 13-24.3 Any drug use, however, contributes to the spread of HIV/AIDS when users trade sex for drugs or when they engage in risky behaviors while under the influence of drugs.

Before You Risk It…

Get the facts. Not having sexual intercourse is the most effective way to avoid STDs, including HIV/AIDS. For teens who choose to be sexually active, these prevention measures lower your risk of an HIV infection.

* Avoid alcohol and drugs. Their use can cause you to make sexual choices you wouldn't make sober.
* Only engage in sexual activity that does not involve vaginal, anal, or oral sex.
* Have intercourse with only one uninfected partner.
* Use a latex condom every time you have sexual intercourse of any kind.

Know the risks. The majority of young people who have HIV are infected sexually. As more teens have become aware of the risk, fewer are having sex and more teens who are sexually active are using condoms.4 The second most common source of HIV is intravenous drug use, but any activity where blood exchange is possible is risky. Teens should not share needles for any activity, including steroid drug injection, tattooing, or body piercing.5

Stay informed. While most people who have the disease now live much longer due to medical research and new drugs, there is no cure.

Know the Signs…

How can you tell if you or someone else may already have HIV? If you have not had unprotected sex or shared a needle, it is very unlikely that you have HIV. The only way to know if you are infected is to be tested. The following may be warning signs of HIV infection:

* Weight loss
* Frequent fevers and sweats
* Lack of energy
* Swollen lymph glands in the armpits, groin, or neck
* Persistent skin rashes
* Severe herpes infections that cause mouth, genital, or anal sores
* Short-term memory loss

No one should assume they are infected if they have these symptoms. Any of these symptoms can be related to other illnesses. Again, the only way to find out if you are infected with HIV is to be tested.

What can you do to help someone whose substance abuse problem is putting them at risk for HIV/AIDS? Be a real friend. You might even save a life. Encourage your friend to stop using substances or seek professional help. For information and referrals, call the National Clearinghouse for Alcohol and Drug Information at 800-729-6686.

Q & A

Q. Can you get HIV/AIDS from casual contact with an infected person or their stuff?
A. No. HIV/AIDS is not spread through sweat, tears, or saliva. The body fluids that have been shown to contain high concentrations of HIV include blood, semen, vaginal fluid, breast milk, and other body fluids containing blood.

Q. If you already have HIV, does it really matter if you drink or use drugs?
A.Yes. Not using tobacco, alcohol, or drugs improves your chances of staying healthy longer. Use of any of these substances can cause other health problems, interfere with your treatment medications, or both.

Q. Who is most likely to get HIV/ AIDS?
A. Anyone who has unprotected sex, shares a needle, or exchanges blood with an infected person is at risk. HIV is a virus. AIDS is a disease. Viruses do not care about age, race, gender, or sexual orientation.

Information

To learn more about HIV/AIDS or obtain referrals to programs in your community, contact one of the following toll-free numbers:

SAMHSA’s National Clearinghouse for Alcohol and Drug Information
800-729-6686
TDD 800-487-4889
linea gratis en español
877-767-8432

Curious about the TV ads of the National Youth Anti-Drug Media Campaign? Check out the Web site at www.freevibe.com or visit the Office of National Drug Control Policy Web site at www.whitehousedrugpolicy.gov.

The bottom line: If you know someone who is risking exposure to HIV/AIDS, urge him or her to stop. If your behavior places you at risk of an HIV/AIDS infection--STOP! If you have already placed yourself at risk, get tested and follow your doctor's instructions. The longer you ignore the real facts, the more chances you take with your life. Talk to your parents, a doctor, a counselor, a teacher, or another adult you trust. You also can call the CDC National AIDS Hotline at 800-342-2437 for more information.

Do it today--it's your life.

Source: health.org

HIV and Older Women

2005-12-24T21:42:00.000-08:00

HIV and Older Women

by Barbara C. Phillips, NP

The numbers of older women becoming infected with the virus that causes AIDS is of growing concern. Learn how you can protect yourself.
HIV infections are on the rise. According to the Center for Disease Control and Prevention (CDC), the number of Americans over 50 who are infected with HIV have grown over 5 times (16,300 people in 1995, to 90,600 in 2003). While seniors represent about 14% of people with HIV, senior women represent 18%. The numbers of women with infections are even higher for American women of color, and come in at a staggering 47% when looking at world HIV infection rates. That means that just under half of all HIV infections are found in women worldwide.
One reason for the higher number of older women with HIV was found in a study recently published by Emory University. They surveyed 514 women over the age of 50, and found that their knowledge about transmission was poor. For example, approximately 50% of women believed that vasectomies and diaphragms prevent the spread of HIV.
Other reasons include the fact that many older women, who have sex with men, are also not using condoms, knowing they are past the point of having to worry about pregnancy. Women also erroneously think they cant get HIV if they are not engaging in behaviors they deem as risky. The truth of the matter is this. HIV is a virus. Its an opportunist. It does not care if you are male or female. It does not care who you have sex with, nor the numbers of people you have sex with. It certainly does not care about the color of your skin, you bank balance or you age.
HIV is primarily spread in two ways. First is though the sharing of contaminated intravenous drug equipment. Second, and more commonly, HIV is spread by unprotected sexual encounters. Women frequently are the receptive partners, and the receptive partners are more likely to become infected. Women who are post menopausal are at higher risk because of the changes in the vaginal tissue. With less estrogen to nourish the vagina, the tissue atrophies (becomes thin) and there is less lubrication. A woman can easily get tiny tears in her vaginal tissues, thus leaving an opening for virus to gain entry to her blood stream.
Whats a woman to do?
1. Know your own HIV status. Contact your health care provider, or (if you want anonymous testing) the local health department for testing. I do not recommend home testing at this time. First, if you are positive, are you really? And if you are negative, are you really? If positive, confirmatory blood testing is required. Many offices have started using rapid testing in the office where preliminary results can be obtained in 20 minutes. In the meantime you can get the appropriate information on how you need to proceed.
2. Know your partners history (this goes for both male AND female partners ladies!). Do they have a history of multiple partners and unprotected sexual encounters? Have they been tested? When? Did they get a follow up test at 6 months? What were the results?
3. Condoms and lubrication are essential. Use them not only on your partners body parts that may be entering you, but also on any toys you may be utilizing as well There are several online and confidential sources to purchase lubricants, condoms and gloves.
4. Limit your exposure when possible. Think twice if you are engaging in high risk behavior with a casual or new partner.
5. Educate yourself. The information presented here is just a small portion of what you need to know. Each of us bears the responsibility to educate ourselves and our partners.
For many women, sexual activity does not stop just because they reach a certain age. I encourage you to continue to enjoy yourselves, but do so safely.

©2005, Barbara C. Phillips, Nurse Practitioner and founder of OlderWiserWomen(tm) inspires women to embrace the freedom, magic and wisdom of Successful Aging. Visit http://www.OlderWiserWomen.com for your copy of "Celebrating You: 50 Tips for Vibrant Living".

Circumcision Can't Prevent HIV

2005-12-11T23:00:00.000-08:00

Circumcision Can't Prevent HIV

by Dan Bollinger

Circumcision may result in a false belief that safe-sex practices are no longer required, implying a worsening of the incidence of HIV infection, according to a joint statement issued September 29, 2005 with: National Organisation of Circumcision Information Resource Centres,South Africa (NOCIRC-SA) www.nocirc-sa.co.za.
(PRWEB) October 2, 2005 -- Two separate papers were presented at a conference in Brazil, claiming that male and female circumcision has the potential to reduce HIV acquisition. Such claims may conversely have negative consequences in the struggle against HIV and AIDS. At the recent congress of the Treatment Action Campaign (TAC), the findings of a study conducted amongst male South African participants were presented, suggesting that the circumcised penis is more resistant to HIV infection. TAC has been reported to be considering advocating circumcision as a result. We are encouraging them to reconsider their new strategy.This study could dangerously mislead people into believing that if they are circumcised, they would be protected against HIV. The natural response of a circumcised male to these reports is to assume that he is more resistant to HIV infection than is the intact male. The implication being that even more circumcised men may engage in unsafe sexual practices under the false impression that they won't contract HIV. Equally troublesome is the fact that this study offers no indication on whether or not the receptive partner of the circumcised male will become more or less vulnerable to HIV infection. The female receptive partner's risk will likely increase without adequate protection. A second study, performed by Stallings amongst African females in Tanzania shows that HIV transmission is also reduced among circumcised FEMALES. This has gone unreported by the media. Such selective reporting suggests the need for analysis from a gender prejudice point-of-view and suggests that male and female circumcision should be dealt with as a unity.The foreskin is not just a piece of skin, but rather a highly specialized erogenous and immunological structure, which cannot be cut off like hair or fingernails. We are therefore concerned about the frequent uncritical reference to particularly the male study in the media. The promotion of its uncorroborated findings, without adequate understanding of the behavioral consequences, is highly irresponsible. Feedback offered to our organization indicates that some individuals are now advocating "chop-shops," where parents will be able to bring their children for the non-consensual, non-therapeutic removal of their foreskins.The "Lancet," the pre-eminent medical journal in the world, rejected the publication of the above French study. The broad quotation within the media is therefore, premature and irresponsible since the study has not been peer- reviewed as yet. When extrapolating globally, the hypothesis of this study could be proven to be wrong. The United States has a very high rate of circumcision coupled with the highest HIV infection rate in the developed world. Scandinavia on the other hand has one of the lowest rates of circumcision in the world coupled with a comparatively low incidence of HIV infection. Global trends should be more accurate than one, demographically limited study. Neither does current research point to a significant difference in infection rates in South Africa amongst the non-circumcising tribes such as the Zulus, and the circumcising tribes such as the Xhosas.Other studies have thus far failed to corroborate that circumcision could prevent HIV. The highly respected Cochrane review, which conducted a meta-analysis of circumcision and its relationship to HIV, "found insufficient evidence to support an interventional effect of male circumcision on HIV acquisitionin heterosexual men." The most important emphasis of HIV prevention should focus on education, the use of non-contaminated medical equipment, and behavioral changes such as condom use, and not foreskin amputation. The amputation of the male prepuce removes the only movable part of the penis, causing increased friction during sexual intercourse, leading to micro-tears of tissue, and subsequent increased vulnerability to possible infection. In South Africa, 'dry sex' practices, whereby lubrication mechanisms are purposely removed, make HIV infection even more likely to occur. It has also previously been demonstrated that circumcised men don't like using condoms as they suffer from a progressively desensitized penis.UNAIDS has cautioned against circumcision. "If circumcision were promoted as a way of preventing HIV infection, people might abandon other safe sexual practices, such as condom use. This risk is far from negligible - already rumors abound in some communities that circumcision acts as a "natural condom". A sexworker interviewed in the city of Kisumu in Kenya summed up this misconception, saying, "I can sleep with circumcised men without a condom because they don't carry a lot of dirt on their penis." Circumcision does not eliminate HIV infection. In one study in South Africa, two out of five circumcised men were infected with HIV, compared with three out of five uncircumcised men. Relying on circumcision for protection is like playing Russian roulette with two bullets in a (five-shot) revolver rather than three."National Organization of Circumcision Information Resource Centres of South Africa implores all organizations associated with the fight against HIV/AIDS to take note of these developments. We should not lose foresight in the fight against HIV/AIDS by these irresponsible statements promoting circumcision of healthy body parts of boys and girls as a preventative strategy. All children have a right to bodily integrity, and such procedures violate that right. This right is enshrined in the United Nations Convention on the Rights of the Child, to which South Africa is a state signatory.

http://www.icgi.org

HIV Prevention a Poor Excuse for Circumcision, Activists Say

2005-11-25T20:48:00.000-08:00

HIV Prevention a Poor Excuse for Circumcision, Activists Say
by Matthew Hess

In response to recent studies linking male circumcision to lower HIV infection rates, health and human rights activists are warning that circumcision should not be used as a tool to combat the spread of HIV. Circumcision is the removal of the foreskin, a protective and highly erogenous zone of tissue that covers the penis.
San Diego, CA (PRWEB) February 3, 2005 -- In response to recent studies linking male circumcision to lower HIV infection rates, health and human rights activists are warning that circumcision should not be used as a tool to combat the spread of HIV. Circumcision is the removal of the foreskin, a protective and highly erogenous zone of tissue that covers the penis.“Preventive circumcision makes even less sense than preventive mastectomy,” said Matthew Hess, President of San Diego based MGMbill.org. “Preventive breast removal would actually prevent many cancers, while virtually all those exposed repeatedly to HIV will still contract the virus, circumcised or not. And despite the findings of a new study in Kenya, circumcision clearly has not been effective in controlling the spread of HIV in the United States."MGMbill.org is a group pushing to add gender neutral language to a U.S. law that bans circumcision of girls under the age of 18. The study referenced by Hess appeared in the February 15, 2005, issue of The Journal of Infectious Diseases. It concluded that circumcised truck drivers in Kenya had a 0.5% chance of contracting HIV from an infected female partner, versus a 1.3% chance for intact men.Hess also criticized a recent $5.4 million grant by the Bill and Melinda Gates Foundation to study the effects of male circumcision on HIV rates in Uganda. “The Gates Foundation has done a lot of good things for Africa over the years,” said Hess. “But this ill-conceived grant is helping to promote genital mutilation of males on a continent that is receiving aid from other agencies to eliminate female genital mutilation. I think it’s very counterproductive.”George Denniston, M.D., a retired professor at the University of Washington School of Medicine, said the HIV-circumcision link is weak at best. “The United States is one of the only developed nations that still routinely practices male circumcision, and yet the U.S. also has the highest rate of HIV infection among all developed countries. To suggest that circumcision should somehow be used as a tool to control HIV is highly irresponsible medicine, but that is what some of these studies seem to be doing.”Denniston has authored several books on the harmful effects of circumcision. He is also President of Doctors Opposing Circumcision, an international group of physicians that advises against circumcision because of the damage it causes to sexual function. The group also argues that circumcision of children is a violation of professional medical ethics and basic human rights.Brian O’Donnell, PA-C, MHS, of New Haven, Connecticut, said that research money would be better spent on ways to increase condom use, which is a proven way to prevent HIV. “Whether or not a man is circumcised, he has to wear a condom during sex to prevent the transmission of HIV from an infected partner. The most common reason men give for not wearing a condom is that it reduces sensation and pleasure. Removing the foreskin only reduces the sensation further.”O’Donnell said he is planning to enter into a research project designed to look at how circumcision has affected condom use in the U.S. and may be contributing to the high rate of sexually transmitted infections and HIV. “This may be what’s happening in the U.S., where 70% of 18-24 year olds are circumcised and the rates of HIV are 5 times that of Europe, where less than 1% of the men are circumcised. It also could explain why the rates of STD's and unintended pregnancies in the USA are up to 74 times higher than in Europe.”O’Donnell added that he sees less condom use among his male patients who are circumcised, and that their rate of STD diagnosis is higher than in intact men. He also warned that a false sense of security is already starting to take hold in Africa, where some people now mistakenly believe they can’t contract HIV if they are circumcised.

http://www.mgmbill.org

HIV / AIDS Complementary Treatment

2005-11-14T19:14:00.000-08:00

Since the discovery of AIDS/HIV there has been a plethora of treatment modules. The following article introduces yet another way of trying to battle AIDS. Enjoy

HIV / AIDS Complementary Treatment
by Jan Greeff

HIV/AIDS: COMPLEMENTARY MANAGEMENT VIA IMMUNE-ENHANCEMENT
Latest technology complementary and supportive products are achieving remarkable results.
A leading firm of clinical consultants who have been contracting to Medical Aid Funds to manage approximately 6 500 persons living with HIV/AIDS on an ongoing basis for many years, reports as follows:
"We are contracted to render HIV disease management services to numerous patients of several medical schemes. We have been using Phytogard as an immune booster for the past 4 years with exceptional results. Some patients are currently controlled on Phytogard alone and maintain or improve their CD4 counts while reducing Viral Loads. Five of our contracted medical schemes are funding the inclusion of Phytogard in our disease management protocols." The success of Phytogard is mainly due to Foodstate*tm technology. For the first time in history specialised vitamin and mineral combinations are presented to the body as food. Utility is improved by up to 15 times compared to chelated chemical isolates and inorganics.
The unique, synergistic and cost-efficient combination of ingredients in Phytogard has been developed in collaboration with leading laboratories from all over the world. They consist of vitamins A and B12, Selenium and Zinc, all in Foodstate*tm form, n-Acetyl Cysteine, Betasitosterols and Alpha Lipoic Acid.
These products can add significant value to complementary health services worldwide.
For more information, please contact Jan Greeff in Barberton, South Africa Tel. +2713 712 2436 e-mail to grewe@absamail.co.za SMS only to +278 454 838 90 or visit http://wellness.oppiweb.com

Im Jan Greeff, married to Juanita since 1973. We have four children, four grandchildren, and are known as the wellness family.
I have been a Lifestyle Consultant for more than twelve years. It has been my privilege to be instrumental in safe, natural intervention to improve the quality of life of countless persons.
My intervention strategy is aimed at achieving optimum wellness via balanced nutrition, moderate exercise and fulfilling relationships.

Protecting Partners

2005-11-01T03:12:00.000-08:00

Office of HIV/AIDS & Viral Hepatitis
Protecting Partners

If you have tested positive for HIV, your first priority is to stay healthy. However, at some point you need to make plans to tell your partner(s) to get tested for HIV.

How do I tell my partner(s) about my HIV status?

Talking to your partner(s) about your HIV status is difficult for most people. Your health care provider can prepare you for talking to your partner(s) about HIV. In some cases, your health care provider will even talk to your partner(s) with you.

For a woman living in a domestic violence situation, talking about HIV or requesting a partner get tested could put you in further danger. Talk to your health care provider about this issue. For more information about keeping yourself safe, contact Donna Williams or Toni Wallace at the Sojourner House (401-861-6191).

If you decide you are not ready to notify your partner(s) or you need help, the Department of Health can talk to your partner(s) for you. The Department can notify your partner(s) that they may have been exposed to HIV. The Department will ensure that your partner(s) receive all crucial health information, testing, counseling, and referrals. To ensure confidentiality, the Department will never use your name and your partner(s) will not know how HIV exposure information was received.

Should my partner(s) get tested?

Yes. Anyone who may have been exposed to HIV needs to be tested. Testing is the only way to know if a partner has been infected.

If a partner decides to get tested for HIV, there are HIV testing sites throughout the state. Partners can also see their own health care provider to be tested.

If a partner decides not to get tested for HIV, there is no way of knowing if he/she has HIV. HIV testing is not required so no one can make a partner get tested. The best response is to try to protect your partner from becoming infected.

How do I protect my partner(s) from getting infected?

Regardless of your partner’s status, you should use condoms and not share needles. Even if both of you and your partner are HIV-positive, you need to protect each other from re-infection and giving each other different strains of the virus.

If your partner is pregnant, it is important that she get medical care as soon as possible. Treatment is available to lower the risk of passing HIV to the baby during the pregnancy or delivery.

What services are available for my partner(s)?

In addition to testing services, your health care provider can also tell you how to get partner counseling and referral services from the Department of Health. For more information on partner counseling service call Phil Barber at Partner Counseling and Referral Service at 401-265-0518.

Source: Rhode Island Department of Health

Depression And HIV/AIDS

2005-10-30T23:32:00.000-08:00

Symptoms of Depression

Persistent sad, anxious, or "empty" mood

Feelings of hopelessness, pessimism

Feelings of guilt, worthlessness, helplessness

Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex

Decreased energy, fatigue, being "slowed down"

Difficulty concentrating, remembering, making decisions

Insomnia, early-morning awakening, or oversleeping

Appetite and/or weight changes

Thoughts of death or suicide, or suicide attempts

Restlessness, irritability

If five or more of these symptoms are present every day for at least two weeks and interfere with routine daily activities such as work, self-care, and childcare or social life, seek an evaluation for depression.
Introduction
Research has enabled many men and women, and young people living with human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), to lead fuller, more productive lives. As with other serious illnesses such as cancer, heart disease or stroke, however, HIV often can be accompanied by depression, an illness that can affect mind, mood, body, and behavior. Treatment for depression helps people manage both diseases, thus enhancing survival and quality of life.
Despite the enormous advances in brain research in the past 20 years, depression often goes undiagnosed and untreated. Although as many as one in three persons with HIV may suffer from depression,1 the warning signs of depression are often misinterpreted. People with HIV, their families and friends, and even their physicians may assume that depressive symptoms are an inevitable reaction to being diagnosed with HIV. But depression is a separate illness that can and should be treated, even when a person is undergoing treatment for HIV or AIDS. Some of the symptoms of depression could be related to HIV, specific HIV-related disorders, or medication side effects. However, a skilled health professional will recognize the symptoms of depression and inquire about their duration and severity, diagnose the disorder, and suggest appropriate treatment.
Depression Facts
Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life. Depression can occur at any age. NIMH-sponsored studies estimate that 6 percent of 9- to 17-year-olds in the U.S. and almost 10 percent of American adults, or about 19 million people age 18 and older, experience some form of depression every year.2,3 Although available therapies alleviate symptoms in over 80 percent of those treated, less than half of people with depression get the help they need.3,4
Depression results from abnormal functioning of the brain. The causes of depression are currently a matter of intense research. An interaction between genetic predisposition and life history appear to determine a person's level of risk. Episodes of depression may then be triggered by stress, difficult life events, side effects of medications, or the effects of HIV on the brain. Whatever its origins, depression can limit the energy needed to keep focused on staying healthy, and research shows that it may accelerate HIV's progression to AIDS.5,6
HIV/AIDS Facts
AIDS was first reported in the United States in 1981 and has since become a major worldwide epidemic. AIDS is caused by the human immunodeficiency virus (HIV). By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight infections and certain cancers (http://www.nci.nih.gov/).
The term AIDS applies to the most advanced stages of HIV infection. More than 700,000 cases of AIDS have been reported in the United States since 1981, and as many as 900,000 Americans may be infected with HIV.7,8 The epidemic is growing most rapidly among women and minority populations.9
HIV is spread most commonly by having sex with an infected partner. HIV also is spread through contact with infected blood, which frequently occurs among injection drug users who share needles or syringes contaminated with blood from someone infected with the virus. Women with HIV can transmit the virus to their babies during pregnancy, birth, or breast-feeding. However, if the mother takes the drug AZT during pregnancy, she can reduce significantly the chances that her baby will be infected with HIV.
Many people do not develop any symptoms when they first become infected with HIV. Some people, however, have a flu-like illness within a month or two after exposure to the virus. More persistent or severe symptoms may not surface for a decade or more after HIV first enters the body in adults, or within two years in children born with HIV infection. This period of "asymptomatic" (without symptoms) infection is highly individual. During the asymptomatic period, however, the virus is actively multiplying, infecting, and killing cells of the immune system, and people are highly infectious.
As the immune system deteriorates, a variety of complications start to take over. For many people, their first sign of infection is large lymph nodes or "swollen glands" that may be enlarged for more than three months. Other symptoms often experienced months to years before the onset of AIDS include:

Lack of energy

Weight loss

Frequent fevers and sweats

Persistent or frequent yeast infections (oral or vaginal)

Persistent skin rashes or flaky skin

Pelvic inflammatory disease in women that does not respond to treatment

Short-term memory loss

Many people are so debilitated by the symptoms of AIDS that they cannot hold steady employment or do household chores. Other people with AIDS may experience phases of intense life-threatening illness followed by phases in which they function normally.
Because early HIV infection often causes no symptoms, a doctor or other health care worker usually can diagnose it by testing a person's blood for the presence of antibodies (disease-fighting proteins) to HIV. HIV antibodies generally do not reach levels in the blood which the doctor can see until one to three months following infection, and it may take the antibodies as long as six months to be produced in quantities large enough to show up in standard blood tests. Therefore, people exposed to the virus should get an HIV test within this time period.
Over the past 10 years, researchers have developed antiretroviral drugs to fight both HIV infection and its associated infections and cancers. Currently available drugs do not cure people of HIV infection or AIDS, however, and they all have side effects that can be severe. Because no vaccine for HIV is available, the only way to prevent infection by the virus is to avoid behaviors that put a person at risk of infection, such as sharing needles and having unprotected sex.
Get Treatment for Depression
While there are many different treatments for depression, they must be carefully chosen by a trained professional based on the circumstances of the person and family. Prescription antidepressant medications are generally well-tolerated and safe for people with HIV. There are, however, possible interactions among some of the medications and side effects that require careful monitoring. Specific types of psychotherapy, or "talk" therapy, also can relieve depression.
Some individuals with HIV attempt to treat their depression with herbal remedies. However, use of herbal supplements of any kind should be discussed with a physician before they are tried. Scientists recently discovered that St. John's wort, an herbal remedy sold over-the-counter and promoted as a treatment for mild depression, can have harmful interactions with other medications, including those prescribed for HIV. In particular, St. John's wort reduces blood levels of the protease inhibitor indinavir (Crixivan®) and probably the other protease inhibitor drugs as well. If taken together, the combination could allow the AIDS virus to rebound, perhaps in a drug-resistant form.
Treatment for depression in the context of HIV or AIDS should be managed by a mental health professional—for example, a psychiatrist, psychologist, or clinical social worker—who is in close communication with the physician providing the HIV/AIDS treatment. This is especially important when antidepressant medication is prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as HIV/AIDS may be available. People with HIV/AIDS who develop depression, as well as people in treatment for depression who subsequently contract HIV, should make sure to tell any physician they visit about the full range of medications they are taking.
Recovery from depression takes time. Medications for depression can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted. No matter how advanced the HIV, however, the person does not have to suffer from depression. Treatment can be effective.
It takes more than access to good medical care for persons living with HIV to stay healthy. A positive outlook, determination, and discipline are also required to deal with the stresses of avoiding high-risk behaviors, keeping up with the latest scientific advances, adhering to complicated medication regimens, reshuffling schedules for doctor visits, and grieving over the death of loved ones.
Other mental disorders, such as bipolar disorder (manic-depressive illness) and anxiety disorders, may occur in people with HIV or AIDS, and they too can be effectively treated. For more information about these and other mental illnesses, contact NIMH.
Remember, depression is a treatable disorder of the brain. Depression can be treated in addition to whatever other illnesses a person might have, including HIV. If you think you may be depressed or know someone who is, don't lose hope. Seek help for depression.
For More Information
Depression Information and Organizations from NLM's MedlinePlus (en Español)
References
1Bing EG, Burnam MA, Longshore D, et al. The estimated prevalence of psychiatric disorders, drug use and drug dependence among people with HIV disease in the United States: results from the HIV Cost and Services Utilization Study. Archives of General Psychiatry, in press.
2Shaffer D, Fisher P, Dulcan MK, et al. The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. Journal of the American Academy of Child and Adolescent Psychiatry, 1996; 35(7): 865-77.
3Regier DA, Narrow WE, Rae DS, et al. The de facto mental and addictive disorders service system. Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry, 1993; 50(2): 85-94.
4National Advisory Mental Health Council. Health care reform for Americans with severe mental illnesses. American Journal of Psychiatry, 1993; 150(10): 1447-65.
5Leserman J, Petitto JM, Perkins DO, et al. Severe stress, depressive symptoms, and changes in lymphocyte subsets in human immunodeficiency virus-infected men. Archives of General Psychiatry, 1997; 54(3): 279-85.
6Page-Shafer K, Delorenze GN, Satariano W, et al. Comorbidity and survival in HIV-infected men in the San Francisco Men's Health Survey. Annals of Epidemiology, 1996; 6(5): 420-30.
7Centers for Disease Control and Prevention (CDC). HIV/AIDS Surveillance Report, 2000; 12(1): 1-44.
8Guidelines for national human immunodeficiency virus case surveillance, including monitoring for human immunodeficiency virus infection and acquired immunodeficiency syndrome. MMWR, 1999; 48(RR-13): 1-27, 29-31.
9Centers for Disease Control and Prevention (CDC). HIV Prevention Strategic Plan Through 2005. Draft, September 2000.
Source: National Institute of Mental Health

L-Carnitine to Treat Fatigue in AIDS Patients

2005-10-25T16:33:00.000-07:00

L-Carnitine to Treat Fatigue in AIDS Patients
This study is currently recruiting patients.
Verified by National Center for Complementary and Alternative Medicine (NCCAM) April 2004
Sponsored by: National Institute of Nursing Research (NINR)

Information provided by: National Center for Complementary and Alternative Medicine (NCCAM)
ClinicalTrials.gov Identifier: NCT00079599

Purpose
Patients with AIDS may develop a deficiency of the micronutrient carnitine and such a deficiency may contribute to fatigue in these patients. This study will determine whether carnitine supplementation will improve fatigue and related symptoms in carnitine-deficient patients with AIDS.
Condition Intervention Phase
HIV Infections
AIDS Drug: L-carnitine Phase II

MedlinePlus related topics: AIDS
Study Type: Interventional
Study Design: Treatment, Randomized, Double-Blind, Placebo Control, Parallel Assignment, Efficacy Study
Official Title: Phase II Developmental Study on Fatigue in AIDS Patients
Further Study Details:

Expected Total Enrollment: 44
Study start: November 2002
Fatigue is a commonly reported symptom in patients with end stage AIDS. Appropriate treatment can relieve suffering and improve quality of life. The role of progression of the disease, depression, anemia, and poor nutritional status in the development of fatigue is well recognized. However, the impact of micronutrient deficiencies has been minimally explored. AIDS patients are at risk for micronutrient deficiencies because of decreased caloric intake, increased metabolic requirements, and treatment with medications that can interfere with absorption, synthesis, and excretion. Patients with AIDS are particularly likely to be carnitine deficient.
Levocarnitine (L-carnitine) is a micronutrient found in meat and dairy products that plays a major role in energy metabolism. Preliminary research has shown that patients with end stage AIDS experienced decreased levels of fatigue after L-carnitine supplementation. This study will evaluate the effectiveness of L-carnitine to treat patients with carnitine deficiency, fatigue, and AIDS.
Participants in this study will be randomly assigned to receive either L-carnitine or placebo for 2 weeks. To reduce the possibility of side effects, the doses of L-carnitine and placebo will be titrated over 6 days to the desired study dose. After 2 weeks, participants receiving placebo will be switched over to receive L-carnitine. All participants will continue on L-carnitine for an additional 2 weeks.
Eligibility
Ages Eligible for Study: 18 Years and above, Genders Eligible for Study: Both
Criteria
Inclusion Criteria:
• AIDS at Stage IV-C and estimated life expectancy < 6 months
• Karnofsky Performance Score > 50
• Clinically significant, persistent fatigue
• If undergoing pre-existing treatment for fatigue, must have been on a stable regimen for at least 4 weeks prior to study entry
• Concurrent use of epoetin alfa (PROCRIT®) will be allowed if the patient has been on a stable dose of epoetin alfa for at least 60 days prior to study entry
Exclusion Criteria:
• Severe cardiovascular, pulmonary, or renal function
• Hemodialysis
• Treatment or replacement therapy with any form of carnitine within 12 months prior to study entry
• Known sensitivity to carnitine
• Acute illness within 30 days of study entry that in the opinion of the study investigator would interfere with participation
• Active drug or alcohol use or dependence
• History of any central nervous system disease involving the brain that may put the patient at risk for seizure (e.g., primary or metastatic brain tumor, stroke) or history of seizure
• History of dementia, aphasia, or other deficits of cognition or speech/language function
Location and Contact Information
Please refer to this study by ClinicalTrials.gov identifier NCT00079599

New York
Department of Pain Medicine and Palliative Care; Beth Israel Medical Center; First Avenue at 16th Street, New York, New York, 10003, United States; Recruiting
Ricardo Cruciani, MD; PhD 212-420-4748 rcrucian@bethisraelny.org

Study chairs or principal investigators

Ricardo Cruciani, MD, PhD, Principal Investigator, Beth Israel Medical Center
More Information
Study ID Numbers: 1 R21 NR08295-01
Last Updated: August 1, 2005
Record first received: March 9, 2004
ClinicalTrials.gov Identifier: NCT00079599
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-10-25

Investigational Drugs

2005-10-24T04:24:00.000-07:00

Investigational Drugs Drugs for HIV/AIDS Investigational drugs, also called pipeline drugs, are experimental drugs that are not yet approved by the FDA and are available only through participation in a clinical trial.

Alovudine

AMD070

Amdoxovir

BMS-488043

C31G

Calanolide A

Capravirine

Carbopol 974P

Carrageenan

Cellulose sulfate

Cyanovirin-N

Dextran sulfate

DPC 817

Elvucitabine

GSK-873,140 (aplaviroc)

Hydroxyethyl cellulose

L-000870810

Peptide T

Poly(I)-Poly(C12U)

PRO 2000

PRO 542

Racivir

SCH-C

SCH-D (vicriviroc)

TMC114

TMC125

TNX-355

UC-781

UK-427,857 (maraviroc)

FREQUENTLY ASKED QUESTIONS ABOUT AIDS AND HIV

2005-10-23T02:36:00.000-07:00

What is AIDS? What causes AIDS?
AIDS stands for Acquired Immune Deficiency Syndrome.
An HIV-positive person receives an AIDS diagnosis after developing one of the CDC-defined AIDS indicator illnesses. An HIV-positive person can also receive an AIDS diagnosis on the basis of certain blood tests (CD4+ counts) and may not have experienced any serious illnesses. A positive HIV test does not mean that a person has AIDS. A diagnosis of AIDS is made by a physician according to the CDC AIDS Case Definition.
Over time, infection with HIV (Human Immunodeficiency Virus) can weaken the immune system to the point that the system has difficulty fighting off certain infections. These types of infections are known as opportunistic infections. Many of the infections that cause problems or that can be life-threatening for people with AIDS are usually controlled by a healthy immune system. The immune system of a person with AIDS has weakened to the point that medical intervention may be necessary to prevent or treat serious illness.
How long does it take for HIV to cause AIDS?
Currently, the average time between HIV infection and the appearance of signs that could lead to an AIDS diagnosis is 8-11 years. This time varies greatly from person to person and can depend on many factors including a person's health status and behaviors. Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS. As with other diseases, early detection offers more options for treatment and preventative health care.
How can I tell if I'm infected with HIV? What are the symptoms of AIDS?
The only way to determine whether you are infected is to be tested for HIV. You can't rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV don't have any symptoms for many years.
Similarly, you can't rely on symptoms to identify a person with an AIDS diagnosis. The symptoms associated with AIDS are similar to the symptoms of many other diseases. AIDS is a diagnosis made by a doctor based on specific criteria established by the Centers for Disease Control and Prevention (CDC).
Where can I get tested for HIV infection?
Many places provide testing for HIV infection. It is important to seek testing at a location that provides counseling about HIV and AIDS. Common locations include local health departments, private physicians, hospitals, and test sites specifically set up for HIV testing.
There is also testing which can be performed anonymously in the privacy of your own home. There are many home tests advertised through the internet, but only the Home Access Test has been approved by the FDA. The Home Access test kit can be found at most local pharmacies. The testing procedure involves pricking your finger with a special device, placing a drop of blood on a specially treated card, then mailing the card in for testing. You are given an identification number to use when you phone in for the test results-- 3 days or 2 weeks later, depending on the test kit purchased.
The CDC National AIDS Hotline can answer questions about testing and can refer you to testing sites in your area. The hotline numbers are 1-800-342-2437 (English), 1-800-344-7432, (Spanish), or 1-800-243-7889 (TTY).
How long after a possible exposure should I wait to get tested for HIV?When do you know for sure that you are not infected with HIV?
The tests commonly used to determine HIV infection actually look for antibodies produced by the body to fight HIV. According to the Centers for Disease Control and Prevention (CDC), most people will develop detectable antibodies within 3 months after infection. In rare cases, it can take up to six months. Therefore, the CDC recommends testing at 6 months after the last possible exposure. (unprotected vaginal, anal or oral sex or sharing needles). It would be extremely rare to take longer than six months to develop detectable antibodies. It is important, during the six months between exposure and the 6-month test, to protect yourself and others from further exposures to HIV. The CDC National AIDS Hotline can provide more information and referrals to testing sites in your area. The hotline can be reached at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
If I test HIV negative does that mean that my partner is HIV negative also?
No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you about the HIV status of your partner(s). HIV is not necessarily transmitted every time there is an exposure.
No one's test result can be used to determine another person's HIV status.
What if I test HIV positive?
If you test positive, the sooner you take steps to protect your health, the better. Early medical treatment, a healthy lifestyle and a positive attitude can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. It is important to know that a positive HIV test should always be confirmed, to be sure that it is a true positive. If your test result is positive, there are a number of important steps you can take immediately to protect your health:

See a doctor, even if you don't feel sick. Try to find a doctor who has experience treating HIV. There are now many new drugs to treat HIV infection. There are important tests, immunizations and drug treatments that can help you maintain good health. It is never too early to start thinking about treatment possibilities.

Have a tuberculosis (TB) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness. TB can be treated successfully if detected early.

Recreational drugs, alcoholic beverages and smoking can weaken your immune system. There are programs available to help you stop.

Consider joining a support group for people with HIV infection or finding out about other resources available in your area, such as HIV/AIDS-knowledgeable counselors for one on one therapy. There are also many newsletters available for people living with HIV and AIDS.

There is much you can do to stay healthy. Learning as much as you can is a step in the right direction. Local and/or national resources may be available. Many HIV/AIDS organizations provide services free or on a sliding scale, based on ability to pay.

Call the CDC National AIDS Hotline for more information and referrals at 1-800-342-2437 (English), 1-800-344-7432, (Spanish), or 1-800-243-7889 (TTY).

For more suggestions on maintaining health, click here.
I'm HIV positive. Where can I go for information about treatments?
The CDC National AIDS Hotline can offer practical information on maintaining health and general information about a wide variety of treatments, including antiretrovirals and prophylaxis for opportunistic infections. The hotline numbers are 1-800-342-2437 (English), 1-800-344-7432, (Spanish), or 1-800-243-7889 (TTY). The National AIDS Hotline can also provide referrals to national treatment hotlines, local AIDS Service Organizations and HIV/AIDS-knowledgeable physicians.
Detailed information on specific treatments is available from the HIV/AIDS Treatment Information Service (ATIS) at 1-800-448-0440. Information on enrolling in clinical trials can be obtained from the AIDS Clinical Trials Information Service (ACTIS) at 1-800-874-2572 (English and Spanish) and 1-800-243-7012 (TTY).
To go to the HIV/AIDS Treatment Information Service website, click here.
For other treatment referrals go to Links.
How safe is the U.S. blood supply?
The U.S. blood supply is among the safest in the world. Nearly all people infected with HIV through blood transfusions received those transfusions before 1985, the year it became possible to test donated blood for HIV.
The Public Health Service has recommended a multifaceted approach to blood safety in the United States that includes stringent donor selection practices and the use of screening tests. Blood donations in the United States have been screened for antibody to HIV-1 since March 1985 and HIV-2 since June 1992. Blood and blood products that test positive for HIV are safely discarded and are not used for transfusion
An estimated one in 450,000 to one in 660,000 donations per year are infectious for HIV but are not detected by current antibody screening tests. In August of 1995 the FDA recommended that all donated blood and plasma also be screened for HIV-1 p24 antigen. Donor screening for p24 antigen is expected to reduce the number of otherwise undetected infectious donations by approximately 25 percent per year. The improvement of processing methods for blood products has also reduced the number of infections resulting in the use of these products. Currently the risk of infection with HIV in the United States through receiving a blood transfusion or through the use of blood products is extremely rare and has become progressively more infrequent, even in areas with high HIV prevalence rates.
Where did HIV come from?
Scientists have different theories as to the origin of HIV but none have been proven. We now know that the virus has existed in the United States, Haiti and Africa since at least 1977-1978. In 1979 rare types of pneumonia, cancer and other illnesses were being reported by doctors in Los Angeles and New York. The common thread was that these were conditions not usually found in persons with healthy immune systems.
In 1982 the Centers for Disease Control and Prevention (CDC) officially named the condition AIDS (Acquired Immune Deficiency Syndrome). In 1984 the virus responsible for weakening the immune system was identified as HIV (Human Immunodeficiency Virus).
Why is CDC recommending that all pregnant women be tested for HIV?
If a woman is infected with HIV, there are now medical therapies available to lower the chance of passing HIV to the infant before, during or after birth. Retrovir (AZT) is the only drug currently approved for pregnant women, but there are many other promising drugs being studied in clinical trials.
HIV testing and counseling provides an opportunity for infected women to gain access to medical treatment which may help to delay disease progression.
HIV testing and counseling can also provide uninfected women with prevention information to reduce the possibility of future exposures.
Can a woman give HIV to a man during vaginal intercourse?
Yes. If the woman is infected, HIV is present in vaginal and cervical secretions and can enter the penis through the urethra or through cuts or abrasions on the skin of the penis. The presence of other STDs can increase the risk of transmission. The correct and consistent use of a latex condom or female condom can reduce the risk of transmitting HIV during vaginal intercourse. For more information, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
For more information on how to use a male or female condom, click here.
Can I get HIV from oral sex?
What is currently known is that there is some risk associated with performing oral sex without protection. Cumulative evidence indicates that the risk is less than that of unprotected anal or vaginal sex.
Currently, risk reduction options when performing oral sex on a man include the use of latex condoms, but also include withdrawal before ejaculation without a condom (avoiding semen in the mouth) and/or refraining from this activity when cuts or sores are present in the mouth.
When performing oral sex on a woman moisture barriers such as a dental dam, a cut-open and flattened condom or household plastic wrap can reduce the risk of exposure to vaginal secretions.
The risk from receiving oral sex, for both a man and a woman, is considered to be very low, and there have been no documented cases of transmission through receiving oral sex.
If you have other questions about oral sex and HIV, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
How effective are latex condoms in preventing HIV?
Several studies have demonstrated that latex condoms are highly effective in preventing HIV transmission when used correctly and consistently. These studies looked at uninfected people considered to be at very high risk of infection because they were involved in sexual relationships with HIV-infected persons. The studies found that even with repeated sexual contact, 98-100% of those people who used latex condoms consistently and correctly remained uninfected. For more on these studies, including free written information, call the CDC National AIDS Hotline at 1-800-342-2437 (English), 1-800-344-7432 (Spanish), or 1-800-243-7889 (TTY).
For more information on how to use a condom click here.
What's the connection between HIV and other sexually transmitted diseases?
Having a sexually transmitted disease (STD) can increase a person's risk of becoming infected with HIV, whether or not that STD causes lesions or breaks in the skin. If the STD infection causes irritation of the skin, breaks or sores may make it easier for HIV to enter the body during sexual contact. Even an STD that causes no breaks or sores can stimulate an immune response in the genital area that can make HIV transmission more likely.
For more information on other sexually transmitted diseases, click here.
Can I get HIV from kissing?
Casual contact through closed-mouth or "social" kissing is not a risk for transmission of HIV. Because of the potential for contact with blood during "French" or open-mouth, wet kissing, CDC recommends against engaging in this activity with a person known to be infected. However, the risk of acquiring HIV during open-mouth kissing is believed to be very low. CDC has investigated only one case of HIV infection that may be attributed to contact with blood during open-mouth kissing. In this case both partners had extensive dental problems including gingivitis (inflammation of the gums). It is likely that there was blood present in both partners' mouths making direct blood to blood contact a possibility.
Should I be concerned about getting infected with HIV while playing sports?
There are no documented cases of HIV infection acquired through participation in sports. The very low risk of HIV transmission through sports participation would principally involve sports with direct body contact where bleeding may be expected to occur. In the event of injury during such sports, sports participation should be interrupted until the wound stops bleeding and is both antiseptically cleaned and securely bandaged. There is no risk of transmission through sports activities where bleeding does not occur.
Can I get HIV from casual contact (shaking hands, hugging, using a toilet, drinking from the same glass, or the sneezing and coughing of an infected person)?
No. HIV is not transmitted by day to day contact in the home, the workplace, schools, or social settings. HIV is not transmitted through shaking hands, hugging or a casual kiss. You cannot become infected from a toilet seat, a drinking fountain, a doorknob, dishes, drinking glasses, food, or pets.
HIV is a fragile virus that does not live long outside the body. HIV is not an airborne or foodborne virus. HIV is present in the blood, semen or vaginal secretions of an infected person and can be transmitted through unprotected vaginal, oral or anal sex or through sharing injection drug needles.
Can I get infected with HIV from mosquitoes?
No. From the onset of the HIV epidemic, there has been concern about transmission of the virus by biting and bloodsucking insects. However, studies conducted by CDC and elsewhere have shown no evidence of HIV transmission through insects-- even in areas where there are many cases of AIDS and large populations of insects such as mosquitoes. Lack of such outbreaks, despite intense efforts to detect them, supports the conclusion that HIV is not transmitted by insects.
What are CDC's recommendations for prevention of transmission of HIV through injecting drug use?
For injecting drug users who can not stop using drugs, the best way to minimize the risk of transmission of HIV and other diseases is to never re-use or "share" syringes, water or drug preparation equipment. Keep in mind the following points:

Use only syringes obtained from a safe, reliable source (a pharmacy or syringe exchange).

Use a new, sterile syringe to prepare drugs.

If possible, use sterile water to prepare drugs; otherwise use clean water from a reliable source (fresh tap water).

Use a new or disinfected container ("cooker") and a new filter ("cotton") to prepare drugs.

Clean the injection site prior to injection with a new alcohol swab.

Safely dispose of syringes after one use.

The availability of new, sterile syringes varies, depending on state and local regulations regarding the sale and possession of syringes, and on other factors, such as the existence of syringe exchange programs sponsored by local HIV prevention organizations.
What about recommendations for cleaning needles and syringes?
If new, sterile syringes and other drug preparation equipment are not available, then previously used equipment should be disinfected with bleach using the following procedures. Disinfecting previously used needles and syringes with bleach can reduce the risk of HIV transmission but is not as safe as always using a new, sterile needle and syringe.

Flush the needle and syringe several times with clean water, being sure the needle is completely submersed.

Then, fill the syringe to the top several times with full-strength liquid chlorine bleach. Filling the syringe with bleach at least 3 times and allowing the bleach to remain in the syringe for at least 30 seconds may increase the likelihood that HIV will be inactivated.

To rinse, flush the needle and syringe again several times with clean water. Do not reuse the pre-bleach wash water for this step.

These procedures should be performed twice: once immediately after use and again just before reuse. Shaking and tapping the syringe are recommended when the syringe is filled with water and bleach. This should improve the effectiveness of all steps.

FREQUENTLY ASKED QUESTIONS ABOUT AIDS AND HIV

2005-10-23T02:34:00.000-07:00

See a doctor, even if you don't feel sick. Try to find a doctor who has experience treating HIV. There are now many new drugs to treat HIV infection. There are important tests, immunizations and drug treatments that can help you maintain good health. It is never too early to start thinking about treatment possibilities.

Have a tuberculosis (TB) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness. TB can be treated successfully if detected early.

Recreational drugs, alcoholic beverages and smoking can weaken your immune system. There are programs available to help you stop.

Consider joining a support group for people with HIV infection or finding out about other resources available in your area, such as HIV/AIDS-knowledgeable counselors for one on one therapy. There are also many newsletters available for people living with HIV and AIDS.

There is much you can do to stay healthy. Learning as much as you can is a step in the right direction. Local and/or national resources may be available. Many HIV/AIDS organizations provide services free or on a sliding scale, based on ability to pay.

Call the CDC National AIDS Hotline for more information and referrals at 1-800-342-2437 (English), 1-800-344-7432, (Spanish), or 1-800-243-7889 (TTY).

Use only syringes obtained from a safe, reliable source (a pharmacy or syringe exchange).

Use a new, sterile syringe to prepare drugs.

If possible, use sterile water to prepare drugs; otherwise use clean water from a reliable source (fresh tap water).

Use a new or disinfected container ("cooker") and a new filter ("cotton") to prepare drugs.

Clean the injection site prior to injection with a new alcohol swab.

Safely dispose of syringes after one use.

Flush the needle and syringe several times with clean water, being sure the needle is completely submersed.

Then, fill the syringe to the top several times with full-strength liquid chlorine bleach. Filling the syringe with bleach at least 3 times and allowing the bleach to remain in the syringe for at least 30 seconds may increase the likelihood that HIV will be inactivated.

To rinse, flush the needle and syringe again several times with clean water. Do not reuse the pre-bleach wash water for this step.

HOW EFFECTIVE ARE LATEX CONDOMS IN PREVENTING HIV?

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Latex condoms, when used consistently and correctly, are highly effective in preventing heterosexual sexual transmission of HIV, the virus that causes AIDS. Research on the effectiveness of latex condoms in preventing heterosexual transmission is both comprehensive and conclusive. The ability of latex condoms to prevent transmission has been scientifically established in laboratory studies as well as in epidemiologic studies of uninfected persons at very high risk of infection because they were involved in sexual relationships with HIV-infected partners. The most recent meta-analysis of epidemiologic studies of condom effectiveness was published by Weller and Davis in 2004. This analysis refines and updates their previous report published in 1999. The analysis demonstrates that the consistent use of latex condoms provides a high degree of protection against heterosexual transmission of HIV. It should be noted that condom use cannot provide absolute protection against HIV. The surest way to avoid transmission of HIV is to abstain from sexual intercourse or to be in a long-term mutually monogamous relationship with a partner who has been tested and you know is uninfected.

INTRODUCTION TO AIDS

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INTRODUCTION TO AIDS
AIDS (acquired immunodeficiency syndrome) was first reported in the United States in 1981 and has since become a major worldwide epidemic. AIDS is caused by HIV (human immunodeficiency virus). By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight infections and certain cancers. People diagnosed with AIDS may get life-threatening diseases called opportunistic infections, which are caused by microbes such as viruses or bacteria that usually do not make healthy people sick.
More than 900,000 cases of AIDS have been reported in the United States since 1981. As many as 950,000 Americans may be infected with HIV, one-quarter of whom are unaware of their infection. The epidemic is growing most rapidly among minority populations and is a leading killer of African-American males ages 25 to 44. According to the Centers for Disease Control and Prevention (CDC), AIDS affects nearly seven times more African Americans and three times more Hispanics than whites. In recent years, an increasing number of African-American women and children are being affected by HIV/AIDS. In 2003, two-thirds of U.S. AIDS cases in both women and children were among African-Americans.
TRANSMISSION
HIV is spread most commonly by having unprotected sex with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum, or mouth during sex.
Risky behavior
HIV can infect anyone who practices risky behaviors such as

Sharing drug needles or syringes

Having sexual contact, including oral, with an infected person without using a condom

Having sexual contact with someone whose HIV status is unknown

Infected blood
HIV also is spread through contact with infected blood. Before donated blood was screened for evidence of HIV infection and before heat-treating techniques to destroy HIV in blood products were introduced, HIV was transmitted through transfusions of contaminated blood or blood components. Today, because of blood screening and heat treatment, the risk of getting HIV from such transfusions is extremely small.
Contaminated needles
HIV is frequently spread among injection drug users by the sharing of needles or syringes contaminated with very small quantities of blood from someone infected with the virus.
It is rare, however, for a patient to give HIV to a health care worker or vice-versa by accidental sticks with contaminated needles or other medical instruments.
Mother to child
Women can transmit HIV to their babies during pregnancy or birth. Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies. HIV also can be spread to babies through the breast milk of mothers infected with the virus. If the mother takes certain drugs during pregnancy, she can significantly reduce the chances that her baby will get infected with HIV. If health care providers treat HIV-infected pregnant women and deliver their babies by cesarean section, the chances of the baby being infected can be reduced to a rate of 1 percent. HIV infection of newborns has been almost eradicated in the United States due to appropriate treatment.
A study sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) in Uganda found a highly effective and safe drug for preventing transmission of HIV from an infected mother to her newborn. Independent studies have also confirmed this finding. This regimen is more affordable and practical than any other examined to date. Results from the study show that a single oral dose of the antiretroviral drug nevirapine (NVP) given to an HIV-infected woman in labor and another to her baby within 3 days of birth reduces the transmission rate of HIV by half compared with a similar short course of AZT (Azidothymidine). For more information on preventing transmission from mother to child, go to http://aidsinfo.nih.gov/guidelines.
Saliva
Although researchers have found HIV in the saliva of infected people, there is no evidence that the virus is spread by contact with saliva. Laboratory studies reveal that saliva has natural properties that limit the power of HIV to infect, and the amount of virus in saliva appears to be very low. Research studies of people infected with HIV have found no evidence that the virus is spread to others through saliva by kissing. The lining of the mouth, however, can be infected by HIV, and instances of HIV transmission through oral intercourse have been reported.
Scientists have found no evidence that HIV is spread through sweat, tears, urine, or feces.
Casual contact
Studies of families of HIV-infected people have shown clearly that HIV is not spread through casual contact such as the sharing of food utensils, towels and bedding, swimming pools, telephones, or toilet seats.
HIV is not spread by biting insects such as mosquitoes or bedbugs.
Sexually transmitted infections
If you have a sexually transmitted infection (STI) such as syphilis, genital herpes, chlamydial infection, gonorrhea, or bacterial vaginosis appears, you may be more susceptible to getting HIV infection during sex with infected partners.
EARLY SYMPTOMS OF HIV INFECTION
If you are like many people, you will not have any symptoms when you first become infected with HIV. You may, however, have a flu-like illness within a month or two after exposure to the virus. This illness may include

Fever

Headache

Tiredness

Enlarged lymph nodes (glands of the immune system easily felt in the neck and groin)

These symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection. During this period, people are very infectious, and HIV is present in large quantities in genital fluids.
More persistent or severe symptoms may not appear for 10 years or more after HIV first enters the body in adults, or within 2 years in children born with HIV infection. This period of "asymptomatic" infection varies greatly in each individual. Some people may begin to have symptoms within a few months, while others may be symptom-free for more than 10 years.
Even during the asymptomatic period, the virus is actively multiplying, infecting, and killing cells of the immune system. The virus can also hide within infected cells and lay dormant. The most obvious effect of HIV infection is a decline in the number of CD4 positive T (CD4+) cells found in the blood-the immune system's key infection fighters. The virus slowly disables or destroys these cells without causing symptoms.
As the immune system worsens, a variety of complications start to take over. For many people, the first signs of infection are large lymph nodes or "swollen glands" that may be enlarged for more than 3 months. Other symptoms often experienced months to years before the onset of AIDS include

Lack of energy

Weight loss

Frequent fevers and sweats

Persistent or frequent yeast infections (oral or vaginal)

Persistent skin rashes or flaky skin

Pelvic inflammatory disease in women that does not respond to treatment

Short-term memory loss

Some people develop frequent and severe herpes infections that cause mouth, genital, or anal sores, or a painful nerve disease called shingles. Children may grow slowly or be sick a lot.

WHAT IS AIDS

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WHAT IS AIDS?
The term AIDS applies to the most advanced stages of HIV infection. CDC developed official criteria for the definition of AIDS and is responsible for tracking the spread of AIDS in the United States.
CDC's definition of AIDS includes all HIV-infected people who have fewer than 200 CD4+ T cells per cubic millimeter of blood. (Healthy adults usually have CD4+ T-cell counts of 1,000 or more.) In addition, the definition includes 26 clinical conditions that affect people with advanced HIV disease. Most of these conditions are opportunistic infections that generally do not affect healthy people. In people with AIDS, these infections are often severe and sometimes fatal because the immune system is so ravaged by HIV that the body cannot fight off certain bacteria, viruses, fungi, parasites, and other microbes.
Symptoms of opportunistic infections common in people with AIDS include

Coughing and shortness of breath

Seizures and lack of coordination

Difficult or painful swallowing

Mental symptoms such as confusion and forgetfulness

Severe and persistent diarrhea

Fever

Vision loss

Nausea, abdominal cramps, and vomiting

Weight loss and extreme fatigue

Severe headaches

Coma

Children with AIDS may get the same opportunistic infections as do adults with the disease. In addition, they also have severe forms of the typically common childhood bacterial infections, such as conjunctivitis (pink eye), ear infections, and tonsillitis.
People with AIDS are also particularly prone to developing various cancers, especially those caused by viruses such as Kaposi's sarcoma and cervical cancer, or cancers of the immune system known as lymphomas. These cancers are usually more aggressive and difficult to treat in people with AIDS. Signs of Kaposi's sarcoma in light-skinned people are round brown, reddish, or purple spots that develop in the skin or in the mouth. In dark-skinned people, the spots are more pigmented.
During the course of HIV infection, most people experience a gradual decline in the number of CD4+ T cells, although some may have abrupt and dramatic drops in their CD4+ T-cell counts. A person with CD4+ T cells above 200 may experience some of the early symptoms of HIV disease. Others may have no symptoms even though their CD4+ T-cell count is below 200.
Many people are so debilitated by the symptoms of AIDS that they cannot hold a steady job or do household chores. Other people with AIDS may experience phases of intense life-threatening illness followed by phases in which they function normally.
A small number of people first infected with HIV 10 or more years ago have not developed symptoms of AIDS. Scientists are trying to determine what factors may account for their lack of progression to AIDS, such as

Whether their immune systems have particular characteristics

Whether they were infected with a less aggressive strain of the virus

If their genes may protect them from the effects of HIV

Scientists hope that understanding the body's natural method of controlling infection may lead to ideas for protective HIV vaccines and use of vaccines to prevent the disease from progressing.

DIAGNOSIS OF AIDS

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DIAGNOSIS OF AIDS
Because early HIV infection often causes no symptoms, your health care provider usually can diagnose it by testing your blood for the presence of antibodies (disease-fighting proteins) to HIV. HIV antibodies generally do not reach noticeable levels in the blood for 1 to 3 months following infection. It may take the antibodies as long as 6 months to be produced in quantities large enough to show up in standard blood tests. Hence, to determine whether you have been recently infected (acute infection), your health care provider can screen you for the presence of HIV genetic material. Direct screening of HIV is extremely critical in order to prevent transmission of HIV from recently infected individuals.
If you have been exposed to the virus, you should get an HIV test as soon as you are likely to develop antibodies to the virus-within 6 weeks to 12 months after possible exposure to the virus. By getting tested early, if infected, you can discuss with your health care provider when you should start treatment to help your immune system combat HIV and help prevent the emergence of certain opportunistic infections (see section on treatment below). Early testing also alerts you to avoid high-risk behaviors that could spread the virus to others.
Most health care providers can do HIV testing and will usually offer you counseling at the same time. Of course, you can be tested anonymously at many sites if you are concerned about confidentiality.
Health care providers diagnose HIV infection by using two different types of antibody tests: ELISA and Western Blot. If you are highly likely to be infected with HIV but have been tested negative for both tests, your health care provider may request additional tests. You also may be told to repeat antibody testing at a later date, when antibodies to HIV are more likely to have developed.
Babies born to mothers infected with HIV may or may not be infected with the virus, but all carry their mothers' antibodies to HIV for several months. If these babies lack symptoms, a doctor cannot make a definitive diagnosis of HIV infection using standard antibody. Health care providers are using new technologies to detect HIV to more accurately determine HIV infection in infants between ages 3 months and 15 months. They are evaluating a number of blood tests to determine which ones are best for diagnosing HIV infection in babies younger than 3 months.