For so many years, the news about efforts to combat HIV/AIDS has been, in a word, depressing. It seemed that with every positive development would come news of escalating infection rates, or that some promising vaccine or therapy was less promising than we had hoped. But 2010 will be remembered as one of the first years where there seems to be almost universal optimism that real progress is being made in this war.
Perhaps the most optimistic front has been in the area of science. During this year, we have been uplifted with promising results of studies raging from the possible efficacy of microbicides, to the potential of gene therapy. At the International AIDS Conference, one of the major themes throughout the event was that effective HIV treatment IS prevention i.e., that reducing viral load may be an effective tool in reducing infection rates. Moreover, for many years, the idea of a pill that could prevent HIV infection was almost universally derided. Yet with the recent announcement of the National Institutes for Health study of pre –exposure prophylaxis in MSM, we now may have another tool to reduce infection rates in individuals at greatest risk.
Not all of the positive news has just been in the field of science. Thanks to President Barack Obama, the United States has its first National HIV/AIDS Strategy with an extra 30 million dollars added for HIV prevention (and 25 million for the struggling ADAP program). Moreover, with the reopening of the National AIDS Policy Office, the approval of needle exchange, the elimination of the travel ban for people with HIV and most importantly, the passing of the Affordable Care Act, the United States has finally taken a broad, visible leadership role in fighting this epidemic.
So while there is undoubtedly good news, there also remain challenges. Less than half of the individuals needing HAART are receiving it. Moreover, the global recession has caused historic belt tightening throughout the world. In the United States, many states and cities are either reducing or considering reduction in HIV/AIDS services. Even staunch HIV advocates are reflecting on the monumental task (not to mention the expense) of keeping tens of millions of HIV+ individuals alive with HAART indefinitely, a lifetime cost that a Cornell University study estimated at $600,000 per person.
So where do we go from here? Perhaps the greatest optimism during 2010 has been the belief from many HIV researchers that a cure may be on the horizon. There are several very promising areas of “cure” research with promising results. However, in this case, the ‘devil is not in the details,’ but in the dollars. In order to find a cure, whether a functional one that allows people to maintain an undetectable viral load without medication or an eradication cure, it will take a lot more money then is being expensed now. For example, the cost of researching and developing a single drug has been estimated at 500 million to 2 billion dollars.
The hundred dollar question is: will we demonstrate the commitment, through the economic resources and the will to revamp the infrastructure to facilitate cure and vaccine research, or will we keep looking around and hoping for some lucky, miraculous (and cheap) breakthrough? A wise man once coined the phrase to me that the history of AIDS is still being written. Let’s make this next chapter, 2011, the year where WE gave the bully a bloody nose.
Tuesday, November 23, 2010
Thursday, October 21, 2010
Disturbing New Information on MSM and HIV
One of the most frustrating aspects of working in HIV is addressing the many myths (as well as conspiracy theories) surrounding it-the most persistent of which is that AIDS is a "gay disease." Clearly this myth started early in the history of HIV in the U.S., yet has persisted despite clear evidence of how HIV is transmitted and the growing diversity of those whom become infected. Moreover, it has been convenient for many to affix the label of "gay" to anyone who has had sex with the same gender. However, a startling new report from the Centers for Disease Control (CDC) may add additional fuel to that myth. A CDC study conducted in 21 cities tested over 8,000 gay and bisexual men participating in the 2008 National HIV Behavioral Surveillance System.
The study found that almost one in five men having sex with men (MSM) was infected with HIV and that almost half of them did not know it. Black MSM were infected at a rate of 28%, as compared to 18% for Latino men and 16% for Caucasian MSM. Black MSM were even less likely to know their status than other races (59% were unaware) with young black MSM, a shocking 71% of which were unaware of their status. There was also a high co-morbidity with HIV status and socioeconomic variables-with HIV + status increasing as education and income decreased.
Studies such as these point to the glaring need for new creative strategies, not to mention social marketing approaches, to attract more and younger MSM to get tested. Moreover, despite all of the hoopla about '"men on the down low" as the culprit for rising infection rates with women, we cannot overlook the fact that many of the men in this study were bisexual and therefore, may have female partners. Previous studies have shown us that when someone knows their HIV status they are more likely to practice safer sex. Hopefully a renewed focus on HIV prevention targeting MSM may lead to a sorely need national dialogue revealing the diversity and complexity of the topic. Perhaps that discussion will help dispel the myth.
The study found that almost one in five men having sex with men (MSM) was infected with HIV and that almost half of them did not know it. Black MSM were infected at a rate of 28%, as compared to 18% for Latino men and 16% for Caucasian MSM. Black MSM were even less likely to know their status than other races (59% were unaware) with young black MSM, a shocking 71% of which were unaware of their status. There was also a high co-morbidity with HIV status and socioeconomic variables-with HIV + status increasing as education and income decreased.
Studies such as these point to the glaring need for new creative strategies, not to mention social marketing approaches, to attract more and younger MSM to get tested. Moreover, despite all of the hoopla about '"men on the down low" as the culprit for rising infection rates with women, we cannot overlook the fact that many of the men in this study were bisexual and therefore, may have female partners. Previous studies have shown us that when someone knows their HIV status they are more likely to practice safer sex. Hopefully a renewed focus on HIV prevention targeting MSM may lead to a sorely need national dialogue revealing the diversity and complexity of the topic. Perhaps that discussion will help dispel the myth.
Thursday, October 7, 2010
HIV may have been present for 32,000 years
Despite the persistent myth that HIV was a man-made disease, unleashed upon the unsuspecting, disenfranchised of our society (read gays and blacks), now comes more evidence that it may have been present in monkeys and apes for a millennia. New research, published in Science magazine last month, report the presence of the ancestor of the simian HIV virus in Africa possibly dating back as far as 78,000 years. This fascinating research, that studied monkey species on a volcanic island off of the coast of West Africa, who developed in isolation, found that four of the six species had been infected with HIV.
Although this study may help to answer certain questions, such as why HIV infects most simian species, but doesn't kill them, it fails to answer the main one: how did a relatively benign monkey virus become one of the greatest health crises in the history of mankind. Many still believe that the human HIV epidemic was caused by, purposely or inadvertently, human meddling.
Evidence of the great age of HIV does point to the likelihood that, over centuries, the virus killed off weaker monkeys leaving behind those who became resistant to it. However, does that mean that it will take thousands of years before we are able to adapt naturally to HIV? Can we survive that long with rising rates, declining government support and the aggressive mutation of the virus?
Our obvious advantage is, of course, our technological superiority. We now have over 30 medications to treat HIV and many believe that a cure is still possible. However, by following the path of HIV and other diseases, it hopefully reminds us of our fragility and vulnerability as we continue, sometimes in the interest of capitalism and expansion, to invade more exotic and isolated lands and interact with previously unknown species.
Although this study may help to answer certain questions, such as why HIV infects most simian species, but doesn't kill them, it fails to answer the main one: how did a relatively benign monkey virus become one of the greatest health crises in the history of mankind. Many still believe that the human HIV epidemic was caused by, purposely or inadvertently, human meddling.
Evidence of the great age of HIV does point to the likelihood that, over centuries, the virus killed off weaker monkeys leaving behind those who became resistant to it. However, does that mean that it will take thousands of years before we are able to adapt naturally to HIV? Can we survive that long with rising rates, declining government support and the aggressive mutation of the virus?
Our obvious advantage is, of course, our technological superiority. We now have over 30 medications to treat HIV and many believe that a cure is still possible. However, by following the path of HIV and other diseases, it hopefully reminds us of our fragility and vulnerability as we continue, sometimes in the interest of capitalism and expansion, to invade more exotic and isolated lands and interact with previously unknown species.
Tuesday, September 14, 2010
Opt-Out and Eliminating Consent for HIV Testing
President Obama's new AIDS Strategy calls for a renewed effort to reduce new HIV infections by 25%, increasing the number of people who know their status from 79% to 90%. Crucial to the success of this benchmark is to test more people for HIV. This is consistent with the Center for Disease Control's recent recommendations (in 2006) to encourage HIV testing to become a routine part of medical care. However, one of the more controversial aspects of this push is the distinction between 'opt -in' vs 'opt-out HIV testing. Opt-in testing generally refers to an opportunity for the patient to be asked, by a provider, if s/he would like to be tested for HIV. Opt-out testing means that a patient will be given an HIV test unless s/he chooses not to have one. The CDC has recommended opt-out testing as well as the elimination of written consent (a medical consent form that authorizes HIV testing).
As one might imagine, this is a pretty contentious topic, even among HIV advocates and medical providers. Supporters of opt -in testing and informed consent argue that people need to understand what they are being tested for and why. Moreover, they argue that eliminating written, or even verbal consent fails to address the reasons why so many people fail to be tested, at the expense of expediency. Ignorance, apathy, stigma and discrimination are still alive and well, they claim, and cannot be ignored. Opt-out testing proponents point to the growing members of people who do not know their HIV status, present for treatment in the latter stages of their disease and the glaring disparity of HIV among the poor and communities of color as evidence that the present system isn't working and that we need new strategies to address the soaring epidemic. They also minimize the impact of stigma and discrimination, due in part to the efforts to make HIV testing more routine.
Nowhere is this debate raging more than in New York City, which still hold the crown for the highest incidence of HIV of any US city. New York State requires written consent, but the current policy is being reexamined. So what is the right policy? One thing is clear: both sides seem to be focused on the same outcome, a reduction of HIV infection. Unfortunately, in an era of dwindling resources it is sad that there is not more consensus on this issue. What isn't clear if if the present policies around informed consent aren't working. There is evidence that many medical providers are not offering HIV testing to their patients, due in part to their discomfort with the subject. Moreover, there is evidence, some of which comes from New York itself that HIV testing is rising under the current rules.
I am concerned that if people are not given an opportunity for consent for HIV testing and to have the conversation that would likely take place with that medical provider, that much of the ignorance and misconceptions about HIV will remain. Moreover, if provider feel a conversation about HIV testing is uncomfortable, then how will they feel about giving someone a positive result? We clearly have a long way to go before our society sees HIV/AIDS as just a medical condition. Before eliminating informed consent, I feel that more training for medical providers, more and robust social marketing to reduce HIV stigma and a renewed emphasis to ensure that HIV testing is being offered in routine medical settings are more effective measures to increase HIV testing.
As one might imagine, this is a pretty contentious topic, even among HIV advocates and medical providers. Supporters of opt -in testing and informed consent argue that people need to understand what they are being tested for and why. Moreover, they argue that eliminating written, or even verbal consent fails to address the reasons why so many people fail to be tested, at the expense of expediency. Ignorance, apathy, stigma and discrimination are still alive and well, they claim, and cannot be ignored. Opt-out testing proponents point to the growing members of people who do not know their HIV status, present for treatment in the latter stages of their disease and the glaring disparity of HIV among the poor and communities of color as evidence that the present system isn't working and that we need new strategies to address the soaring epidemic. They also minimize the impact of stigma and discrimination, due in part to the efforts to make HIV testing more routine.
Nowhere is this debate raging more than in New York City, which still hold the crown for the highest incidence of HIV of any US city. New York State requires written consent, but the current policy is being reexamined. So what is the right policy? One thing is clear: both sides seem to be focused on the same outcome, a reduction of HIV infection. Unfortunately, in an era of dwindling resources it is sad that there is not more consensus on this issue. What isn't clear if if the present policies around informed consent aren't working. There is evidence that many medical providers are not offering HIV testing to their patients, due in part to their discomfort with the subject. Moreover, there is evidence, some of which comes from New York itself that HIV testing is rising under the current rules.
I am concerned that if people are not given an opportunity for consent for HIV testing and to have the conversation that would likely take place with that medical provider, that much of the ignorance and misconceptions about HIV will remain. Moreover, if provider feel a conversation about HIV testing is uncomfortable, then how will they feel about giving someone a positive result? We clearly have a long way to go before our society sees HIV/AIDS as just a medical condition. Before eliminating informed consent, I feel that more training for medical providers, more and robust social marketing to reduce HIV stigma and a renewed emphasis to ensure that HIV testing is being offered in routine medical settings are more effective measures to increase HIV testing.
Tuesday, July 27, 2010
Day Five of the International AIDS Conference of 2010
The conference is starting to wind down. From a personal and environmental perspective, you can feel the air slowly ‘leaving the balloon.’ The palpable energy level has dropped appreciably. Many of us are just overloaded. There is so much information being disseminated, as well as events, press conferences, and activities, many occurring concurrently, that it is physically impossible to attend but a fraction of it. One of my greatest regrets is that I haven’t had an opportunity to have any substantive conversations with my brothers and sisters from other counties. There has just been so little time. I have had the opportunity to speak with a couple of the gentlemen in my traveling party who work for organizations that have similar programs to my owe. I have found those conversations to be enlightening and helpful.
I had the opportunity to attend The Other City,’ Sheila Johnson’s independent film about HIV in Washington D.C. Suffice to say, because I don’t want to spoil the movie, it is well worth seeing and I am going to work hard to bring it to the Philadelphia area. After the movie, we have a brief discussion period which included some convention delegates from Africa and Haiti. While it certainly wasn’t the first time I heard it, they remarked at how surprised they were that HIV was a problem in the United States. Their perception of the U.S. is that we are wealthy and that the HIV epidemic is under control here. The real irony here is that most Americans, including many black Americans, feel the same way. I can’t keep track of the number of conversations I have had with American black folks who have told me that they didn’t think that HIV was a problem because they hardly hear about it. While I acknowledge that there is not enough HIV reporting, there is plenty of information available for those who seek it. So therein lies the problem, why don’t we want to know. Clearly, some of us don’t believe that we are at risk. Others still hold on to the myths (that it’s a gay disease) and conspiracy theories (that there is an actual cure). Still others find it depressing and feel that they already have enough to deal with.
So what do we do? How do we get black folks attention, especially with the next International HIV Conference in Washington D.C., looming? Think about it: What message do we want to take to that conference? Will it be that we are still dragging our feet and HIV in the US has worsened? Or will we begin to live up to the hype, the international image that we have HIV better managed and might actually be in a position to show other folks how to do it? I ran into actress Sheryl Lee Ralph here. She suggested a million person march on HIV. Hmmm, not a bad idea. Volunteers?
Goodbye from Vienna. This will be my last official Vienna blog, but please follow my blog, called unabashedly, ‘Gary’s Blog at www.bebashi.org and at The Body website (www.thebody.com).
Auf wiedersehen!
I had the opportunity to attend The Other City,’ Sheila Johnson’s independent film about HIV in Washington D.C. Suffice to say, because I don’t want to spoil the movie, it is well worth seeing and I am going to work hard to bring it to the Philadelphia area. After the movie, we have a brief discussion period which included some convention delegates from Africa and Haiti. While it certainly wasn’t the first time I heard it, they remarked at how surprised they were that HIV was a problem in the United States. Their perception of the U.S. is that we are wealthy and that the HIV epidemic is under control here. The real irony here is that most Americans, including many black Americans, feel the same way. I can’t keep track of the number of conversations I have had with American black folks who have told me that they didn’t think that HIV was a problem because they hardly hear about it. While I acknowledge that there is not enough HIV reporting, there is plenty of information available for those who seek it. So therein lies the problem, why don’t we want to know. Clearly, some of us don’t believe that we are at risk. Others still hold on to the myths (that it’s a gay disease) and conspiracy theories (that there is an actual cure). Still others find it depressing and feel that they already have enough to deal with.
So what do we do? How do we get black folks attention, especially with the next International HIV Conference in Washington D.C., looming? Think about it: What message do we want to take to that conference? Will it be that we are still dragging our feet and HIV in the US has worsened? Or will we begin to live up to the hype, the international image that we have HIV better managed and might actually be in a position to show other folks how to do it? I ran into actress Sheryl Lee Ralph here. She suggested a million person march on HIV. Hmmm, not a bad idea. Volunteers?
Goodbye from Vienna. This will be my last official Vienna blog, but please follow my blog, called unabashedly, ‘Gary’s Blog at www.bebashi.org and at The Body website (www.thebody.com).
Auf wiedersehen!
Day Four of the International AIDS Conference of 2010
‘Charity begins at home.’ A cliché? Certainly! But with dwindling resources for everything and a raging HIV Epidemic in Black people in the United States, should we concentrate more of our efforts here? This question, which has created an ongoing tension for many HIV/AIDS advocates in the U. S., was the proverbial ‘elephant in the room during a breakfast meeting I attended with billionaire philanthropist Sheila Johnson this morning. Ms Johnson acknowledged coming to the same conclusion through her international work with CARE upon learning of the devastation that HIV was causing in Washington DC. For years, we (Black U.S. HIV advocates) have witnessed the constant flow of wealthy celebrities overseas, often to Africa, to attempt to make some small impact in the epidemic. We have struggled with the dichotomy of two virtual epidemics: one here ad the other overseas. If we are truly our brother’s keepers, how can we begrudge anyone helping our brothers and sisters in the ‘motherland?’ No one will discount the devastation of HIV in Africa.
As I travel throughout the conference and look into the many faces of its participants, it is clear that most, if not all, are very, very passionate about the impact of HIV in there respective countries and/or, for the constituents they represent: women, transgender, MSM (men having sex with men), sex workers, etc... Few seem to advocate for resources to be sent elsewhere. Therefore, is it selfish for those in the U.S. who have more resources and clearly have an edge in terms of access to life sustaining antiretroviral therapy, to place most of our emphasis on home? While no one would argue that we have more in the U.S., for black people, we clearly do not have enough. Moreover, we now recognize that HIV rates in some areas of the U.S.: parts of the rural south, the Bronx, North Philadelphia and of course Washington DC, rival countries in Sub Saharan Africa. Therefore, do we now have the justification to advocate more vociferously for more of our resources to remain at home? Did we ever need to ‘justification?’ And if we don’t advocate, what will the consequence be?
Well, ladies and gentleman, we are living the consequences of not just diverted resources, but our own ignorance and apathy. We have very little margin for error. While we certainly have no right to tell Oprah, or Alicia Keys how to spend their money, we can and we must continue to educate them and others (including those of more moderate means) that our own house is on fire and that if we run down the street to help our neighbors than we just might not have a home to come back to. It is a difficult conversation to have. But I’m ready. Let’s talk about it!
Goodbye from Vienna. Will be in touch tomorrow!
As I travel throughout the conference and look into the many faces of its participants, it is clear that most, if not all, are very, very passionate about the impact of HIV in there respective countries and/or, for the constituents they represent: women, transgender, MSM (men having sex with men), sex workers, etc... Few seem to advocate for resources to be sent elsewhere. Therefore, is it selfish for those in the U.S. who have more resources and clearly have an edge in terms of access to life sustaining antiretroviral therapy, to place most of our emphasis on home? While no one would argue that we have more in the U.S., for black people, we clearly do not have enough. Moreover, we now recognize that HIV rates in some areas of the U.S.: parts of the rural south, the Bronx, North Philadelphia and of course Washington DC, rival countries in Sub Saharan Africa. Therefore, do we now have the justification to advocate more vociferously for more of our resources to remain at home? Did we ever need to ‘justification?’ And if we don’t advocate, what will the consequence be?
Well, ladies and gentleman, we are living the consequences of not just diverted resources, but our own ignorance and apathy. We have very little margin for error. While we certainly have no right to tell Oprah, or Alicia Keys how to spend their money, we can and we must continue to educate them and others (including those of more moderate means) that our own house is on fire and that if we run down the street to help our neighbors than we just might not have a home to come back to. It is a difficult conversation to have. But I’m ready. Let’s talk about it!
Goodbye from Vienna. Will be in touch tomorrow!
Day Three of the International AIDS Conference of 2010
With yesterday’s release of the CDC’S report on the relationship between poverty, and another study on morbidity and mortality released by the University of California, Day three of the International AIDS Conference of 2010 began on a more somber note. To be blunt: It’s about Poverty, stupid. While the CDC’s report demonstrated a clear link between HIV infection and poverty in urban centers, the UC report focused on dramatically heightened mortality rates of ‘disadvantaged’ (read poor back folks) who have been linked to care and started on state of the art antiretroviral therapy-rates that were in excess of third world countries. None of the deceased patients ever received viral suppression, despite robust supportive and case management services to help them. In short, even getting low income minorities into care is, as Winston Churchill would say (and I paraphrase); ‘Is not the end, is not the beginning of the end, but the end of the beginning.’
Many of us have been impacted in many ways by the global financial recession. We probably know people who have lost their jobs or perhaps even their homes. We are all pinching pennies to make ends meet. But, no where may the effects of the recession be felt more greatly than in HIV prevention and care. Think about it: if we have more minorities falling into poverty, or becoming more entrenched in it, then we may see greater HIV infection rates in those urban areas where most of them (and us) live. Moreover, even if we link them into care, how will we ensure that they stay in care and take their medication? So many of us have become comfortable thinking about HIV disease as a chronic, manageable condition; much like diabetes. But we all know black folks, probably in our families, who have ‘sugar’ (what some of our seasoned citizens call diabetes) who slide up to the table and eat those greasy chicken wings or smack on that sweet potato pie. And we watch those same folks lose their vision, or even some toes, because of uncontrolled diabetes. However, with HIV, they may lose a lot more than some toes. Moreover, unlike most other ‘chronic conditions like diabetes, HIV is transmissible.
So the reality of my work, (which I am never unrealistic about), hit a little harder today. It also reminds me that the US National Strategy on HIV/AIDS will require unprecedented coordination and cooperation by not just HHS, the CDC and SAMSHA, but from other agencies that (should) focus on the poor such as HUD and the Departments of Labor and Education. With drop out rates of 50% in Philly and unemployment rates in the black community more than double the national rate’ we must do more to address poverty in order to have an impact on health disparities, especially with HIV.
Goodbye from Vienna. Will be in touch tomorrow!
Many of us have been impacted in many ways by the global financial recession. We probably know people who have lost their jobs or perhaps even their homes. We are all pinching pennies to make ends meet. But, no where may the effects of the recession be felt more greatly than in HIV prevention and care. Think about it: if we have more minorities falling into poverty, or becoming more entrenched in it, then we may see greater HIV infection rates in those urban areas where most of them (and us) live. Moreover, even if we link them into care, how will we ensure that they stay in care and take their medication? So many of us have become comfortable thinking about HIV disease as a chronic, manageable condition; much like diabetes. But we all know black folks, probably in our families, who have ‘sugar’ (what some of our seasoned citizens call diabetes) who slide up to the table and eat those greasy chicken wings or smack on that sweet potato pie. And we watch those same folks lose their vision, or even some toes, because of uncontrolled diabetes. However, with HIV, they may lose a lot more than some toes. Moreover, unlike most other ‘chronic conditions like diabetes, HIV is transmissible.
So the reality of my work, (which I am never unrealistic about), hit a little harder today. It also reminds me that the US National Strategy on HIV/AIDS will require unprecedented coordination and cooperation by not just HHS, the CDC and SAMSHA, but from other agencies that (should) focus on the poor such as HUD and the Departments of Labor and Education. With drop out rates of 50% in Philly and unemployment rates in the black community more than double the national rate’ we must do more to address poverty in order to have an impact on health disparities, especially with HIV.
Goodbye from Vienna. Will be in touch tomorrow!
Day two of the International AIDS Conference of 2010
Day two of the International AIDS Conference of 2010 began with a bang: an address at the opening plenary by former President Bill Clinton. As expected, it was standing room only. Prior to today, I had only gotten a glimpse of the sheer number of delegates present. However, it was at the Clinton address that I began to see just how many people are here. It is truly amazing-So many people of different hues, nationalities, and roles: physicians, researchers, representatives from government and non government entities and, of course, people living with the virus.
As you can imagine, the address from former President Clinton was thoughtful and moving. I was first struck by his knowledge of the issue (of HIV/AIDS). His address covered many areas. For example, he spoke of the work of his foundation in countries as varied as the Ukraine to Zambia. He also spoke about the progress being made especially in reducing mother to child transmission and in increasing the number of people living with HIV who receive life-sustaining medication. He challenged us to spend our limited HIV funds more smartly before we demanded more. He even acknowledged that, as President of the United States for 8 years, how he did not do enough about HIV/AIDS. However, being the politician that he is, his most controversial statements covered the direction that he believes we should take for activism. While acknowledging the rights of activists to protest whatever and whoever they choose, he also reminded those who have recently protested President Obama for his failure to fund PEPFAR at the level that he ‘promised,’ that his (Obama’s) commitment came long before the almost complete economic collapse of our country. I acknowledge that my respect for Bill Clinton had dwindled as a result of his tactics in campaigning for his wife Hillary against Obama. Therefore, I was even more pleased to hear his common sense defense of President Obama, Former President Clinton expressed that activism would be better served by putting more pressure on Congress to cooperate (yes, I used the words ‘Congress’ and ‘cooperate’ in the same sentence) with the Obama administration and to appropriate more funding.
This raises a very controversial topic: Just how much ‘slack’ should Obama receive. As the first Black president, Obama, unfortunately was given an extremely rotten hand to play: two long, expensive wars; financial instability; and a totally uncooperative Republican party, to name a few. Should we wait for some of the smoke to clear before we go on the attack? Does his successful push for more health care in the United States count for anything? At the heart of the matter is, do we really trust him? Can we trust any politician?
I believe that it is a delicate balancing act between maintaining consistent, but flexible pressure on all of the powers that be, including Obama, but at the same time ‘turning up the heat,’ as it were, on those who have historically opposed universal health care. Personally, I am grateful for the contributions thus far and in anticipation of those to come from these two great men: Clinton and Obama.
Goodbye from Vienna. Will be in touch tomorrow!
As you can imagine, the address from former President Clinton was thoughtful and moving. I was first struck by his knowledge of the issue (of HIV/AIDS). His address covered many areas. For example, he spoke of the work of his foundation in countries as varied as the Ukraine to Zambia. He also spoke about the progress being made especially in reducing mother to child transmission and in increasing the number of people living with HIV who receive life-sustaining medication. He challenged us to spend our limited HIV funds more smartly before we demanded more. He even acknowledged that, as President of the United States for 8 years, how he did not do enough about HIV/AIDS. However, being the politician that he is, his most controversial statements covered the direction that he believes we should take for activism. While acknowledging the rights of activists to protest whatever and whoever they choose, he also reminded those who have recently protested President Obama for his failure to fund PEPFAR at the level that he ‘promised,’ that his (Obama’s) commitment came long before the almost complete economic collapse of our country. I acknowledge that my respect for Bill Clinton had dwindled as a result of his tactics in campaigning for his wife Hillary against Obama. Therefore, I was even more pleased to hear his common sense defense of President Obama, Former President Clinton expressed that activism would be better served by putting more pressure on Congress to cooperate (yes, I used the words ‘Congress’ and ‘cooperate’ in the same sentence) with the Obama administration and to appropriate more funding.
This raises a very controversial topic: Just how much ‘slack’ should Obama receive. As the first Black president, Obama, unfortunately was given an extremely rotten hand to play: two long, expensive wars; financial instability; and a totally uncooperative Republican party, to name a few. Should we wait for some of the smoke to clear before we go on the attack? Does his successful push for more health care in the United States count for anything? At the heart of the matter is, do we really trust him? Can we trust any politician?
I believe that it is a delicate balancing act between maintaining consistent, but flexible pressure on all of the powers that be, including Obama, but at the same time ‘turning up the heat,’ as it were, on those who have historically opposed universal health care. Personally, I am grateful for the contributions thus far and in anticipation of those to come from these two great men: Clinton and Obama.
Goodbye from Vienna. Will be in touch tomorrow!
Day One of the International AIDS Conference of 2010
Day One of the International AIDS Conference of 2010, but Day Three for me in Vienna, Austria. This is a time of ‘firsts’ for me. This is my first International AIDS Conference and my first time travelling to Europe . I am attending the conference as a delegate of BTAN, the Black AIDS Treatment Network of the Black AIDS Institute. My day job is as the Executive Director of BEBASHI- Transition to Hope; the first Black AIDS Services Organization in the country which is, this year, commemorating its 25th anniversary. I was honored to be chosen for this important job that will include a three year commitment and will involve creating a treatment advocate/education initiative in Philadelphia. It was a difficult trip. I am sure that veterans of international travel will understand, but I have certainly learned a few lessons. However, so far, it has been well worth it. When I told my collegues that I would be attending the conference and that it was in Europe, I was meant with virtually universal support. However, whenever I embark on a new endeavor or initiative, I have trained myself to ask a crucial question: What for? In other words, why an international AIDS conference when the focus of my career has been to help primarily minority people in the Philadelphia metropolitan area. To be blunt: how will learning more about HIV/AIDS around the world help poor black folks in Philly? It’s an important question but one that was easily answered in my first two days of meetings and presentations. While I expect this to be (and it has so far) been a life changing experience, I will summarize the main expectations in three ways:
1. Information: With eight days of meetings, presentations, poster sessions as well as informal conversations and networking, I have already begun to learn a great deal especially about new trends, interventions, etc... that I can utilize in my work in Philadelphia. For example, yesterday, I attended a special session facilitated by the Black AIDS Institute that featured some of the best minds in African American HIV/AIDS Treatment, Policy and Care, including Dr. Kevin Fenton of the Centers for Disease Control, Dr. Helene Gayle, of CARE and United States Representative Barbara Lee. Their words and careers have been an inspiration to me and I valued the opportunity not just to hear, but to meet them.
2. Context: Another program that I attended today was a meeting facilitated by the African and Black Diaspora Global Network on HIV and AIDS (ABDGN). Launched at the International AIDS conference in Toronto Canada in 2006, ABDGN's mission is to strengthen the response to emerging HIV/AIDS epidemics among African and black communities in the Diaspora. While I am certainly aware of the existence of black people in many countries around the world, this session, as well as the one sponsored the day before by the Black AIDS Institute, helped to remind me of the devastation of HIV, not just in Sub Saharan Africa and the Caribbean, but among other black people including those in Canada, Germany, France, England, etc… As a loooong term HIV/AIDS activist (since 1987), I and many like me have struggled to get our folks in the United States to recognize that while this is a global epidemic, that the United States is a part of that globe. Yet, we cannot lose sight of the fact that there are no walls around the United States and some of those very same people, my brothers and sisters from the Diaspora, may end up here. Moreover, we cannot allow others around the world to suffer because of the lack of information or access to treatment that is readily available to us. An International AIDS Conference helps to remind me of something that we actually have printed on one of BEBASHI’S T-Shirts: “One World, One Epidemic.”
3. Contribution: This final theme is one that hasn’t really happened yet and that is: What will my contribution be; both to this Conference and to my community. The final presentation of the day that I attended was on the United States National HIV/AIDS Strategy. There have been Strategic Plans, such as the one led By Dr, Helen Gayle when she was at the CDC, to cut the number of new HIV infections in half; yet there has never been a true United States Strategy. Without elaborating too much on the plan, it focuses on three primary goals: Reducing the number of new infections; increasing access to care and optimizing health outcomes for people living with HIV/AIDS and; reducing HIV-related health disparities. Needless to say, even though developing the strategy was not an easy task, now comes the hard part: implementing it.
Goodbye from Vienna. Will be in touch tomorrow!
1. Information: With eight days of meetings, presentations, poster sessions as well as informal conversations and networking, I have already begun to learn a great deal especially about new trends, interventions, etc... that I can utilize in my work in Philadelphia. For example, yesterday, I attended a special session facilitated by the Black AIDS Institute that featured some of the best minds in African American HIV/AIDS Treatment, Policy and Care, including Dr. Kevin Fenton of the Centers for Disease Control, Dr. Helene Gayle, of CARE and United States Representative Barbara Lee. Their words and careers have been an inspiration to me and I valued the opportunity not just to hear, but to meet them.
2. Context: Another program that I attended today was a meeting facilitated by the African and Black Diaspora Global Network on HIV and AIDS (ABDGN). Launched at the International AIDS conference in Toronto Canada in 2006, ABDGN's mission is to strengthen the response to emerging HIV/AIDS epidemics among African and black communities in the Diaspora. While I am certainly aware of the existence of black people in many countries around the world, this session, as well as the one sponsored the day before by the Black AIDS Institute, helped to remind me of the devastation of HIV, not just in Sub Saharan Africa and the Caribbean, but among other black people including those in Canada, Germany, France, England, etc… As a loooong term HIV/AIDS activist (since 1987), I and many like me have struggled to get our folks in the United States to recognize that while this is a global epidemic, that the United States is a part of that globe. Yet, we cannot lose sight of the fact that there are no walls around the United States and some of those very same people, my brothers and sisters from the Diaspora, may end up here. Moreover, we cannot allow others around the world to suffer because of the lack of information or access to treatment that is readily available to us. An International AIDS Conference helps to remind me of something that we actually have printed on one of BEBASHI’S T-Shirts: “One World, One Epidemic.”
3. Contribution: This final theme is one that hasn’t really happened yet and that is: What will my contribution be; both to this Conference and to my community. The final presentation of the day that I attended was on the United States National HIV/AIDS Strategy. There have been Strategic Plans, such as the one led By Dr, Helen Gayle when she was at the CDC, to cut the number of new HIV infections in half; yet there has never been a true United States Strategy. Without elaborating too much on the plan, it focuses on three primary goals: Reducing the number of new infections; increasing access to care and optimizing health outcomes for people living with HIV/AIDS and; reducing HIV-related health disparities. Needless to say, even though developing the strategy was not an easy task, now comes the hard part: implementing it.
Goodbye from Vienna. Will be in touch tomorrow!
Thursday, May 27, 2010
Does Pregnancy Pose an HIV Infection Risk for Men?
Previous studies have demonstrated that pregnant women are at greater risk of HIV infection. However, a new study, presented at the International Microbicides Conference in Pittsburgh in May seems to demonstrate that men have almost double the risk of HIV infection if their partner is pregnant and HIV+. The study, conducted in 7 countries in Africa, involved over 3,300 serodiscordant (one partner is HIV+ and the other is not) couples. Over two years and 800+ pregnancies it was demonstrated that pregnancy increased the risk of HIV infection for both males and females. The study reports that several factors other than pregnancy, such as sexual behavior, probably contributed to the increased risk for women. However, even when accounting for those factors and even circumcision, the heightened risk for men seemed much more direct. The researchers theorized that certain physiological and immunological changes that occur in a woman during pregnancy may be behind this remarkable finding. Therefore, further study to zero in on these changes is warranted. However, for those who may feel that pregnancy gives one a 'free pass' as far as the concern of the woman getting pregnant, this study demonstrates that it is even more imperative to use protection, especially if HIV status is unknown.
Thursday, May 20, 2010
New Developments in HIV Eradication
One of the most persistent myths about the HIV epidemic is that the government (or the other perceived villain- pharmaceutical companies) have discovered a cure but that, for whatever reasons, have not made it available. This reasoning fails to take into account the complexity of vaccine development in general, not to mention the unique challenge of curing HIV. One of the crucial steps to finding a cure involves eradicating all of the virus from the body. Complicating this are stubborn reservoirs of HIV that remain in the body and seem out of reach of antiretroviral medication. These reservoirs consist of old CD4 cells that preserve latent HIV throughout the body, essentially storing, or 'archiving' it for decades. Therefore, even though antiretroviral medication may significantly reduce viral reproduction and clear the host of most HIV virus, they never completely purge HIV from the body. When the medication is interrupted or ceases its effectiveness, because of viral resistance, this reservoir can become reactivated, ensuring more viral replication and eventually, more illness. Therefore, the inability to eradicate HIV from the body has been the main stumbling block towards finding a cure.
However, recent developments by Dr. Robert Siliciano of Johns Hopkins University has brought new hope that HIV eradication may be achievable. Dr. Siliciano believe that there are two reservoirs of old (or latent) HIV, one that consists of what are called CD4 memory cells. These cells are created to combat various infections that we have developed, such as measles. HIV meds are only effective against cells infected with HIV that are active. However, activating all memory cells simultaneously can be dangerous. Therefore, the goal is to activate only those cells that are infected with HIV, so that the HIV meds can, in effect, take them out. Dr. Siliciano and group have found a handful of compounds that they believe may selectively activate HIV infected cells. The trick will be finding compounds that will be safe in humans.
Sound complicated? Well this is just a small glimpse of the work being done all over the world to either create a vaccine for HIV, or to find a cure. However, as this brief snapshot demonstrates, it is a very difficult, frustrating and costly endeavor. Therefore, we should be more appreciative of the efforts of researchers such as Dr. Siliciano and his colleagues or Michael Swanson, a doctoral student at the University of Michigan and his group who have discovered a lectin (naturally occurring chemicals in plants that bind to sugars on the surface of disease-causing microorganisms such as viruses) found in bananas, that might lead to the development of inexpensive microbicides to prevent HIV transmission or even new treatments.
In the meantime, while these dedicated researchers wage their own battle in laboratories around the world, we to must do out part to reduce HIV infection: Prevention.
However, recent developments by Dr. Robert Siliciano of Johns Hopkins University has brought new hope that HIV eradication may be achievable. Dr. Siliciano believe that there are two reservoirs of old (or latent) HIV, one that consists of what are called CD4 memory cells. These cells are created to combat various infections that we have developed, such as measles. HIV meds are only effective against cells infected with HIV that are active. However, activating all memory cells simultaneously can be dangerous. Therefore, the goal is to activate only those cells that are infected with HIV, so that the HIV meds can, in effect, take them out. Dr. Siliciano and group have found a handful of compounds that they believe may selectively activate HIV infected cells. The trick will be finding compounds that will be safe in humans.
Sound complicated? Well this is just a small glimpse of the work being done all over the world to either create a vaccine for HIV, or to find a cure. However, as this brief snapshot demonstrates, it is a very difficult, frustrating and costly endeavor. Therefore, we should be more appreciative of the efforts of researchers such as Dr. Siliciano and his colleagues or Michael Swanson, a doctoral student at the University of Michigan and his group who have discovered a lectin (naturally occurring chemicals in plants that bind to sugars on the surface of disease-causing microorganisms such as viruses) found in bananas, that might lead to the development of inexpensive microbicides to prevent HIV transmission or even new treatments.
In the meantime, while these dedicated researchers wage their own battle in laboratories around the world, we to must do out part to reduce HIV infection: Prevention.
Tuesday, April 27, 2010
A New Super Villain: Gonorrhea?
We used to call it venereal disease. Many preferred the more common term: "The Clap." Eventually, a more appropriate term evolved: sexually transmitted disease. Recently, the term "disease" has been exchanged for "infection." Whatever name it was called, we all knew that Gonorrhea, while embarrassing and painful, was also curable. In other words, many felt that is was just a minor inconvenience.
Now comes new information that a strain of Gonorrhea may be evolving into a "superbug," a drug resistant bacteria that will be much harder to treat. Speaking at the Society for General Microbiology’s spring meeting in Edinburgh, Scotland, Catherine Ison, a microbiologist with the Health Protection Agency in London, reported that the bacteria Neisseria gonorrhoeae has become multi-drug resistant and threatens to make the STI more and more difficult to treat. Gonorrhea infects approximately 700,000 Americans a year, with the highest infection rates in the U.S. among teens, young adults and African Americans, according to the Centers for Disease Control and Prevention. Gonorrhea can infect the eyes, throat and mouth as well as male and female genital areas. For decades it has commonly been treated with first tier antibiotics such as Penicillin. Now, even newer medications such as ceftriaxone and cefixime may be becoming less effective. According to Dr. Ison, "choosing an effective antibiotic can be a challenge because the organism that causes gonorrhea is very versatile and develops resistance to antibiotics very quickly."
Multi drug resistance is not a new phenomenon. We have struggled with it for years in HIV treatment, as well as in treatment a variety of infections such as Staph, MRSA, and Campylobacter Bacteria (one of the most common causes of diarrheal illnesses in humans). One potential culprit to this phenomenon is the increase of antibiotic use in farm animals. Recently, "major increases in antibiotic-resistant bacterial infections in human populations have led to public health concerns regarding antibiotic use for non therapeutic purposes (i.e., not used to treat disease) in animals destined for food production," according to a statement by the Pew Charitable Trusts. "Bacteria are able to develop antibiotic resistance when exposed to low doses of drugs over long periods of time. To promote growth and weight gain, entire herds or flocks of farm animals are routinely fed antibiotics and related drugs at low levels in their feed or water — a practice that has been identified as a major contributor to antibiotic resistance."
Gonorrhea is often asymptomatic in women and can be mistaken for a bladder or vaginal infection with symptoms such as painful urination and vaginal discharge. Men may experience a burning sensation when urinating as well as painful or swollen testicles. Untreated gonorrhea can cause infertility in both sexes, join infection and, when passed by a pregnant woman to her fetus, blindness and a life-threatening blood infection in babies. Moreover, sexually transmitted disease can make one more vulnerable to HIV infection.
Yet, as with most sexually transmitted infections, Gonorrhea is 100% preventable. The answer is not rocket science. It's about making better choices, knowing one's partner, getting screened for STI'S and good old fashioned safe (abstinence) and safer (condoms, dental dams, etc) sex.
Now comes new information that a strain of Gonorrhea may be evolving into a "superbug," a drug resistant bacteria that will be much harder to treat. Speaking at the Society for General Microbiology’s spring meeting in Edinburgh, Scotland, Catherine Ison, a microbiologist with the Health Protection Agency in London, reported that the bacteria Neisseria gonorrhoeae has become multi-drug resistant and threatens to make the STI more and more difficult to treat. Gonorrhea infects approximately 700,000 Americans a year, with the highest infection rates in the U.S. among teens, young adults and African Americans, according to the Centers for Disease Control and Prevention. Gonorrhea can infect the eyes, throat and mouth as well as male and female genital areas. For decades it has commonly been treated with first tier antibiotics such as Penicillin. Now, even newer medications such as ceftriaxone and cefixime may be becoming less effective. According to Dr. Ison, "choosing an effective antibiotic can be a challenge because the organism that causes gonorrhea is very versatile and develops resistance to antibiotics very quickly."
Multi drug resistance is not a new phenomenon. We have struggled with it for years in HIV treatment, as well as in treatment a variety of infections such as Staph, MRSA, and Campylobacter Bacteria (one of the most common causes of diarrheal illnesses in humans). One potential culprit to this phenomenon is the increase of antibiotic use in farm animals. Recently, "major increases in antibiotic-resistant bacterial infections in human populations have led to public health concerns regarding antibiotic use for non therapeutic purposes (i.e., not used to treat disease) in animals destined for food production," according to a statement by the Pew Charitable Trusts. "Bacteria are able to develop antibiotic resistance when exposed to low doses of drugs over long periods of time. To promote growth and weight gain, entire herds or flocks of farm animals are routinely fed antibiotics and related drugs at low levels in their feed or water — a practice that has been identified as a major contributor to antibiotic resistance."
Gonorrhea is often asymptomatic in women and can be mistaken for a bladder or vaginal infection with symptoms such as painful urination and vaginal discharge. Men may experience a burning sensation when urinating as well as painful or swollen testicles. Untreated gonorrhea can cause infertility in both sexes, join infection and, when passed by a pregnant woman to her fetus, blindness and a life-threatening blood infection in babies. Moreover, sexually transmitted disease can make one more vulnerable to HIV infection.
Yet, as with most sexually transmitted infections, Gonorrhea is 100% preventable. The answer is not rocket science. It's about making better choices, knowing one's partner, getting screened for STI'S and good old fashioned safe (abstinence) and safer (condoms, dental dams, etc) sex.
Tuesday, March 16, 2010
African American Women and STI'S
Recent news has not been kind about women and girls of color and their sexual health. In 2008, a Centers for Disease Control and Prevention (CDC) study reported that almost one-half of adolescent black females were infected with at least on STI (Sexually Transmitted Infection). Now, new evidence has further documented the impact of STI'S on women and girls of color. According to the CDC, 48 percent of black women between ages 14 and 49 have the virus which causes genital herpes. Blacks in general are more than three times as likely as whites to have herpes simplex virus type 2 (HSV-2) (39.2 percent vs. 12.3 percent). Biological factors make women more susceptible to genital herpes than men. American women in general are nearly twice as likely as men to be infected (21 percent vs. 11 percent). Moreover, up to 80 percent of genital herpes infections in the United States are undiagnosed.
The news is no better on the local front. A recent report from the Philadelphia Department of Public Health revealed a dramatic 238% increase in primary and secondary cases of Syphilis in females. Many of the cases in females occurred in adolescents and young adults aged 15-24 years old.
The high rates of genital herpes infections and syphilis, as well as other STI'S among women of color, may contribute toward the high rate of HIV in the black community by making transmission easier. In 2007, more than 25% people infected with HIV in the United States were among women and girls aged 13 years and older. More than 278,000 women and adolescent girls in this country are living with HIV. For female adults and adolescents, the rate of HIV/AIDS diagnoses for black females was nearly 20 times as high as the rate for white females and nearly 4 times as high as the rate for Hispanic/Latino females.
Last year, the CDC implemented new guidelines to encourage HIV testing to be a part of routine medical care. Clearly, sexually transmitted infection screening should also be a part of this routine care. Significant progress in reducing the spread of HIV in Sub-Saharan Africa has been made by preventing, diagnosing and treating STI's. It's time we apply these priorities in this country, especially in women and girls of color.
The news is no better on the local front. A recent report from the Philadelphia Department of Public Health revealed a dramatic 238% increase in primary and secondary cases of Syphilis in females. Many of the cases in females occurred in adolescents and young adults aged 15-24 years old.
The high rates of genital herpes infections and syphilis, as well as other STI'S among women of color, may contribute toward the high rate of HIV in the black community by making transmission easier. In 2007, more than 25% people infected with HIV in the United States were among women and girls aged 13 years and older. More than 278,000 women and adolescent girls in this country are living with HIV. For female adults and adolescents, the rate of HIV/AIDS diagnoses for black females was nearly 20 times as high as the rate for white females and nearly 4 times as high as the rate for Hispanic/Latino females.
Last year, the CDC implemented new guidelines to encourage HIV testing to be a part of routine medical care. Clearly, sexually transmitted infection screening should also be a part of this routine care. Significant progress in reducing the spread of HIV in Sub-Saharan Africa has been made by preventing, diagnosing and treating STI's. It's time we apply these priorities in this country, especially in women and girls of color.
Tuesday, January 19, 2010
Don't Believe the Hype
I recently ended a very frustrating e-mail correspondence with a well meaning, yet uninformed woman who originally contacted me to sing the praises of a herbalist who she claims has cured HIV (and lupus and cancer, by the way). In response to my polite skepticism, she directed me to his website where the "documentation" of his alleged success (and no doubt the pictures from his Nobel prize for medicine) could be found. Needless to say, I found no concrete evidence that his treatments cured anything, let alone HIV. Most troubling was her insistence that his claims were "proven." It reminds me of another conversation with a gentleman who read a book written by a dietitian who claimed that he had evidence that there was no link between HIV and AIDS. Supporting his claim were 1500 people who placed their name in the book indicating support of this theory. Not one, of course, held any reputable position at any research institution or university.
Those of us who have worked in the HIV/AIDS field have experienced communication with people who are convinced that there is a cure for HIV and that either:
1. The Government has it and wants "black people to die so they are hiding it or;
2. The Pharmaceutical companies have it but want people to keep spending money on
medication or;
3. Some other individual (usually an alternative medicine professional) has it but
the government and pharmaceutical companies have banded together to stop it
from being distributed.
We call these beliefs: "Conspiracy Theories." The troubling thing about these theories is less that a few individuals will submit to an unproven treatment and possibly have there hopes dashed, but that many of us are so willing to believe in theories and claims with so little basis in fact. Moreover, there cynicism makes HIV prevention efforts that much harder.
I pray that, one day, a cure for HIV/AIDS is found. However, HIV is a very difficult viral adversary, perhaps one of the most difficult that we have every encountered. Many of the greatest minds in the world have been struggling, without success to find a vaccine or a cure. Maybe, one day, someone will find a natural substance or treatment that will cure HIV. But, shouldn't that individual be required to subject that treatment to the rigors of science to prove, not only that it works, but that it doesn't harm the patient? Don't get me wrong, I believe that we should should not blindly believe everything we are told. Moreover, there are many non-medication treatments such as accupunture and light therapy (for Seasonal Affective Disorder)that work! Yet, why are we so willing to embrace treatments that have never fully been studied, but reject those with reams of documented evidence supporting them-not just for HIV, but for other conditions such as mental illnesses? Many cite the Tuskegee study as the underlying reason for this skeptisism, but many people to whom I speak, have never even heard of the Study. Clearly, the scientific and medical communities have a long way to go to regain the trust of the American Public. Until it does, we will continue to see people shun, and even reject modern medicine, often to our detriment.
Those of us who have worked in the HIV/AIDS field have experienced communication with people who are convinced that there is a cure for HIV and that either:
1. The Government has it and wants "black people to die so they are hiding it or;
2. The Pharmaceutical companies have it but want people to keep spending money on
medication or;
3. Some other individual (usually an alternative medicine professional) has it but
the government and pharmaceutical companies have banded together to stop it
from being distributed.
We call these beliefs: "Conspiracy Theories." The troubling thing about these theories is less that a few individuals will submit to an unproven treatment and possibly have there hopes dashed, but that many of us are so willing to believe in theories and claims with so little basis in fact. Moreover, there cynicism makes HIV prevention efforts that much harder.
I pray that, one day, a cure for HIV/AIDS is found. However, HIV is a very difficult viral adversary, perhaps one of the most difficult that we have every encountered. Many of the greatest minds in the world have been struggling, without success to find a vaccine or a cure. Maybe, one day, someone will find a natural substance or treatment that will cure HIV. But, shouldn't that individual be required to subject that treatment to the rigors of science to prove, not only that it works, but that it doesn't harm the patient? Don't get me wrong, I believe that we should should not blindly believe everything we are told. Moreover, there are many non-medication treatments such as accupunture and light therapy (for Seasonal Affective Disorder)that work! Yet, why are we so willing to embrace treatments that have never fully been studied, but reject those with reams of documented evidence supporting them-not just for HIV, but for other conditions such as mental illnesses? Many cite the Tuskegee study as the underlying reason for this skeptisism, but many people to whom I speak, have never even heard of the Study. Clearly, the scientific and medical communities have a long way to go to regain the trust of the American Public. Until it does, we will continue to see people shun, and even reject modern medicine, often to our detriment.
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