Obama Lifts HIV Travel Ban

On October 30, 2009, President Barack Obama announced that the United States would be doing away with its 20 year old ban preventing people living with HIV/AIDS from entering the country. The U.S. has been one of about a dozen countries that bar HIV+ travelers. The change will officially take place starting January 1, 2010, after a 60day waiting period. The ban was established in 1987 when there was widespread fear and ignorance about HIV. The federal government's tried to eliminate the ban in 1991, but was thwarted by Congress. In 1993, Congress made HIV infection the only medical condition specifically listed as ground for inadmissibility to the U.S.

While many may feel that such a law protected Americans from HIV infection from immigrants and travelers, there has been no evidence that it has done so. In reality, HIV rates continue to soar, especially among the poor and minorities. The law also had other adverse consequences by keeping out hundreds of thousands of tourists, refugees and students. Another impact of the law was the unforseen obstacle that it created for the international adoption of children with HIV. Moreover, no major international HIV/AIDS conference has been held in the U.S. since 1993, because HIV-positive activists and researchers were not allowed to enter the country.

The elimination of this law is another example of how the Obama Administration may have begun to turn the corner pertaining to the HIV/AIDS epidemic. However, there is still a long way to go.

New HIV Vaccine Shows Promising Results

Researchers and HIV/AIDS activists are have been encouraged by the results of an experimental HIV vaccine. According to a Wall Street Journal/Associated Press report: "For the first time, an experimental vaccine has prevented infection with the AIDS virus." The vaccine reduced the risk of HIV infection by more than 31%. While this result may not seem overwhelming, it is a significant moment in the often frustrating race to find a vaccine for HIV. Previous efforts have resulted in failure after failure. One such effort, Merck's experimental Phase II vaccine trial which began in late 2004 and involved HIV-negative volunteers was stopped after the experimental vaccine failed to prevent HIV infection in participants or prove effective in delaying the progression of the virus to AIDS. As a result, several vaccine trials were being postponed or modified following the abrupt halt of Merck's vaccine trial. As a result of so many recent failures, many researchers had begun to feel that a vaccine might not be possible and that resources should be redirected to new techniques to prevent HIV infection such as microbicides and cheaper versions of the female condom.

However this new HIV vaccine trail, involving 16,000 volunteers in Thailand, might just provide new hope. The new vaccine combined two previously ineffective ones: the first to rouse the immune system to launch an attack on the virus and the other to strengthen the response. Researchers caution that we are still a long way away from implementation of widespread immunization of any type of vaccine. However, for the first time, scientists and epidemiologists are expressing optimism that a HIV vaccine is possible.

Every day, 7,500 people world-wide are newly infected with HIV and two million died of AIDS in 2007 , according to the U.N. agency UNAIDS.

Demonizing HIV

AIDS activists have been buzzing lately about a new German HIV awareness advertisement depicting a woman having sex with Adolph Hitler. By now, I am sure you are wondering: what does the Fuhrer have to do with AIDS? Well, in the ad, which is available online, a heterosexual couple is seen having sex. The man's face becomes that of Adolph Hitler followed by a slogan describing AIDS as a "mass murderer. Print versions of the campaign also use Saddam Hussein as well as other despots.
The company that created the campaign, Das Comitee, defended the advertisement stating that it was meant to show "the ugliness of the illness."

I understand the philosophy of using 'shock value' to get people's attention. Its discomforting to realize that in 2009, we have to 'shock' people to make them aware of HIV/AIDS. However, the designers of this campaign are obviously missing something and it underscores the danger of developing public awareness campaigns in a vacuum-with vetting them with a diverse audience, especially people living with HIV. Now, I don't know for sure if that was done. However, given the tremendous stigma associated with HIV, I would hope that someone would have realized that many people viewing the ad would associate the people living with HIV with these dictators. Despite good intentions, it's the wrong message!

HIV Testing

Few would argue that HIV testing is one of the most vital tools in addressing the HIV epidemic. But, does everyone feel that way, or even understand the significance of knowing his/her HIV status. A recent study conducted by the Kaiser Family Foundation (June 2009) found that despite efforts to encourage more HIV testing, including making it a part of routine medical care, "reported rates of HIV testing have remained flat over time." In fact, the share of non-elderly (ages 13-64) who report having been tested within the last year has not changed in over a decade. Although some groups, such as African Americans, Latinos and young adults are more likely to report having been tested, even their rates have remained virtually unchanged over the last several years. In 2009, less than one-half of the adults in the United States say that they have ever been tested.

Another study conducted by the Centers for Disease Control (Morbidity and Mortality Report-June 27, 2009) suggests that many people do not submit to HIV testing until late into the course of their infection. In the study, 45% of the testers progressed to a full blown AIDS diagnosis within 3 years of their positive HIV test. More troubling is that over a third (38%) progressed to full blown AIDS within a year. Moreover, minorities, especially African American men, were more likely to progress to full blown AIDS within 3 years of HIV diagnosis, e.g... were late testers.

The moral of the story, get tested: even if you do not think you are at risk. Too many people are apparently waiting until they get sick to get an HIV test. Consequently, they are giving HIV a head start and limiting the possibilities for successful treatment. HIV may be becoming a chronic disease, but the quality of life may be significantly improved by early testing and treatment. So, what are you waiting for?

Zoonoses

Confused? I had not heard of that word either, until I did a little research for this blog about animal to human disease transmission. Zoonoses are emerging infectious diseases that have transferred to humans from animal hosts. I embarked on this research after learning of the discovery of a new HIV strain thought to have originated from gorillas native to Cameroon. This makes the fourth documented strain of HIV: strain "M, the most common and "N," "O" and now "P." The latter three seem to manifest themselves primarily from the Cameroon region.

With so much evidence available that HIV is a Zoonose; ie..., that it originated from an animal host, in this case, chimpanzees, then why do so many people still believe that the HIV epidemic is a government conspiracy or some equally paranoid theory. In fact, most of the temperate diseases (found in temperate of tropical climates) such as measles, mumps, rubella, smallpox, influenza A and tuberculosis, are believed to have come from domestic animals. Moreover, most of the major infectious diseases also originated in animals: West Nile, Mad Cow, Cholera, Syphilis, Malaria, Ebola, Lyme Disease, Hantavirus, SARS, Swine Flu.

Clearly we need a little science lesson. Its time to jettison the conspiracy theories and understand that WE, our behavior, our ignorance, our intolerance and our apathy pose our greatest risk for HIV infection, not a government test tube!

Men are Driving The HIV Epidemic

That's right, I said it: its men who are driving this epidemic. For all of the talk about the disproportionate impact of HIV on minority women, who do we think are infecting them: men. By the way, the fastest growing population being infected with HIV is not women; its young black men who have sex with men (MSM) between the ages of 13-29. Overall, there are 30,000 new HIV infections annually among MSM. Now before you go into the "AIDS is a gay disease mode," we must remember that gay and bisexual men probably make up a small percentage of men overall. We have to stop focusing so much on labeling people: "gay," "straight," "down-low," etc.. Many people are resistant to accepting certain labels. A man who primarily has sex with women but occasionally also has sex with men, may consider himself straight. Likewise, the incarcerated man who see his sex with another man in prison, a partner who by the way, may be officially labeled in the prison as a "b***h," therefore making it more socially acceptable. The focus has to be on responsibility such as: knowing one's HIV status; prompt diagnosis and treatment of sexually transmitted infections and last but not least; safe and safer sex. So for the men reading this, the 'ball's in your court.' Man-up!

Adolescent Hopelessness and HIV

A new report published in Healthday News on Jun 29, 2009, has found that almost 15 percent of American adolescents believe that they will die before age 35, a belief that may be strongly linked to unsafe behavior. Greater than one in seven youths have a pessimistic view about their future mortality and are more likely to take risks. The findings, published in the July issue of Pediatrics, are based on a three-year study of attitudes and behaviors among 20,594 teens from the 7th through 12th grades. The teens were asked about their views on personal mortality as it related to behaviors such as attempting suicide, using illegal drugs, sustaining fight-related injuries that required medical care, engaging in unprotected sex, being arrested by the police and contracting HIV or AIDS. Other important findings included:
*Race and wealth were important variables. While 10 percent of
white teens expressed this pessimism, 21 percent of Hispanic teens and 26
percent of African American youth harbored this fatalistic view.
*Adolescents who predicted a short lifespan were more likely to engage in risky
behavior, and teens who engaged in risky behavior (throughout the first year of the
study) "were more likely to develop a pessimistic view of their future."

Clearly, more needs to be done to both assess these attitudes early on, especially for minority and low income children, and to make every effort to develop programs that help to instill a sense of optimism and hope. Without this new focus, we will continue to raise a generation of children who feel that "they have nothing to lose."