Editorial
For the past few years I, and I’m sure many subscribers to HIV Weekly, have been concerned by criminal prosecutions for the ‘reckless’ transmission of HIV in the UK. I’ve no doubt that these prosecutions have really contributed to the stigma that already surrounds HIV. The police and prosecution in many of the cases - as well as much of the media - have been all too ready to stir up popular prejudices about people with HIV and the communities most affected by the virus.
In response to the widespread ignorance around HIV that pervades the criminal justice system, NAM has produced a new book called Criminal HIV Transmission. Written by Edwin J Bernard, the editor of NAM’s monthly newsletter, AIDS Treatment Update, it provides some basic facts about HIV (which have been sadly overlooked in so many of the cases), explains how HIV can be transmitted, and outlines why scientific evidence cannot prove HIV transmission between individuals.
It’s primarily aimed at people who work within, or are in contact with, the criminal justice system, such as the police, lawyers, judges and members of juries. But the book is also likely to be useful for those who work at HIV support organisations, as well as HIV-positive individuals with an interest in criminal HIV transmission.
The book cost £14.95 for professionals, but is available at the discounted rate of £9.95 to voluntary organisations.
Finally, thanks to everybody who sent me a supportive email in response to last week’s editorial. They were all greatly appreciated.
Michael Carter
Editor, HIV Weekly
Anti-HIV treatment
There is no cure for HIV, but potent combinations of anti-HIV drugs can lower the amount of HIV in the blood to undetectable levels, preventing HIV from damaging the immune system and putting off, hopefully for ever, illness caused by HIV.
If HIV continues to reproduce when you’re taking anti-HIV therapy, this can result in drug resistant HIV emerging. Some people have drug resistant HIV because they were infected with virus that was already resistant, and the other main cause of drug-resistance is not taking your HIV drugs properly.
A new study shows that resistance can start to develop in the early months of HIV treatment, particularly if a person’s viral load falls slowly after they first start antiretroviral drugs. The study involved 15 people who were intensively monitored after they started a triple combination of HIV drugs. Two people who did not have any drug-resistance before they started treatment, along with four other patients who did have resistance prior to starting antiretroviral therapy, developed further resistance.
The risk of resistance was associated with a slow decline in viral load, and the risk of viral load falling slowly was increased if a person didn’t take their HIV drugs properly (adherence).
In a separate study, doctors looked at how quickly viral load fell in people taking two different combinations of anti-HIV drugs. The first group of patients was taking efavirenz (Sustiva) with AZT (zidovudine, Retrovir) and 3TC (lamivudine, Epivir). This combination of drugs includes medicines from two classes of antiretroviral drugs and is known to have a very powerful anti-HIV effect. The other patients were taking three NRTI drugs – abacavir, AZT and 3TC. This combination of drugs isn’t generally recommended because it’s been associated with a higher risk of resistance.
The study showed why this might be the case – viral load fell more rapidly in people who were taking the combination that included efavirenz.
Gay men and HIV
The results of the 2005 UK Gay Men’s Sex Survey have been published. The survey showed that many HIV-positive gay men were putting men whose HIV status they did not know at risk of acquiring HIV.
The study was completed by 16,500 men, 7% of whom were HIV-positive. Of the HIV-positive gay men who had practiced anal sex in the year before taking part in the study, around a third had practiced unprotected insertive anal sex with a man whose HIV status was unknown to them. This increased to over 50% of positive men who had more than 30 sexual partners in the last year.
Information was also gathered in the survey about sexual health and drug use. Over 60% of positive men had visited a sexual health clinic in the last month, according to the study. It also found that 48% of HIV-positive men smoked, and that HIV-positive men had the highest level of recreational or illicit drug use.
A finding of the study that may surprise some was that HIV-positive men were more likely than either HIV-negative or untested men to think that they were of above average attractiveness!