Showing posts with label HIV/Undetectable. Show all posts
Showing posts with label HIV/Undetectable. Show all posts

December 22, 2016

UNDETECTABLE= NOT Transmissible!

“We are not dirty, we are not a threat, and we are not disease vectors. In fact, we are the solution. People living with HIV who achieve viral suppression, who become undetectable, are the solution to the end of new HIV infections in the United States… When we look back 20 years from now we’re going to judge ourselves in terms of how well we responded to this opportunity.”
— Dr. Rich Wolitski, person living with HIV and Acting Director for the Office for HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services
When Dr. Wolitski delivered his speech at the closing plenary of the 2016 United States Conference on AIDS (USCA), he received a standing ovation. He was referring to this year’s newest findings of HPTN 052 and the PARTNER study, which showed that people living with HIV who are undetectable are not transmitting the virus to their negative partners

How wonderful that something many of us have assumed for years has been proven to be true. So now we can spread the news and encourage people with HIV to seek treatment and stick with it. And hey, there’s nothing like a little intercourse a la natural with your partner to reward yourself for being undetectable, am I right?

Not so fast. There is some strong resistance to a message that equates undetectable to untransmittable, and it’s not coming from where you might think.
Here are five reasons why this breakthrough message matters.

1. The science is solid.
The PARTNER Study has recorded 58,000 acts of penetrative sex without condoms between 1,000 positive/negative couples, in which the HIV positive partner had an undetectable viral load. There were no infections between the couples. Not a single one. The same results were reported in the HPTN 052 study and the empirical evidence to date. As Dr. Wolitiski said in his USCA speech, “this is a game-changing moment in the history of the HIV epidemic.”

Resistance to the conclusion that undetectable people pose no risk of infection has been either a matter of scientific data scrutiny or a fear that people may not actually be undetectable when they think they are. Let’s break that down.

A review of the argument against saying “zero risk” is enough to make you cross-eyed. It is based on the premise that nothing, really, is without risk. Detractors of the non-infectious message will calmly explain the perils of placing any risk at zero and then hypnotize you with statistical origami. Suffice it to say that proving zero risk is statistically impossible. You risked electrocution by turning on your device to read this article.

There will always be somebody who claims a terminally unique HIV infection, even if the precise circumstances of their claim may be murky. Weird things happen. Some folks are convinced that people who drink alcohol sometimes spontaneously combust. But you don’t see warning labels about it slapped on every bottle of Wild Turkey by overzealous worrywarts.

And yes, there is the possibility that someone might develop a viral load if they are not adherent to treatment and then transmit the virus. But the message here is that people who are undetectable cannot transmit HIV. If you stay on treatment and are undetectable you will not transmit HIV. Can we please celebrate this simple fact without remote qualifiers?
It is also important to note that a Canadian consensus statement concluded that any “viral blips” or sexually transmitted infections (STIs) were “not significant” to HIV transmission when someone is undetectable.

2. Major health experts are on board (but not all community leaders).
Public health leaders, from the New York Department of Health to the National Institutes of Health (NIH), have embraced these findings and its meaning to people with HIV, while community advocates and organizations have been reluctant to get on board, citing a theoretical risk of infection. Or maybe they consider changing their fact sheets and web sites an enormous bother.

Bruce Richman of Prevention Access Campaign. (Sean Black / Courtesy A&U Magazine.
The Prevention Action Campaign and their seminal message “U=U” (undetectable equals untransmittable) was founded on the energetic efforts of a man named Bruce Richman. He entered the HIV advocacy scene a few years ago, seemingly out of nowhere, carrying aloft the banner of undetectability. Richman gathered signatures of health experts the world over for a consensus statement about the research, while cajoling every U.S. HIV organization in sight to adopt language that removes the stigma of infectiousness from people who are undetectable.

My review of the web sites and statements from major HIV organizations includes no strong language about undetectable people not transmitting HIV. Worse, some exaggerate the risk from those who are undetectable. How could such a new research breakthrough be met with such ignorance and apathy by our own leaders? I will defer shaming anyone by name while they take a little time to update their official language. (Notable exceptions to this sad rule include work going on in the United Kingdom and France that flatly states that undetectable means non-infectious.)

This skepticism from our own community reduces people with HIV, again, to a problem that must be managed. It suggests that those of us who have achieved undetectability don’t have the judgment to keep taking our medications or to see our physician regularly to be sure our treatment plan is still effective. It keeps us in the role of untrustworthy victims unable to make decisions that will keep the rest of you safe from us. What infuriating, stigmatizing nonsense.

3. This is about HIV. Only HIV.
Auxiliary issues often creep into this debate that may be well-meaning but only muddy the waters, such as the fear that promoting the message of non-infectiousness will lead to more sexually transmitted infections (STIs) because of the freedom it allows (see also: critics of PrEP, the birth control pill, and any other vehicle that might lead to unbridled sexual pleasure).

Rates of STIs — which were on the rise before the advent of PrEP or news from the PARTNER Study — are deeply concerning but ultimately tangential. We are in desperate need of comprehensive sexual health programs, to be sure, but in this instance I feel compelled to “kill the alligator closest to the boat.” This is about being HIV undetectable, not syphilis impermeable. Being undetectable will not prevent other infections or address promiscuity or remove stubborn stains.

Advocates are also sensitive to the continued compartmentalization of our community, between those who are positive or not, who is on PrEP or not, and now, between those with HIV who are able to achieve viral suppression and those who cannot, despite their best efforts. I sympathize with this new divide among HIV positive people but believe the greater good – removing shame and stigma from those who are not capable of transmitting – shouldn’t be downplayed. All HIV positive people of good will can and should celebrate this development, regardless of their own viral load.

4. This is a major victory for HIV criminalization reform.
Terribly important work is being done to repeal and reform HIV criminalization laws that prosecute people with HIV for not disclosing their status to a sexual partner. Our lead defense is often that the defendant never posed a risk to their partner in the first place, due to their use of protection or the fact the defendant was undetectable and therefore rendered harmless.

Imagine the glee with which prosecutors might punch holes in this defense, based on statistical mumbo-jumbo saying “zero risk” is impossible and using it to explain to a jury that Joe Positive did, in fact, pose a risk to his sexual partner and should be jailed for it. Put that doubt into the heads of a jury, and another person with HIV gets a 30-year sentence for daring to have sex at all.

5. This profoundly changes how people with HIV view themselves.
Internalizing the fact that I cannot transmit HIV to anyone has had an effect on me that is difficult to describe. I can only liken it to the day the Supreme Court voted for marriage equality. Intellectually, I knew I was a gay man and a worthy human being. But on the day of the court’s decision I walked through the streets of my neighborhood with my head held higher. Something had changed. I felt whole.

In my thirty-five years living with HIV, I have never felt exactly that way. I deserve to. And so do millions of other people with HIV.

Of all the arguments to adopt the message that undetectable people cannot transmit HIV, that enhanced feeling of self-worth may be the most important reason of them all.

May 2, 2016

Having GloriousSex with the Undetectable

So there I was at a funeral and all I could think about was sex. Before you think that’s inappropriate, it was the celebration of life for Jim Deva and the eulogies were incredibly sex-positive.

As the speakers reflected back on his life, his irreverence, his fight for sexual liberation, I began reflecting on my current state, my lack of sex, my lack of involvement in our community. But most importantly, my lack of sex.

What had happened to me? Why had I become so withdrawn from other gay men? Why were nearly all my friends straight? Why oh why was I so satisfied with my right hand?

As I left St Andrew-Wesley’s Church, I turned to my friend Lucy and said, “I need to have sex tonight. I need to fuck as a tribute to Jim.”

I left the funeral’s after-party at Celebrities to meet up with a friend at Pumpjack. I was already getting pretty drunk at this point. After a little while on the dancefloor, my friend introduced me to someone —let’s call him Darryl. Within seconds, I’d grabbed Darryl and started kissing him passionately, even a bit rough. It was like I’d switched into animal mode. I quickly suggested we go fuck and he said he lived around the corner. So we rushed back to his place.

We pretty much tore each other’s clothes off and he hopped onto his bed and got on all fours. I began eating his ass. A nice, smooth, tidy ass. Without even thinking, I put a big gob of spit on my knob and shoved it in him. I switched back and forth between eating his ass and fucking him till I finally shot my load. By this time it was 3am. The hangover was beginning and I needed to head home, take my contacts out and go to bed. So I gathered up my stuff and left.

The next day, I couldn’t get my mind off what had happened. First, I’d finally had sex after months of nothing. Second, I topped! I’d tried topping maybe 15 years earlier but hadn’t enjoyed it. Third, I barebacked.

I’d only barebacked (knowingly) with a boyfriend and I’d never topped that way. And it felt amazing. Two weeks went by and all I could think about was how hot that sex was. Rough, raw, and so full of pleasure. So I contacted the friend I’d met Darryl through and asked for his number. I texted Darryl and we arranged for him to come over the next day.

We fucked and watched movies. In fact, I fucked him three times that day. His smooth bubble butt, his nervous laugh, his constant grin. He was such a hottie.

It was a great day filled with great sex. He left later in the evening. And then I began to think.

This guy just lets me fuck him bare and give him loads without questions? I’m amazed he’s not positive yet. Wait a second. I never asked him his status.

So I sent him a text:

Me: Do you mind if I ask you a personal question?

Darryl: Sure. But do you want me to call you?

Me: No, that’s okay, I’m heading to bed soon. Are you HIV-positive?

Darryl: Yes, positive undetectable. Do you know what that means?

Me: Yep. Totally cool with it.

I later got the full story. Apparently Darryl had arrived at my place for our second “date” shaking, ready to disclose his status to me. But when I opened the door and he was staring in my face, he just couldn’t do it. He knew that if he disclosed at that moment, I could call the cops on him for the first time we had sex without his disclosure.

The irony — if I was at risk, he’d have to keep putting me at risk or otherwise tell me the truth and risk going to jail. Laws criminalizing non-disclosure could actually be putting us at risk. And of course the first time we hooked up we were both drunk — he never thought to tell me and I never thought to ask.

Politically, I was already against non-disclosure laws. And I wasn’t about to be a hypocrite.

I quickly went online to reassure myself about the science I’d heard of — that we’d been having safe sex. Ever since I was a teenager, I’d always said that status would never get in the way. But that was theory. This was the first time I’d knowingly slept with a positive guy.

And it wasn’t just okay. It was fantastic. The sex was great. I didn’t wear a condom. I’m still alive. I’m still negative.

So much of the fear I’d held started to evaporate in that moment. Twenty years of fear. Twenty years of anxiety. It didn’t go away completely but it started to loosen its grip — a funeral and four loads later.

I hooked up with Darryl again but he was struggling with alcohol and substance problems and we stopped seeing each other. I started searching out undetectable guys so I could fuck without condoms. I started having more sex than I’ve ever had in my life and it was far better and less anxiety inducing.

I have Darryl to thank for that. And that’s a huge thank you, given how much my life has changed and how important sex has become to me in the last year. 

Daily Xtra’s new monthly columnist, Kevin Moroso, says he’s having more and better sex now than he’s ever had in his life, and it’s condom-free.
Shimon Karmel

April 8, 2016

The Older HIV Population Might be Smaller with Suppressed Virus than thought

> 1 Million are living with HIV in the US, 1 in 8 Living with HIV are Unaware of their infection

 Suppressed = Undetectable virus and under           control with less chances of transmitting.  In the U.S. the core of the transmission is happening through younger carriers, many who refused go get tested in a regular basis or at all.

The Centers for Disease Control and Prevention’s (CDC) may have overestimated the size of the U.S. HIV population while greatly underestimating the proportion that has a fully suppressed viral load. Publishing their findings in the Journal of Acquired Immune Deficiency Syndromes, researchers used HIV laboratory reporting to estimate HIV prevalence in New York City and 19 other jurisdictions and then used previously published data to construct a revised HIV treatment cascade.

The treatment cascade, also known as the HIV care continuum, refers to the descending proportion of people living with HIV who have been diagnosed, are retained in medical care, have been prescribed antiretrovirals (ARVs) and are virally suppressed.

The CDC has estimated that 1.2 million Americans were living with HIV in 2011. The U.S. care continuum estimate, which also refers to 2011, has long stated that 86 percent of the American HIV population has been diagnosed, 40 percent is engaged in care, 37 percent has been prescribed ARVs and 30 percent is virally suppressed. These figures are frequently cited as troublesome barometers of the dismal job the U.S. health care system is doing taking care of HIV-positive individuals.

Recent research has suggested that viral suppression rates have been steadily
increasing among Americans living with the virus.

The researchers in this new study estimated that, in fact, the CDC’s HIV prevalence estimate for 2011 was 25.6 percent too high, that the true number of Americans living with the virus was 819,200, or somewhere between 809,800 and 828,800. Their revised care continuum, also concerning 2011 figures, estimates that 86 percent of the HIV population has been diagnosed, 72 percent is retained in care, 68 percent is on ARVs and 55 percent is virally suppressed.

To read the study abstract, click here.

December 24, 2015

Charlie Sheen Opens up Regards Costs of his HIV Diagnosis and How He’s Fighting it


Sheen, who revealed his diagnosis on the "Today" show in November, said he's doing well. 
"I’m really clear, really good, positively focused. It was such a tremendous weight lifted off my shoulders when I made the announcement," Sheen told The Enquirer's Editor-in-Chief Dylan Howard. "I realized afterwards, I wish I had possibly done it sooner. As we’ll discuss, there were a lot of different elements in the mix that prevented me from doing that." 
Sheen previously told Matt Lauer during his "Today" interview that he was a victim of "shakedowns" and extorted for millions of dollars in order to keep his diagnosis a secret. 
And while the diagnosis lead to a lot of reflection, anger and denial for Sheen, he told The Enquirer that it didn't last long. 
"It was shortly afterwards -- I think it was the second day -- I said to my mom, 'This disease picked the wrong guy.' If anybody can fight this thing and discover a cure, it’s me. I will exhaust every resource available to me. I will sit with every expert. I will move forward until something’s revealed." 
Sheen, who currently said that he takes three pills a day (at a cost of about $4,000 a month) knows that his treatment is unaffordable for some, but hopes to find a way to lower the cost. And by talking about his diagnosis and researching every option possible, the 50-year-old actor told The Enquirer he wants to spread a message of hope. 
"If there’s a cure out there, I will find it and share it," said Sheen. "You have my word."
To read more of Sheen's interview, head here, or pick up the new issue of the National Enquirer on newsstands now.

Years of personal torment came to an end when Charlie Sheen confirmed his HIV diagnosis back in November. But in some ways, his battle was just beginning. After weeks of silence and alone time to regroup, Sheen spoke out for the first time about his new life living publicly with HIV to RADAR, unloading new revelations that will both stun and inspire his fans.

DYLAN HOWARD: I didn’t think we’d ever be talking again (after Radar reported you were HIV-positive).

CHARLIE SHEEN: I didn’t either, to be honest, but here we are. Anything’s possible.

DH: Anything is possible, indeed. It has been a number of weeks since your announcement. How is Charlie Sheen today?

CS: I’m really clear, really good, positively focused. It was such a tremendous weight lifted off my shoulders when I made the announcement. I realized afterwards, I wish I had possibly done it sooner. As we’ll discuss, there were a lot of different elements in the mix that prevented me from doing that.

DH: Why do you wish you’d done it earlier?

CS: Because of how I felt afterwards.

PHOTOS: ‘Burn!’ Charlie Sheen’s Ex Torches Photos & Other Mementos To Exorcise Their Chaotic Past

DH: Did you not think you’d feel that way afterwards?

CS: I didn’t realize the weight I was carrying — until it was relieved.

DH: After your diagnosis, how would you characterize your emotional state?

CS: I was angry. I was in denial. I was in shock.

DH: Angry at who?

CS: Myself, the world. But that didn’t last long. It was shortly afterwards — I think it was the second day — I said to my mom, ‘This disease picked the wrong guy.’ If anybody can fight this thing and discover a cure, it’s me. I will exhaust every resource available to me. I will sit with every expert. I will move forward until something’s revealed.

DH: You mentioned your anger. Did you ever consider suicide?

CS: I didn’t, no, and I never considered it before the diagnosis. I’ve never been that guy. I’ve always said if somebody’s gonna kill themselves, they should jump off a building. It’s pretty sure-fire! Slashed wrists are usually just a cry for help.

PHOTOS: Inside Charlie Sheen’s HIV & AIDS Related Physical Deterioration

DH: How did you tell your dad Martin, and your mother, Janet, of the medical condition when you were first diagnosed?

CS: My mom was in the room with me so we heard it at the same exact time; we both dealt with it there.

DH: What was your immediate reaction?

CS: I thought I was going to wake up from a bad dream, but that wasn’t the case. Then I gave it some time. I told my father about a month later and he was shocked at first and sad, but ultimately, everyone’s come to a place of love and support and helping me stay and get healthier.

DH: Your mother didn’t tell your father for a month?

CS: I asked her to keep it between us for the time being. It was my condition and I had to decide how I was going to tell people.

DH: In terms of sharing your journey, how do you plan to educate yourself more about HIV so you can in turn educate others?

CS: I’m gonna continue to meet with the top experts in the field and continue to surround myself with bigger brains than mine. I’ll see where the future is headed with treatment. I am in a rare position to turn my diagnosis into a positive, and that began with telling my truth to Matt Lauer, and now I’m talking to you and The National ENQUIRER so that I can reach your audience with my story and continue to shine a light on this disease while brilliant scientists continue to search for a cure.

PHOTOS: ‘Burn!’ Charlie Sheen’s Ex Torches Photos & Other Mementos To Exorcise Their Chaotic Past

DH: Can this be a positive in your life?

CS: It already is. It makes me take pause and ponder the concept that perhaps everything that led up to this was to gain the spotlight of popularity to finally deliver a message that truly matters. I’m grateful for everything I’ve been able to do in life. I’ve made a lot of people laugh and see the world differently through me. Now, maybe it’s time to change the world.

DH: But there have been others who have come forward with HIV or AIDS. You obviously were afraid to come forward and, thus, keep it quiet.

CS: Well, I wouldn’t say I was afraid. But again, there was a privacy aspect of it. What I would say to others? If they’re living in fear or living in some shackled existence, take it to the next level and be free of that prison.

DH: What is it like for someone living with HIV today? What’s the medical regimen you have to go through on a day-to-day basis?

CS: I have to take three pills each day. The total cost is about $4,000 a month. I know that’s prohibitive to a lot of people’s economic scenarios. Perhaps in my research, and in my journey, we can help develop ways that make it affordable for all.

PHOTOS: Charlie Sheen’s Expertise Of Hiring Prostitutes, Hiding Porn, Drug Meltdowns & More In Jon Cryer’s New Book

DH: Did you ever seek stem-cell treatments to mitigate the effects of HIV? If so, where?

CS: I’ve done stem cells on two bum shoulders that have been chronic for years, and I was not really blown away by the results. I didn’t see it as a real hopeful treatment program for something this systemic.

DH: If you could summarize how you are today, Charlie, how would you describe it?

CS: Sober, focused, hopeful, vigilant and, um, poetic!

DH: And glad this interview is over!

November 4, 2015

Next on HIV: Long Acting Injectable HIV Treatment to Replace Pills


A future of HIV treatment that doesn't depend on daily dosing seemed to move a little closer today with an announcement that early findings show an injected combination of two antiretroviral medicines given monthly or every two months effective in controlling HIV among people whose virus was already suppressed. The findings come from the first 32 weeks of a study that involved more than 300 adults in the U.S., Europe and Canada, but potentially offer the hope of simplified treatment for patients worldwide in resource-limited settings where obstacles to daily treatment remain greatest.

The LATTE 2 study, which compared the outcomes of receiving injections of long-acting formulations of the antiretroviral medicines ripilvirine, from Janssen Sciences pharmaceutical company and cabotegravir, from ViiV Healthcare, to the outcomes of taking a combination three-drug daily pill, is a 96-week randomized trial to determine the potential effectiveness of long-acting HIV treatment. Of 309 adults enrolled in the study in the study, 286 were sorted into three groups after their viruses were suppressed with a daily pill -- 56 participants continuing the daily pill, 115 receiving injections of ripilvirine and cabotegravir every four weeks, and 115 receiving the injections every eight weeks. Patients in all three groups achieved comparable rates of viral suppression, according to the announcement today. Of nine participants who experienced adverse reactions to treatment that caused them to withdrew from the study, six were in the group receiving monthly injections, two were in the group receiving injections every two months, and just one was in the group of participants receiving the daily pill. The most common undesirable side effect was pain at the injection site, which 93 percent of participants receiving injections reported and which caused two participants in the monthly injection group to withdraw from the study. With continued signs of efficacy the study will be followed by a larger late phase trial, to gather more data on the safety and effectiveness of long-acting injectable HIV treatment.

"Reaching resource limited settings is very much on top of the list for Janssen," said Peter Williams, the company's team leader for the ripilvirine side of the study. That will mean addressing some challenges, he added. Currently both drugs used in the injectable regimen need to be kept refrigerated, a challenge in both transport and storage, he noted. Further development could change that, according to the company. In addition, ensuring that vials of both drugs are available at the same time could pose a supply chain challenge, he said, "that we have to be realistic about." The regimen, which is injected intramuscularly, will not be self-administered.
This excerpt was cross-posted with  Science Speaks.   Read the full article.
Peter Williams of Janssen
Peter Williams of Janssen

September 23, 2015

Five Promising HIV Drugs Coming to Your “Repressed" Virus pipeline


There are currently 28 drugs for the treatment of HIV approved by the U.S. Food and Drug Administration (FDA). But there's always room for improvement and more choices. At ICAAC/ICC 2015, Roy Gulick, M.D., provided a look into the antiretroviral therapy pipeline. Many new drugs are in development, both in existing classes and in new classes, but here are the five that are farthest along in clinical development.
The biggest need for a new nucleoside reverse transcriptase inhibitor (NRTI) is less long-term toxicity, Gulick explained. Currently, the drug that is farthest along in development is tenofovir alafenamide (TAF). We've heard a lot of buzz about TAF as studies have continued to show that TAF is non-inferior to tenofovir disoproxil fumarate (TDF, Viread) and has fewer toxicities in the kidneys and bones. The FDA will decide on a new coformulation of elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild) using TAF by early November 2015. The FDA will also decide on a new coformulation of tenofovir/emtricitabine (Truvada) using TAF by early April 2016.

Non-Nucleoside Reverse Transcriptase Inhibitor: Doravirine
The biggest need for a new non-nucleoside reverse transcriptase inhibitor (NNRTI) is less toxicity, better tolerability, activity against viral resistant strains and fewer drug interactions, according to Gulick. Doravirine (DOR) is an investigational NNRTI that has been shown to be potent at low doses, with fewer side effects when compared to efavirenz (Sustiva, Stocrin).

Integrase Inhibitor: Cabotegravir
We're currently in the new era of the integrase inhibitor, but even integrase inhibitors could benefit from having fewer dosing frequencies. Cabotegravir (CAB) is an integrase inhibitor that has a structure similar to dolutegravir; it has a similar resistance profile and is potent at low oral dosages. However, cabotegravir really stands out because of its nanotechnology formulation, which gives it a half-life of 21 to 50 days. This supports monthly or quarterly dosing when cabotegravir is delivered in subcutaneous or intramuscular injections. Studies found that injection site reactions were mild, and this formulation is being studied for both treatment and prevention.
Additionally, oral cabotegravir, when taken with a long-acting form of rilpivirine (Edurant), works as maintenance therapy -- as shown in the LATTE study. This two-drug maintenance regimen could be an option for patients who have achieved undetectable viral loads on other regimens. What's more, the LATTE-2 study is looking into long-acting cabotegravir and long-acting rilpivirine as an injectable two-drug maintenance therapy.

CD4 Attachment Inhibitor: BMS-663068
A CD4+ attachment inhibitor is a new drug class that provides a new mechanism of action against HIV -- which is especially important for patients with multi-drug resistance, Gulick said. HIV's entry into a CD4+ cell is a three-step process: first CD4+ binding (in which the virus recognizes the target CD4+ cell), followed by coreceptor binding (either attaching to CCR5 or CXCR4) and ending with virus-cell fusion. We currently have maraviroc (Selzentry, Celsentri) as a CCR5 antagonist and enfuvirtide (T-20, Fuzeon) as a fusion inhibitor, but we lack a CD4+ attachment inhibitor.
BMS-663068 is being studied as the first CD4+ attachment inhibitor. BMS-663068 is a prodrug of BMS-626529 that inhibits CD4+ binding by itself binding to the gp120 protein on HIV. Early pharmacokinetic data suggests once or twice daily dosing; however, there is a baseline susceptibility in about 12% of patients because of envelope polymorphisms, according to Gulick.
A recent study compared regimens with BMS-663068 to regimens with atazanavir (Reyataz) boosted with ritonavir (Norvir) in treatment-experienced patients. At week 48, 61% to 82% of those taking BMS-663068 achieved an undetectable viral load versus 71% of those in the atazanavir group. Studies are ongoing.

Maturation Inhibitor
A maturation inhibitor is another new drug class that would provide a new mechanism of action against HIV. After infecting a host cell, HIV creates copies of itself, with the final step being maturation of the new copies. A maturation inhibitor would stop this step.
Years ago, the maturation inhibitor bevirimat was studied as HIV treatment, but up to 50% of patients had baseline polymorphisms, rendering the drug ineffective, Gulick said. A successful maturation inhibitor would have no baseline polymorphisms that confer resistance.
BMS-955176 is a "second-generation" maturation inhibitor that has shown a much better resistance profile than bevirimat. Early study data in humans showed good antiviral activity for BMS-955176 at four different dosage levels. Studies for this drug are also ongoing.

What Else Will Be in the Pipeline?
Just a few years ago, there was some concern that the pipeline may have dried up, but according to Gulick, the pipeline is fuller than ever. Still, new treatment with better potency, fewer toxicities and less-frequent dosing are welcome as we look toward a cure. Moreover, there’s still a great need to reduce inflammation and enhance immune responses; therefore, we look forward to continued progress in drug development.

August 12, 2015

I Have HIV but I’m Not HIV+


Brian Ledford writes for the Body:

My past post "Yes, I Have HIV but I Am Not HIV Positive" has received a lot of mixed emotions and reactions.
Many people supported what I was writing about while others not so much. I welcome all feedback either positive or negative about anything I write because it means that we are talking about the issue. I am a firm believer that we learn from each other and even if we may not agree, we are able to come together and share ideas with one another.
This blog post is a follow up to that post and some of the things that have happened since it was published. I believe the reason that post received so much attention is due to the fact that it is controversial and people do not always like being faced with controversy. But we do all have to admit that when we are forced to face it, we are forced to think about it.
This is a quote sent to me by e-mail from a reader of my last blog:
"Yes, why can't we have HIV like others have Diabetes and High Blood Pressure? The disease of HIV has changed so much in one generation from a death sentence to chronic condition but the terms HIV positive and HIV negative have not evolved with them. I believe that when you tell someone you are HIV+ they think of all the nasty things that accompanied the disease back in the 80s and early 90s, issues that just aren’t relevant today."

I could not agree with this reader any more. When a person hears the term "HIV+" they have a pre-determined stereotype that comes associated with it. These stereotypes also carry the negative stigmas that many associate with the early days of the HIV/AIDS crisis. Have we not evolved from those days? Is HIV no longer considered a death sentence like it was then?

When people hear the term HIV+, they do go though certain stages such as fear "Will I catch it from eating after them?" "Will I catch it from sharing a bathroom with them?" and so many more. If they do not have thoughts such as those, they may think along the lines "He had it coming for sleeping with just anyone." or "She must of used drugs and probably deserves what has happened."
While we all want to think the best in people, we all know that as soon as they hear that term, they start to develop a judgement about the person based on the "knowledge" they have heard in the past. I will stand by what I said in my previous post and I do believe that if we start to evolve the terminology used to describe HIV and AIDS, we can start to change those stereotypes and erase the stigmas that surround that term.
Another reader wrote: "Rather than worrying about how to tell the world if one is infected with the HIV-virus I think it is more important how we carry ourselves as individuals."
While with this statement, I do agree with part of it. The part I disagree with is the way we tell the world. The fact is that the way we tell the world and the way we represent the virus is the way the world will perceive the virus and those living with it. However, I do agree with that how we carry ourselves as individuals also plays a huge part in helping the world to better understand HIV.
Does the person who may of contracted HIV through Sexual Assault deserve to go through these stigmas and stereotypes? What about the child who was born with HIV because their parents could not afford treatment during the pregnancy or they simple did not know. Do they deserve to have to go though it? In fact, do any of us deserve to go though it simply because people are holding on to the older ideas they think they knew about HIV in the beginning of the epidemic? 

Yes I do know that the terms "positive" and "negative" refer to the testing and the results are read that you either test positive for the HIV antibodies or you do not, but why must we label ourselves as so? Let's leave those terms where they belong, in the testing facility. You either test positive or negative, you do not lave to label yourself as such.
I will stand behind my decision to no longer say that I am HIV Positive, but instead say that I am living with HIV. You could even put a play on the words and say that HIV is living with you. These types of terminology are ones that people are not use to hearing and it may bring them to open up and ask questions about HIV which in turn could help change the way they think about the virus and those living with it. 

February 18, 2015

'Undetectable' Is the New 'Negative


An HIV-positive freelance writer on being proud about your undetectable viral load. 
David Duran
David Duran
With the news spreading across the Web of the PARTNER study showing that no HIV-positive individual with an undetectable viral load has transmitted HIV within the first two years of the study, HIV-positive men are tossing out their condoms and celebrating. All online profiles are immediately being changed to say "negative," and the fear of ever having to disclose their status is now a thing of the past. Let that sink in for a moment. Now, how stupid does that sound? 

Well, you most likely won't be surprised by the reactions from the haters and skeptics to this monumental news. This news has been long-awaited by those who know their positive status, are taking medication and are taking care of themselves. Is it a license to be reckless? No, but it is a reassurance that treatment as prevention does work. 

As someone who happens to be HIV positive, my major fear regarding the disease is passing it on to someone else. My second fear is the rejection I could possibly face with disclosure. Do I disclose before being intimate? If a partner asks me upfront, I am always honest right back, and when the topic is left up to me to bring up, I'd say that I do initiate the conversation the majority of the time. But in the back of my head, I always would reassure myself that my viral load is undetectable and most likely would not be putting anyone at risk. With this landmark finding, is it possible that everyone, especially gay men, will be more inclined to get tested, know their status and be upfront and open about it all the time? 

In a perfect world, everyone would get tested, know their status, and take the appropriate steps thereafter. The shame and stigma that surround HIV would diminish, and the world would go on as normal, and HIV would be controlled and the spread of the virus contained. Having an undetectable viral load would be sexy. Knowing your status and getting tested regularly would be, well, regular. Being HIV positive and having an undetectable viral load would be considered the same thing as being HIV negative. Instead, we would frown upon those who don't know their status. Being HIV positive and having an undetectable viral load would be accepted, especially within the gay community. 

So will all this happen overnight? Will Grindr or other dating apps see an increase in gay men changing their status to say, "Undetectable as of..."? In this dream scenario, HIV-positive people who are on treatment and taking care of themselves by maintaining an undetectable viral load would feel more empowered to come out and show everyone their A-plus report card each time they have their labs done, wearing those test results with honor and being proud for being healthy. 

Unfortunately, unless those of us who are HIV positive become more open about our status and stop hiding behind the stigma, things most likely won't change overnight. We can all already hear the naysayers with the release of the first two years of this second study. And at the same time, we shouldn't automatically ditch the condoms or all our safe-sex practices. As we all know, there is a world of other communicable infections. 

What I hope will not happen is for HIV-positive people with undetectable viral loads to hide behind these results and live life as if they were HIV negative. Not being able to transmit the virus is the only thing the two types of individuals have in common. An undetectable viral load is not to be used as a justification for not disclosing your status before engaging in unprotected sex. Instead, these results should build up your confidence so that you can be more open about your HIV status and, if you are HIV positive, keep up on maintaining your undetectable viral load as well as being healthy. 

The more we open up and discuss what it means to be HIV positive with an undetectable viral load, the more society, especially those within our own community, will begin to understand, learn and accept. With advancements in antiretroviral therapies, attaining and maintaining an undetectable viral load is not difficult, especially if treatment is started immediately after learning of a positive HIV status. 

The more information is put out there for the world to know and learn from, the easier it will become for the ignorance and discrimination surrounding HIV to be eliminated. So all my HIV-positive brothers and sisters who are on treatment and have reached an undetectable viral load, take a moment to breathe a sigh of relief. If you are like me and our first major fears align, this news will certainly help lift that extra weight that we had pushing us down. Be proud of having an undetectable viral load!

 David Duran

David Duran is a freelance writer. He writes extensively about travel, business, entertainment, LGBT issues and HIV/AIDS. This article originally was published on The Huffington Post.

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