Castro District, Castro San Francisco guide and voice of the gay and lesbian community!

Posted on www.365gay.com June 1,2010
By 365gay.com staff writer

For more than a decade, researchers and advocates have marked HIV Vaccine Awareness Day with varying degrees of hope, cynicism and despair. This year, in large part because of the results of the Thai Prime-Boost vaccine study, there is greater cause for hope than ever before and a renewed sense of urgency to transform this hope into a reality.

In September 2009, the world's largest AIDS vaccine trial to date showed the first evidence that an experimental AIDS vaccine could lower the risk of HIV infection. The results were complex; the observed benefit from the vaccine was modest; and the field is still years away from a highly protective vaccine.

"The caveats to the Thai Prime-Boost study results are important and true. But letting them become the entire story does a severe, even dangerous, disservice to the field, the trial and especially the 16,000 people who participated in the trial," said Mitchell Warren, Executive Director of AVAC: Global Advocacy for HIV Prevention. "Despite the many perspectives on and interpretations of the trial and its results the Thai AIDS vaccine trial provides evidence for the first time that it is possible to reduce the risk of HIV infection with a vaccine. AVAC and others have worked to explain the uncertainty of the results and the need for follow-up research. We will continue to do this because the science is complicated, and the future is unknown."

But for HIV Vaccine Awareness Day, AVAC's loud and clear message is that the Thai Prime-Boost trial changed the game for AIDS vaccines. A preventive AIDS vaccine is possible. The results were surprising to many and prompted some skepticism. But it is potentially disastrous if all that advocates, potential donors and future HIV vaccine trial volunteers and researchers think about the trial is that it gave a murky result, that it failed or that it left us no closer to an AIDS vaccine than we had been before.

"In fact, there's renewed energy in the AIDS vaccine field today, even as we grapple with what these results mean and where we go from here," said Warren. "The next steps for the field must involve more not less: more trials, more community volunteerism, more political will and sustained funding. One way to help ensure this is to celebrate what's happened to date, even as we prepare for everything that still needs to be done."

AVAC proposes three key steps for the AIDS vaccine field.

>Work aggressively to see what information can be gleaned from further analysis of the biological samples from more than 16,000 Thai men and women who participated in the trial and hope that we might learn why this vaccine combination worked at all.

>Build on this result, testing similar vaccines and combinations in different populations.

>Ensure that there is an increasingly diverse scientific portfolio to develop and test entirely different approaches.

There is no question that more resources are needed for existing AIDS treatment and prevention programs. People living with HIV deserve treatment and care, not waiting lists and death. But people who are at risk of HIV infection also deserve new ways to protect themselves.

Fully funding HIV treatment and prevention programs and HIV research would require only a fraction of the trillions of dollars governments have spent on bailing out big companies, and it would be a wise investment for the long-term economic stability of families, communities and nations.

"It's easy to call for all of these things, but it is much, much harder to achieve them," said Warren. "We hope that the next chapter of AIDS vaccine research shows the field capable of greater efficiency and prioritization: triaging current projects, jettisoning some, cutting costs within others, scaling up still others, and developing a clear strategy for collaborative action on key goals. We need a fully funded comprehensive approach to AIDS prevention and treatment, which includes finding new HIV prevention options, such as AIDS vaccines and antiretroviral-based HIV prevention, including pre-exposure prophylaxis (PrEP) and microbicide gels that could be used by women and men to protect themselves from HIV infection."

Posted on www.AssociatedPress.com
May 10, 2010
By The Associated Press

Domestic violence isn't something that happens only to straight people During his physical exam, Troy, a clinical psychologist and a patient of mine for nearly nine years, confided that his partner had been abusing him for two years. My first thought was to blurt out, "Rihanna, what were you thinking?" A psychologist should know better! Instead I shut my big mouth and listened. As obvious as the right course of action -- to get out quickly -- seems, I can't presume to know how any of us would react in a similar situation. Domestic violence occurs in one in four same-sex relationships, but fewer than one third of cases are ever reported. Victims fear insensitivity from the police, and men especially feel emasculated by needing to seek help regarding physical or emotional abuse. In Troy's case the abuse started after he lost his job: "My boyfriend always made more money than me, and after I was laid off, he joked about it front of our friends." As is often the case in relationships, that emotional abuse led to physical abuse.

Paging the Doctor!
I live in New York City, where good gay doctors can be found in every neighborhood, but if you're living in Omaha, Neb., or Jackson, Miss., an openly gay doctor may be harder to track down. The Gay and Lesbian Medical Association's very useful site, GLMA.org, has a search engine to help you locate gay doctors in hundreds of cities. Many medium-size and larger cities also have a "pink pages," an LGBT community directory, listing gay doctors. But because those directories are ad-supported, I recommend cross-referencing any listings with the GLMA website. Incidentally, Aetna has become the first U.S. health insurance company to link its website directly to the GLMA database; as a result, Aetna's DocFind online health-care provider listing includes more than 1,200 LGBT-friendly medical professionals. I hope this will inspire other insurers to do the same.

Q&A
Q : Four years ago I was diagnosed with genital herpes, but I am on suppressive therapy with Valtrex and don't have outbreaks now. My partner and I want to have unprotected sex. He has never had herpes. Should we worry that I'm contagious? We've also decided to open our relationship, so I am even more concerned about spreading herpes.

It's wise for you to stay on suppressive therapy; not only does it reduce the likelihood of further outbreaks, it also decreases the amount of viral shedding (when the virus comes out of dormancy and produces lesions). You can still spread herpes even when there are no active lesions. As for your partner, while it's possible that he's disease-free, it's also possible that he has herpes but has never had an outbreak. Only an exam by his doctor will determine if he is disease-free. As to the complicated matter of opening up your sexual relationship, I recommend always using condoms. But even using condoms and prophylactic therapy with Valtrex cannot guarantee that you won't pass herpes along to your partners. You should also consider that playing around with others will increase your partner's chances of contracting herpes from someone else.

Posted on HIVplusmag.com
May 1, 2010
By HIVplusmag.com Editors

HIV prevention and treatment service coverage for injection-drug users (IDU) is too low in many countries to prevent transmission, a discrepancy that affects infection rates at the local level, new research shows.

"Governments that have not made needle and syringe programs and opioid substitution available need to be convinced that these interventions are the most effective ways to stop HIV spreading among [IDUs], and to the wider community," said lead author Dr. Bradley Mathers of the University of New South Wales National Drug and Alcohol Research Center.

Australian health authorities distribute 213 clean needles per IDU each year, compared with 188 for the United Kingdom, 46 in Canada and 22 in the United States. In Russia, which has the second-largest IDU population after China, there is no methadone substitution. Other prevention measures among Russian IDUs are, similarly, virtually non-existent. HIV prevalence among Russian IDUs is 40 percent, versus just 1.5 percent among IDUs in Australia.

"Our high level of prevention in Australia has paid off with low levels of HIV infection among [IDUs] compared with countries with a similar level of injecting drug use," Mathers said.

Globally, just 8% of IDUs had access to a syringe exchange program last year, Mathers said. Coverage ranged from 100% in the Czech Republic and Ireland to less than 3% in China, Malaysia and Thailand. Opioid substitution therapy was available in only 70 of 151 countries with known IDU populations.

Only one of every 25 HIV-positive IDUs globally is receiving antiretroviral treatment. The worst treatment coverage was found in Kenya, Pakistan, and Russia.

The full report, "HIV Prevention, Treatment, and Care Services for People Who Inject Drugs: A Systematic Review of Global, Regional, and National Coverage," was published in The Lancet.