God, AIDS, Africa & HOPE

Reflections / Gedanken

E-Health News: Strike threatens lives’ of AIDS patients

Source: http://www.health-e.org.za/news/article.php?uid=20032909

People taking life-long antiretroviral therapy have been left stranded and are being forced to skip crucial treatment as the public sector strike continues. Hospitals and clinics administering anti-retroviral and tuberculosis treatment have been empty this week, with doors being closed on patients needing the medication. Without this life-saving medication they could easily become sick again. A patient who did not want to be named told Health-e News Service that close to 60 patients on ARVs at the Koos Beukes clinic, in Soweto, were turned away earlier this week. She was among that group. “I was due to fetch my treatment. When I went there it was locked. How can they do that? The nurses always tell us that we should not skip our treatment, now they are the ones’ doing this to us, making us skip our medicine for two weeks. What do they expect us to do? They just want money and they don’t care about us, they need to help us”. The patient’s fear is almost palpable. “I feel very bad. I can’t live without my treatment. It will be a draw-back because it means that my CD4 count will reduce. Then, I’ll die. I don’t want to die. I want to continue living like I am”, she says. Two blood sisters also came for their treatment and could not find it. Luckily, they decided to go to the nearby Chris Hani Baragwanath Hospital’s HIV/AIDS unit where they received help, said one of the sisters. “When we arrived, they told us that they are not working because they are afraid of being threatened by striking nurses since they had been intimidated the day before. They told us to go and didn’t even suggest an alternative place to go to. We decided to come here because without the tablets we won’t survive. A lot of people didn’t get their treatment because only the 3 of us came to Bara. I can only imagine what happened to the others”. The other sister was also relieved that they managed to get their ARV treatment, saying without them the chances of surviving become slim. “This is very hard because when you skip your treatment, even for one day, it becomes very tough. The experience we had there at the other clinic was not good, especially because no one even advised us of an alternative place. We rely on these pills”, she explained. ARV medication is a life-long intervention. A doctor from the Clinical HIV Research Unit at Helen Joseph Hospital says the effects of defaulting on treatment could be detrimental to ones’ life. Dr Francesca Conradie says the danger of skipping treatment may result in making medicines the patients are currently taking useless when they resume taking treatment. “Antiretroviral therapy reverses the damage done to the immune system. It is a very effective therapy. But because the virus mutates so quickly, you have to make sure that our patients don’t miss any tablets. One of the questions asked is: ‘Does a day or two make any difference’? It is very possible that it does. Once a person becomes resistant to a drug, you lose it. It cannot be used again. And if the virus starts to replicate, you lose that drug and the immune system damage can occur. The stakes are very high”. Conradie also expressed concern for pregnant women who have to protect their unborn babies from HIV infection. “The stakes are high for pregnant women because if their virus goes out of control they can transmit their virus to the baby, which is very difficult to treat. I’d say for both her and her unborn baby. We’ve got good medication in this country and an outstanding ARV programme… the biggest in the world…very successful…and we’re going to blow this all into the water by drug interruption”, she says. She has also warned that the strike may have crippling effects on TB patients who may develop drug-resistant tuberculosis if they default on treatment. “It consists of four 4 medicines for the first two months and two medicines for the next four months. If you don’t adhere to that, it’s possible that drug resistance will occur and we call those organisms multi-drug resistant TB. This is more expensive and the cure rate is poorer”.

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, Society and living environment, , , , ,

POZ Magazine: HIV Prevention in Southern Africa Ignores MSM

HIV prevention campaigns in southern Africa focus on heterosexual transmission of the virus and ignore men who have sex with men (MSM), according to a study reported by PlusNews. Among sexually active people with multiple concurrent partners in Malawi, Namibia and Botswana, researchers found over half of the men surveyed had sex with both men and women in the previous six months. Nonetheless, MSM issues are not part of ongoing HIV prevention work in these countries.

Source: http://www.poz.com/rssredir/articles/Africa_HIV_Prevention_1_18987.shtml

Filed under: General, HIV and AIDS, HIV Prevention, HIV Treatment, Politics and Society, Society and living environment, , , , , , ,

28.08.2010 A brief visit…

.. to the National conference of people living with HIV in Bielefeld. I have the honour to be part of a podium discussion about pictures, used in media about people living with the virus. Interesting two hours.. What kind of pictures are dominant? How do people perceive those pictures? How different are the pictures in South Africa and in Germany? How much of the pictures, real or virtual (e.g. by writing about HIV) from Europe filters through to Africa? The positive gay couple in the “big brother container”, the Nadja court proceedings, the dying African people, the big eyes of suffering kids, the report about bare backing on TV.. so many different ways to portray people living with the virus…
New AIDS and old AIDS, meaning: chronic disease (and all is normal) against death sentence (before HAART treatment) – what is the reality of people living with the virus and how to translate it via media into the public domain?

So many questions – and certainly a diversity of answers – important questions and important answers. An important discussion…

Filed under: HIV and AIDS, Reflection, Society and living environment, , , , , , , ,

POZ Magazine: New Strategy Could Eradicate Latent HIV-Infected Cells

Researchers report that they have taken the first step toward killing cells that are latently infected with HIV—cells that serve as a reservoir of persistent HIV reproduction and that current antiretroviral (ARV) drugs can’t reach. Their findings have been accepted by the open-access journal AIDS Research and Therapy.
Combination ARV therapy is incredibly potent. Numerous studies have shown that the therapies in widest use today can suppress all but the tiniest amount of HIV. However, the miniscule amount of HIV that remains—likely coming from reservoirs, such as resting CD4 cells, that aren’t always reached by ARV therapy—can completely reseed the body with virus as soon as a person stops taking his or her treatment.
Those resting cells have snippets of HIV DNA integrated into their own DNA, but they aren’t actively making new virus. Unfortunately, ARVs don’t affect cells that aren’t actively reproducing, and the amount of HIV DNA in the CD4s is so small that it doesn’t trigger the cell’s natural self-protection mechanism, which causes cells to self-destruct when their DNA gets altered too much.
Now, a group of Israeli researchers believes they have developed a method for getting to those latent cells and killing them. The group, led by Abraham Loyter, PhD, of Hebrew University in Jerusalem, is looking at ways to force the virus to integrate in multiple places in the cell’s DNA, triggering the cell’s chemical panic button and causing it to kill itself, a process called apoptosis.
Loyter and his colleagues developed two chemicals—dubbed INS and INrs peptides—that can prompt this process and combined them with an experimental protease inhibitor. The group then treated HIV-infected human immune cells for two weeks with the compounds, which they called the “mix.” Loyter’s group then allowed the remaining cells to grow out for an additional two weeks. HIV DNA levels were measured at three time points: before treatment with the mix, after two weeks of treatment, and then again two weeks after treatment was stopped.
Loyter’s team found that the “mix” worked as they’d hoped. After two weeks of treatment with the combination, no HIV DNA could be found, and this remained the case for an additional two weeks after the last dose of the treatment was added to the cells. The authors caution it is possible that some residual integrated HIV DNA was still present in the cells. Nevertheless, their results are encouraging.
“Stimulation of viral integration by the INS and INrs peptides, combined with the prevention of virion production by the protease inhibitor, not only resulted in blocking of HIV-1 infection but also in extermination of the infected cells by invoking apoptosis,” the authors concluded.
“Whilst this research is promising, a major caveat with these studies is that they are preliminary,” Loyter cautioned. “So far these experiments have only been shown to ‘cure’ HIV from small dishes of cultured cells in the authors’ laboratory, but the findings are an exciting development in the quest to eradicate this devastating global pandemic.”

Source: http://www.poz.com/rssredir/articles/hiv_mix_dna_761_18978.shtml

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , ,

26.08.2010 Nadja… and a personal opinon

A suspended sentence is the result of the court proceedings against Nadja Benaissa. It is welcome news that she has not to go to prison. But the case remains to be a controversial one: The office of the prosecutor clearly violated the rights of Nadja in the way she was arrested and in publishing her HIV status or the number of her past lovers directly after her arrest. The question whether the criminal law is the right tool to clarify such cases remains in doubt. If it comes to sexual intercourse both parties have to play their part to avoid any infection.
By the way: not only those are infectious, who know their status, but also those, who have not been tested. Everybody in our days should be aware of the risk and act accordingly. To put the onus legally only on one party is in my opinion not right.

There is enough legislation to deal with cases of people willingly and with intention infecting other people – otherwise the law is surely not a tool to fight stigma and discrimination. The deeds of the prosecutors in this case have certainly not contributed to advocate testing and de-stigmatisation.

The case shows that also in Europe, not only in Africa, there is a long way to go until people feel comfortable to reveal their infection without fear of discrimination and stigmatization.

Filed under: HIV and AIDS, Politics and Society, Society and living environment, , , , , ,

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