Many people looking into HIV Treatment for the first time are concerned about drug-resistant strains of HIV.  It’s no wonder, with all the news out there about a “super bug”.  It is true that HIV mutates and evolves very quickly, and inside a person’s body, it can be resistant to specific drugs that person is taking.  But this is just one piece of the HIV drug resistance story – and maybe not the most useful piece for people who are newly diagnosed and wondering how they will respond to meds.

(more…)

When I was a little girl, I dreamed of becoming rich and famous so that I could single-handedly save the world.  At the top of my “world that needs saving” list was a little Caribbean country called Haiti—“the poorest country in the world”, as I had been told.  I am no longer a little girl, and instead of being rich and famous, I work in the humble HIV prevention field.  While I no longer believe it’s a one-woman gig, Haiti is still near the top of my “world that needs saving” list.  Haiti has the highest HIV infection rates in the Caribbean and is second only to the worst affected sub-Saharan African countries on a world scale.  The January 12th earthquake is being called one of the most devastating natural disasters in human history, and we are all bombarded with news and images.  In hopes of blogging something original, I have tried to focus my attention on how the HIV/AIDS community is responding to the quake.

(more…)

After a day of listening to updates on HIV related disease and treatments, the word I kept writing down was inflammation. It’s not a word that applies only to the physical aspects of HIV, but the social aspects too. On a torrential Monday in November, I attended the BC Centre For Excellence in HIV/AIDS (BCCfE)’s treatment update, and this one featured speakers representing the International AIDS Society. It was a real gift to hear these folks from around the globe and note similarities and differences in the work we all do to support people living with HIV.

HIV disease is one of inflammation. Once it enters the bloodstream HIV attacks the gut, decimating protective CD4 cells and degrading the gut’s protective mucosa. The immune system fires up in response. A revved up CD4 response means more targets for HIV to attack, and the image of a body on fire wouldn’t be out of line. Specific topical inflammations can increase the risk of HIV transmission. Thankfully, HIV treatments act on HIV at different stages in its replication process, keeping HIV virus under control and allowing the immune system to rebuild. This attack/rebuild dance can continue for years and people can enjoy health they mightn’t have imagined before 1996, when HAART became the norm. 

If only it were that way for the social inflammation created by the mere idea of HIV. Not that I needed reminding, but Monday’s presenters pointed out that stigma, discrimination, racism, heterosexism and denial of any problem are ongoing hallmarks of HIV in countries the world over. On top of the issues noted above, women and girls bear the realities that sexism, intimate partner violence, unequal economic opportunities, childbearing and child rearing bring. HIV makes the burden even heavier. I thought of the late Jonathan Mann when Dr. Chris Beyrer echoed something Dr. Mann said in the early 90’s: for women in some cultures, marriage is a significant risk factor for HIV infection.

Moral judgments on harm reduction strategies as a means to reduce infection are of no use to anyone. “Now is not the time to limit use of any intervention with proven efficacy.” Beyrer was speaking of the infection rates in Russia, where rates in the IDU population is close to 50%, but I also thought about the struggle of Insite’s harm reduction work here at home.

HIV inflames the body and the cultures in which exists. It reveals biases that may have otherwise gone unremarked or more easily ignored. But now highlighted, we must continue to fight the virus and the ugliness it can create. What an energizing forum it was – a conference full of fighters from all over the world.

- Janet

This blog represents the ideas of individual writers, and does not necessarily reflect any formal stance taken by Positive Women’s Network.

Thanks to Canada’s Access to Medicines Regime (CAMR) 21,000 people living with HIV in Rwanda received a generic triple fixed-dose combination antiretroviral drug called Apo-TriAvir, produced by the Canadian generic pharmaceutical manufacturer Apotex.  And thanks to the completely convoluted, inefficient and backward process that is CAMR, they stopped receiving these life-saving meds after just one year—not good for their own health and not at all good in terms of avoiding future drug-resistance.  A handful of the people who I respect most in the world (including the folks at the Canadian HIV/AIDS Legal Network) are fighting hard to have CAMR reformed so that it can actually work to get HIV meds where they are needed, in the quantity needed, for a price that developing countries can afford.  While they valiantly slog through the process of trying to get Bills S-232 and C-393 passed by the Canadian Senate and House of Commons respectively, I would like to take this opportunity to rant about the undeniable impracticality and outright inutility of CAMR as it stands.

(more…)

 
You know the phrase, “I have a gut feeling” used to describe something you’re sure of but can’t explain? It characterizes the gut as the site of something significant. Interestingly, it is a significant site, certainly more than just where food is digested.  Up to 70% of the body’s immune cells reside there, and when it comes to HIV infection, it’s particularly important. Researchers now realize that HIV remains in the gut  even when viral load is under control in the blood.

(more…)

There are certain topics that seem to be “off limits” in discussions with other new parents.  Unless I already know that a mom feels the same way I do, there will be places in our conversation where I self-censor because she may have different views or a different approach, and I don’t want to seem “pushy”.  Breastfeeding is one of those topics.  Many women feel very strongly about breastfeeding and many don’t.  Some women who feel strongly don’t have much of a choice anyway, because it’s just not working for them or for baby, or because they don’t have the right kind of support.  For women living with HIV, there has been even less choice involved, as breastfeeding is one of the ways that HIV can be transmitted from mother to child.  Some recent studies show that mother-to-child transmission (MTCT) during breastfeeding is significantly reduced when the mother is taking antiretroviral treatment (ARVs).  The World Health Organization (WHO) has promised to change its HIV and breastfeeding recommendations before the end of the year, giving HIV positive women more choice when it comes to feeding their babies.

(more…)

Apparently, it’s not cool at the moment to be hopeful about finding a cure for HIV/AIDS, and it seems even the vaccine hype of recent years is mellowing.  Well, I want to share with you the fact that I am hopeful.  An exciting discovery just a couple weeks ago has renewed my faith that we will beat HIV.  A recent study found that people who are successfully managing HIV with antiretroviral therapy (ART) may be able to destroy the HIV lying dormant in their cells, by targeting these cells with chemotherapy.  It’s not that I’m allowing myself to get too excited about this particular possibility – don’t want to count our chickens before they hatch and all that.  But to me as an observer (rather than a researcher), this new area for exploration came completely out of the blue, and it reminds me that there are a million-and-one different angles and directions from which to approach finding a cure.  As long as we have the ability and the means to be creative in research, to explore and learn more about this still mysterious virus, we simply cannot guess what all the possibilities are for conquering HIV/AIDS.

(more…)

Somehow I always manage to spot Dr. Julio Montaner in the news.  It could be because I have a bit of a thing for pioneering Argentine doctors (this is Miriam speaking, not Janet!), but it’s more likely because Dr. Montaner has been in the news a lot lately.  He’s been busy garnering support for his ambitious pilot project – “Seek and Treat for Optimal Prevention of HIV/AIDS” (STOP HIV/AIDS).  The goal of the project is to increase access to HIV treatment and care among vulnerable communities in B.C. while decreasing the HIV transmission rate.  How would it work?

(more…)

In 1996, the audience at the International AIDS Conference in Vancouver heard about Highly Active Retroviral Therapy (HAART), a combination of drugs designed to limit the replication power of HIV and revitalize the immune system. HAART became the standard of treatment in the developed world, and a combination of three or more drugs with dizzying dosing schedules required tables and timers to make them effective. But HAART changed the shape of life for people with HIV. Flash forward: putting drugs into combination formulas lessened the number of pills, eased up on the scheduling challenges and some side effects. We are now in an age where HIV is often billed a chronic manageable illness, although class, race, gender and geographical differentials defy this as a universal term. Even here in treatment-rich BC, not everyone who qualifies is on treatment. The reasons why go beyond medicine.   

(more…)

There are lots of questions that come up when someone is newly diagnosed with HIV. One of those questions can be, “Can I have a healthy baby?” Many positive women want to have children, and for most women, the answer is yes. HIV itself is no reason to put parenting dreams away, but health care providers across the country may not know that. Women can face stigma and reluctance from care providers when the topic of pregnancy is broached, but new national guidelines to provide reproductive care to positive men and women should make some changes.

PWN is part of a national committee working to develop HIV pregnancy planning guidelines that can be used across Canada. While there are some great facilities in spots across the country (BC’s Oak Tree Clinic is one of them), a set of clear national guidelines would help so that women receive supportive, informed care no matter where they live. Guidelines that can be used to provide services to positive people across the country will help to educate care providers and hopefully work to dispel some of the stigma that positive women and couples experience with pregnancy.

Many members of PWN are moms, and discussions about pregnancy and raising kids often arise in the drop-in. An often asked question is about transmission during pregnancy. If HIV is treated during pregnancy, the transmission rate from mother to baby is less than 2%. Another concern is whether a woman will live to see her children grow up. With advances in treatments and evidence of PHAs living longer and longer, we have lots of reasons to be optimistic (no parent, regardless of HIV status, has a crystal ball to guarantee they’ll live to see their kids grow up).

These national guidelines will be aimed at positive people in various family units. Magnetic couples will be able to get information about getting pregnant safely when the woman is positive and the man isn’t, and vice versa. What if both partners are positive? What if a single or lesbian woman wants to get pregnant?  Care providers and PHAs deserve clear information about options. 

I’ll keep you up to date as things progress. The committee will be meeting at the CAHR conference later this month, and I’ll let you know what happens there. In the meantime, if you want information on pregnancy or pregnancy planning, the folks at Oak Tree would love to hear from you.

- Janet