Health Law Inspires Hope But Also Worry Among Those With HIV

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From kaiserhealthnews.org.

Matt Sharphad high hopes for the nation’s health law. The self-employed health consultant is HIV positive and has been denied insurance in the past because of his illness, so he was relieved to learn that the law wouldn’t allow that to happen again.

But now, the 57-year-old San Francisco Bay Area resident is less sure that Obamacare will live up to his expectations.

He plans to enroll in coverage through the state’s insurance marketplace — but he still doesn’t know if his doctors will be included.  And although he will get help with premiums and medications through an existing program for HIV patients, Sharp worries he won’t be able to afford co-payments and other out-of-pocket expenses.

“I am apprehensive,” said Sharp, a former classical dancer. “There is a lot of unease with the whole rollout. But when you are talking about a person in my situation…

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HIV May Be Becoming Less Fit as it adapts to the Immune System

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From aidsmap.com

HIV, at least in some parts of the world, may be developing a lower replicative capacity as it adapts to variations in the human immune system, studies in southern Africa and elsewhere suggest.

Philip Goulder of the University of Oxford told the AIDS Vaccine conference last month that competition between HIV and certain varieties of human HLA (human leukocyte antigen) genes may be contributing to a diminution in HIV virulence, a lower community viral load, and an increased proportion of ‘elite controllers’ in the population.

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Goulder remarked that these changes seemed to be happening surprisingly fast, and that in some populations the introduction of antiretroviral therapy would also tend to reduce the fitness of the HIV that was still circulating.

Continue…

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Regular Clinic Attendance Especially Beneficial for People with HIV who have Low CD4 Counts

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From aidsmap.com

Strong association between regular clinic attendance and achieving undetectable viral load

People taking HIV treatment who have a low CD4 cell count are especially likely to achieve an undetectable viral if they attend their routine clinic appointments, research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes suggests.

The US study showed that retention in HIV care had a stronger association with viral suppression for people with a low CD4 cell count than people with stronger immune systems.

Overall, people with higher CD4 cell counts were more likely to achieve an undetectable viral load. However, the effect of regular clinic attendance on the chances of viral suppression was greater for people with immune suppression.

“While it is well established that retention in care is important for all HIV-infected patients”, write the authors, “our data suggest that retention in care may be even more central…

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Computerised Counselling Offers Many Benefits for HIV Therapy Patients

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From aidsmap.com.

Computerised counselling can achieve reductions in viral load and HIV transmission risk behaviour, investigators from the United States report in the online edition of the Journal of Acquired Immune Deficiency Syndromes. The counselling programme was associated with significant reductions in viral load, improvements in adherence to HIV therapy and reductions in risky sexual behaviour.

“The adherence effect was most pronounced among those whose plasma HIV-1 load was not suppressed at baseline,” comment the investigators. “This reduced viral load and fewer sexual transmission risk behaviors seen among those undergoing the intervention both may contribute to decreasing HIV transmission to sexual partners.”

Thanks to antiretroviral therapy, many people with HIV now have a normal life expectancy. The best outcomes are seen in individuals who adhere to their treatment. Good adherence also has a secondary benefit, as suppression of viral load is associated with a reduced risk of HIV transmission…

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Obamacare Could Insure 171,000 People With HIV

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From aidsmeds.com.

Nearly 47,000 people with HIV who are in care and an additional 124,000 who are not have the potential to gain insurance coverage thanks to the Affordable Care Act (ACA, or “Obamacare”), according to Kaiser Family Foundation. The nonprofit health research organization analyzed data from the Centers for Disease Control and Prevention’s (CDC) Medical Monitoring Project to provide this first-of-its-kind analysis of how the 2010 health care law likely affects the HIV population. The study does not take into account any actual enrollment into ACA-related health care plans that may have taken place since open enrollment began in October 2013.

Out of an estimated 1.2 million Americans who are living with the virus, nearly 407,000 are in care.  Eighty-seven percent of those in care have incomes below 400 percent of the federal poverty level (FPL), which is the cutoff for receiving federal subsidies to pay for the…

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Poor Black and Hispanic Men Are the Face of H.I.V.

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From the nytimes.com

“According to a major C.D.C.-led study, a male-male sex act for a young black American is eight times as likely to end in H.I.V. infection as it is for his white peers.”

The AIDS epidemic in America is rapidly becoming concentrated among poor, young black and Hispanic men who have sex with men.

Despite years of progress in preventing and treating H.I.V. in the middle class, the number of new infections nationwide remains stubbornly stuck at 50,000 a year — more and more of them in these men, who make up less than 1 percent of the population.

Giselle, a homeless 23-year-old transgender woman with cafe-au-lait skin, could be called the new face of the epidemic.

“I tested positive about a year ago,” said Giselle, who was born male but now has a girlish hair spout, wears a T-shirt tight across a feminine chest and identifies herself…

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