Monday, December 30, 2013

Let's Talk About PrEP: Day 4: Holy Hangover Batman

Let's Talk About PrEP: Day 4: Holy Hangover Batman: Ok, so I admit it, at times I forget that my frat boy, college days are well behind me. I'm not that same boy who would drink Jack Danie...

Thursday, November 14, 2013

Tuesday, November 5, 2013

What do you know about PrEP?

http://www.youtube.com/v/LVljWQOFEL0?autohide=1&version=3&showinfo=1&autohide=1&autoplay=1&attribution_tag=HOvzNFtI840AbMc6vZSZqw&feature=share

Thursday, October 17, 2013

Sunday, October 6, 2013

Thursday, July 18, 2013

My HIV Journey "Live" : HIV Care Continuum Initiative


The HIV Care Continuum Initiative: The Next Step of the National HIV/AIDS Strategy


The HIV Care Continuum Initiative: The Next Step of the National HIV/AIDS Strategy

Posted: 07/15/2013 12:25 pm - Huffingtonpost.com                                                       
Three years ago, President Obama announced an historic comprehensive plan to help turn the tide on HIV/AIDS in the United States: the National HIV/AIDS Strategy. The Strategy has given a new sense of direction, and purpose in our fight against HIV and AIDS.
Since the Strategy's release, scientific developments have advanced our understanding of how to best fight HIV. We now understand that to prevent long-term complications of HIV, treatment is recommended for all adults and adolescents living with HIV in the United States.
This is a significant shift; previous recommendations were to hold treatment until people showed signs of immune decline. Recent research also shows that an important benefit of earlier treatment is that it dramatically reduces the risk of HIV transmission to partners. Furthermore, HIV testing technology is faster, and more accurate than ever before, and HIV drug treatment is less toxic, and easier to administer.
All of this has powerful implications for how we focus our efforts.
And there is a clear need to do so: data released since the Strategy shows that along the HIV continuum of care -- which is the progression from diagnosis to receiving optimal treatment -- nearly 200,000 persons living with HIV in the United States are undiagnosed, and only one in four has the virus under control.
Today we are thrilled to announce two new developments specifically focused on addressing many of the factors that lead people to fall out of the continuum of care.
First, President Obama signed an Executive Order creating the HIV Care Continuum Initiative.

The Initiative directs Federal agencies to prioritize addressing the continuum of HIV care by accelerating efforts and directing existing federal resources to increase HIV testing, services, and treatment, and improve patient access to all three.

To ensure we succeed in this effort, the President's Executive Order establishes an HIV Care Continuum Working Group. The group will coordinate federal efforts to improve outcomes nationally across the HIV care continuum, and will be co-chaired by the White House Office of National HIV/AIDS Policy and HHS's Office of the Assistant Secretary for Health. The working group will provide annual recommendations to the President on actions to take to improve outcomes along the HIV care continuum.
Second, today HHS announced a new multi-year demonstration project that brings together OASH, CDC, and the Health Resources and Services Administration (HRSA) in a collaboration to expand the capacity of community health centers, local health departments, and their grantees to better integrate HIV prevention and treatment across the continuum of care. HHS will invest $8-10 million a year to support health centers and local health departments in integrating public health practice, and clinical care. The project will target areas with high numbers of racial and ethnic minorities, who are disproportionately affected by the epidemic, and communities with a substantial unmet need for comprehensive HIV services.
These two actions complement many of the ways we are already addressing the importance of continuum of care now.
The National Strategy shares its third anniversary with the Affordable Care Act, landmark legislation that is vital to our fight against HIV/AIDS.
Already, the law has expanded access to HIV testing, and ends the practice of putting lifetime caps on care when patients need it the most. Beginning in 2014, it will bring to an end to insurance practices like denying coverage for pre-existing conditions, including HIV infection.
Beginning this October, when the online Health Insurance Marketplaces open for enrollment, millions more Americans will have the opportunity to enroll in affordable coverage that includes HIV testing and other preventive care, with coverage set to begin January 1, 2014.
And the health care law also allows states to expand their Medicaid programs. Many people living with HIV will no longer have to wait for an AIDS diagnosis to become eligible for Medicaid.
The law aligns with the National HIV/AIDS Strategy's overall goals to reduce new infections, improve access to care, and reduce HIV-associated health disparities.
This includes fighting HIV stigma and discrimination. It includes advocating for the health of communities at greatest risk for HIV, including young, black, gay men and transgender people. It includes supporting research, in order to find more prevention and treatment breakthroughs.
And it means making smarter, more coordinated investments to fight the epidemic. That's why the president's Executive Order is so important.
Just a few months ago, President Obama spoke of realizing the promise of an AIDS-free generation in his State of the Union. Thanks to remarkable advances in HIV treatment and prevention, we have the opportunity to reach that landmark sooner than most of us would have imagined even just a few years ago. The HIV Care Continuum Initiative will help us get there even faster.

Long-acting GSK1265744 and TMC278-LA appear safe and practical in early study


Long-acting GSK1265744 and TMC278-LA appear safe and practical in early study
Liz Highleyman
 
Published: 05 July 2013
William Spreen of GlaxoSmithKline. Photo by Liz Highleyman, hivandhepatitis.com.
A combination of antiretroviral drugs in long-acting nanosuspension formulations achieved adequate blood levels and appeared safe in HIV-negative study volunteers, offering the potential for a maintenance or PrEP option that could be taken once a month, researchers reported on Wednesday at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur.
While modern antiretroviral therapy is highly safe and effective, agents that could be administered less frequently could improve convenience for people with HIV. A long-acting option could prove especially attractive for maintenance therapy once viral load is suppressed, or for pre-exposure prophylaxis (PrEP) in HIV-negative people.
William Spreen from GlaxoSmithKline and colleagues evaluated the safety and pharmacokinetics of a nanosuspension formulation GSK1265744 an investigational HIV integrase inhibitor similar to dolutegravir, plus TMC278-LA, a long-acting formulation of Janssen's approved non-nucleoside reverse transcriptase inhibitor rilpivirine (Edurant). GSK1265744 has shown good antiviral activity in a ten-day monotherapy study and is now in phase 2b development. A nanosuspension refers to tiny drug crystals suspended in a liquid, enabling it to remain active for longer in the body. Decreasing particle size increases the total drug surface area, allowing for a manageable injection volume.
This phase 1 trial enrolled 47 healthy, HIV-negative volunteers, 40 of whom received at least one injection. Just over half were women, most were white and the mean age was 40 years. 
Participants were randomly allocated to four treatment cohorts. Due to limited safety data, all participants received a 14-day lead-in of 30mg/day oral GSK1265744 to assess its safety and tolerability. Following a seven-day 'wash-out' period, they then got a single 800mg 'loading dose' via intramuscular (IM) injection. After this they received:
  • Cohort 1 – three doses of 200mg GSK1265744 via subcutaneous (SC) injection at weeks 4, 8 and 12 (no TMC278-LA).
  • Cohort 2 – three monthly doses of 200mg GSK1265744 via IM injection at weeks 4, 8 and 12, plus 1200mg TMC278-LA via IM injection at week 8 and 900mg at week 12.
  • Cohort 3 – three monthly doses of 400mg GSK1265744 via IM injection at weeks 4, 8 and 12, plus 1200mg TMC278-LA via IM injection at week 8 and 600mg at week 12.
  • Cohort 4 – a second 800mg GSK1265744 dose via IM injection at week 12 (no TMC278-LA).
Seven participants withdrew prematurely from the study for any reason during the oral lead-in phase and three did so during the injection phase.
In all dose cohorts, plasma drug concentrations reached levels expected to be therapeutic within three days. Levels of both GSK1265744 and rilpivirine between doses remained well above the IC90, or 90% inhibitory concentration. GSK1265744 reached concentrations that reduced viral load in a previous monotherapy study of people with HIV.
Both drugs had a long PK 'tail', meaning concentrations remained high for a prolonged period and declined slowly. In practice, this would allow for some 'forgiveness' in case of missed or delayed doses, Spreen explained. 
All regimens were generally safe and well tolerated. One participant discontinued the study during the oral lead-in phase due to dizziness, and one stopped during the injection phase due to transient skin rash. Overall, headache was the most common non-injection-related side-effect. There were no reported severe (grade 4) side-effects or laboratory abnormalities and no notable electrocardiogram changes. 
Most participants reported injection-site reactions such as pain, tenderness, redness or nodules, but these were mostly mild and no one withdrew for this reason. Moderate injection-site pain was more common with IM compared with SC injections, but nodules were more common and somewhat larger with SC administration.
"Co-administration of injectable long-acting nanosuspensions [of GSK1265744 and TMC278] was safe and generally well tolerated in healthy adults," the researchers concluded. 
"Monthly or quarterly dosing regimens achieved clinically relevant plasma concentrations" of GSK1265744 and TMC278, they continued, adding that these data support evaluation in longer-term clinical studies.
Spreen noted that a dosing-ranging study is pending, and researchers plan to look at various strategies involving oral lead-in or induction therapy with both drugs for up to six months before proceeding to long-acting injections.

Negative Gay Men Consider Viral Load Before Unprotected Sex

 
Negative Gay Men Consider Viral Load Before Unprotected Sex
July 17, 2013- POZ.COM


HIV-negative gay men are much less likely to engage in unprotected anal intercourse with an HIV-positive partner if they perceive him to have a detectable viral load, the National AIDS Treatment Advocacy Project reports. Australian researchers looked at risk behavior in an ongoing study of 76 serodiscordant couples (meaning that one was HIV positive and the other HIV negative) and presented their findings at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) in Kuala Lumpur.

Fifty-six (74 percent) of the HIV-positive partners had an undetectable viral load at the beginning of the study, and the remainder had a detectable viral load. Meanwhile, sixty-one (80 percent) of the HIV-negative partners believed their partner had an undetectable viral load, while the remainder believed their partner had a detectable viral load or didn’t know their viral load. This left a difference of five HIV-negative men who were either mistaken or uninformed about their partner’s viral load.

Fifty-five (72 percent) of the HIV-negative partners reported unprotected anal intercourse (UAI) with their partner. Among them, 48 (63 percent of the study group) reported insertive UAI—or being the top—while 32 (45 percent) reported receptive UAI (bottoming) without ejaculation and 19 (25 percent) reported receptive UAI with ejaculation. In other words, the HIV-negative partners were more likely to be the top during condomless anal sex.

Of the 61 HIV-negative men who thought their partner had an undetectable viral load, 49 (80 percent) had UAI in the previous three months. Of the 15 HIV-negative men who thought their partner had a detectable viral load or did not know his viral load, six (40 percent) had UAI in the previous three months.

Believing that a partner had a detectable viral load lowered the likelihood of UAI by 84 percent.

US: Bill to lift ban on HIV positive organ donation passes House committee

US: Bill to lift ban on HIV positive organ donation passes House committee

by for PinkNews.co.uk
18 July 2013, 12:21am
  
  
A bill which could eventually allow the donation of HIV positive organs to HIV positive recipients has passed the House after having passed the US Senate back in June.
The HIV Organ Policy Equity Act (HOPE), which is sponsored by both Democrats and Republicans would allow organs from HIV positive people to be donated to HIV positive recipients, and more so would allow researchers to study the safety of such practice.

The Human Rights Campaign also commended the passage of the bill. Back in March, the HRC praised the passage of the bill in the Senate Committe, and in June it passed in the full Senate.

“The HOPE Act represents sound public health policy,” said HRC legislative director Allison Herwitt. “The action by the House Energy & Commerce Committee is a major step forward in removing an outdated barrier which impedes access to lifesaving transplants for persons living with HIV and AIDS.”
The bill was sponsored by Representative Lois Capps.

HIV-positive patients in the US have been lobbying for the right to receive HIV-infected transplant organs for some time. They argue that there are hundreds of HIV-infected organs available every year and that making the change would save lives and give more people the chance of a transplant.
There are more than 100,000 actively waiting for life-saving organs, and around 50,000 more are added annually, and lifting the ban could decrease waiting time for all.

Allowing organs from HIV positive donors to HIV positive recipients with liver or kidney failure could save up to 1,000 people each year.
The ban on HIV positive organ donation was put in place in 1988, and aruments for it being lifted come partly from the fact that the treatment of HIV and AIDS has advanced significantly since.
The Centers for Disease Control issued draft Public Health Service Guidelines in September 2011, recommending research in this area, but said that in the US, federal law blocks it from taking place.
Over 40 medical and patient advocacy groups endorse the act, including the United Network for Organ Sharing, which manages the US’s organ transplant system.

Wednesday, July 17, 2013

Am I responsible for my friend’s HIV infection, addiction and death?


Am I responsible for my friend’s HIV infection, addiction and death?

By: Aaron M. Laxton- Writer, Blogger and Activist

Do we have an obligation to intervene when our friends are engaging in behaviors that are dangerous and potentially deadly? Some of my closest friends and peers are shooting, snorting, and sleeping their way to potential HIV infection and eventually death.  Am I responsible through inaction for their ultimate demise? We have all seen the commercials that teach us to stop a person who has been drinking from getting behind the wheel of a vehicle, however why do we not do the same thing for other dangerous actions?  If we expect to turn the tide of new infections as well as the death of our generation by way of addiction to drugs such as crystal meth and heroin, then it is time that we start to have REAL conversations with each other.
 

Recently Glee fans from around the world were saddened to hear of the sudden death of the Cory Monteith, who played the lead character of Finn. Monteith made his own personal struggle with addiction public last year when he entered drug rehab for the first time.  It now appears as if Monteith’s battle with addiction to methamphetamines was still ongoing. Monteith’s death follows on the heels of Spencer Cox, world renowned AIDS Activist, who also lost his battle with addiction and only further serves to highlight the need for action.

Crystal Meth

As I travel across the United States sharing my experiences as a person living with HIV since June 6, 2011 one thing stands out to me, people are still using crystal meth.  As a recovering addict, I can tell you that during the height of my addiction I would have loved for anyone to have told me how much I was hurting myself.  What started out simply as something I would do while partying with friends soon became a major addiction that wrecked every aspect of my life, ending with my being becoming infected with HIV. I could easily have been another Monteith or Cox. My life while using meth consisted of trolling hookup sites looking for my next trick, while looking for my next fix. There were never enough tricks and there was definitely never enough meth.  Psychologically, I had devolved to state of amphetamine-psychosis, a consequence of chronic amphetamine use. Symptoms mimic those of schizophrenia and include hallucinations, hearing voices, paranoia, mental confusion, loss of time, emotional flatness, not eating, inability to sleep just to name a few.  

 Logging on to any hook-up application or websites I’m  continually amazed to see the headlines for “Party N Play”, “PNP” all code for fellow-tweakers  (a term used to describe a person who uses meth).  Bathhouses are filled with guys who are doped up on chemicals purchased from warehouse store; the actions they engage in while under the influence creates a breeding ground, no pun intended, for new HIV infection. You might ask, “How does this guy know about what goes on in my bathhouse?” My response is that I am most likely a card-carrying member of your bathhouse. I have no shame is disclosing the fact that I frequent bathhouses around the world. Regardless of what your social standing we are all equalized when we are wandering the halls of the bathhouse in a towel simply looking for our next trick. It is time for us to have the tough conversations with our friends who are dealing with addiction. 

The reality is that the bathhouses are filled with your friends who slip in after a night of partying.  You may never know about it because they believe that you would judge them. It is time to admit that you likely have at least one friend or acquaintance who is an addict, but they believe they have it under control. All addicts think that they have it under control but the truth is that addiction is in control.

Raw, Bareback Sex

We need to face it that there are two messages being told. The most prevalent and politically-correct message is that condoms need to be used each and every time that you have sex. The reality is thatthat not everyone wants to use condoms and consequently we are not wearing them, more personally… I will not wear them. The reason that no one freely admits that we are not using condoms is because we do not want to be preached at and shamed. While condoms offer protection against exposure to HIV they are just one of many tools that we have currently. If we are truly committed to reducing shame and having a conversation about reducing new HIV infections we must end the stigma surrounding unprotected sex. I will always choose to have no sex at all than to have sex with a condom.

It is time for us to have these tough conversations with each other regarding risk-reduction practices and prevention outside of simply putting a condom on. It is time to wake up and recognize that beating people over the head with the “condom” message isn’t cutting it. A better conversation to have with friends who refuse to use condoms might be whether they have heard of PrEP (Pre-exposure Prophylaxis) or what other risk-reduction practices they use.

People are going to make their own choices regardless of how you feel about it. If we are committed to changing the tide of new HIV-infections & addiction then it is time for us to start having real conversations free of judgment and stigma.  Are you responsible for your friend’s HIV infection? That is only something that you can answer. Ultimately each person is responsible for their own actions. As friends and family don’t we have a higher responsible to intervene when a person is engaging in behavior that presents a high probability of negative results such as HIV-infection and in some cases death? Without these tough conversations, how many more of our friends fall victim to addiction and risky behavior?

Monday, June 17, 2013

My HIV Journey: HIV Criminalization




If you are HIV positive and you are not concerned about criminalization then you are clueless. These are laws that affect us all! These laws were enacted in 1988 are not based on current science and they use fear and rhetoric rather than evidence-based data. If you are positive and you are unaware of HIV criminalization laws in your state you need to educate yourself.

Monday, June 3, 2013

Do I really want to disclose my HIV status at IML?

I was recently asked a very interesting question regarding how “accepting” people were of my HIV status at IML. My first reaction was, “Well of course attendees to IML are accepting of HIV” but then I thought about it a bit more. Not everyone’s experiences are mine and vise versa. So I will share my experience…
Aaron Laxton is an HIV activist and "Mama's Kinky Educator." Follow him on Twitter at @aaronlaxton He lives in St. Louis and his column runs monthly.
Aaron Laxton is an HIV activist and “Mama’s Kinky Educator.” Follow him on Twitter at @aaronlaxton He lives in St. Louis and his column runs monthly.
While wandering in and out of the hotel I immediately clicked with this little hottie who was new to the leather-scene. We hung out and alcohol was flowing… We bounced from party to party and it was easy to forget that there was something that made me a little different; I am HIV positive. As the night went along, I knew that there was a conversation that would need to be had. On one hand, I could simply withhold the news regarding my HIV positive status and go against everything that I stood for; on the other hand I could disclose and completely ruin any chance that I had with this hottie.
Well there was really no choice; I knew what I had to do… I had to disclose. For anyone who is HIV positive, disclosure is something that places you in a vulnerable position… a position that allows you to be rejected. There were people around and I did not want to pull him to the side, I simply texted the following, “I don’t want to weird you out. It doesn’t really matter since we are not doing anything and it doesn’t put you at risk. I am HIV poz but undetectable. You are really sexy. I understand whatever your thoughts are but I would never place you at risk. I wanted you to know.”
Normally this is not a conversation that I would have via text message however it is sometimes the safest medium for difficult conversations. I hit the send button and watched as he read the message. I waited… nothing. Well it was late and everyone in the hotel crashed. The next day the hottie got up and went on his way and I was left to think about the previous night’s perceived rejection due to my HIV positive status. I sulked around the hotel and I spoke to several leather-men who I admire and look up to. They both offered their words of wisdom and they both agreed that I did the right thing for disclosing. My friend even went on to provide an example of how he approaches the conversation with people. As I spoke to two of the wisest people I know, Jon and DJ, something was said that definitely resonated with me, “sometimes you plant a seed and that experience of disclosure sets the stage for future interactions with those who are HIV positive.” In my mind however I was rejected and I had this huge “HIV POSITIVE” and “DAMAGED GOODS” tattooed on my forehead.
After milling around in the market it finally hit me. 1) The news that I had given to the hottie was a lot to digest. 2) He did not get up and run away, a reaction that believe it or not I have experienced once before. 3) Ultimately I had stuck by my principles and disclosed my status even though I knew that it might result in me being rejected.
Later that evening the tone from my iphone signaled that I had just received a text message. As you might imagine I was elated to see that it was the hottie from the night prior. He was not running scared but instead was texting me that he wanted to hang out that evening. We end up having a deep conversation at the Victory Party and without doubt I feel as if I have a friend for life. There are all types of connections that we make with people and not all intimacy is sexual. Sometimes we are lucky enough to make that connection with a person who allows you to learn about yourself and to grow.
So to that person that asked about how “accepting” people are of my HIV positive status at IML, I say this… people might react positively or negatively but in the end that is more about who they are instead of who you are. Whether they accept my status or not, I am still HIV positive and I have nothing to be ashamed about. In this situation I allowed the perceived stigma of HIV to affect me when in reality I was stigmatizing myself.

Wednesday, April 17, 2013

Meningitis Outbreak – Should You Protect Yourself Prior to Major Events?



 Meningitis Outbreak – Should You Protect Yourself Prior to Major Events?

By now, most of you have seen the news stories regarding meningitis outbreaks that were initially isolated to New York but have now moved to Los Angeles. If we have learned nothing else from the early days of the AIDS plague, it should be that early response trumps a reactive-scramble to matters of public-health. It is not my intent to sound the alarm over meningitis however, it is something that needs to be watched quite carefully. With several major leather events, CLAW & IML on the horizon, attendees need to be fully informed regarding what it is and how they can protect themselves.
Meningitis is inflammation of the protective membranes covering the brain and spinal cord and the most common symptoms are headache, fever, neck stiffness, confusion, vomiting and an inability to tolerate light or loud noises. Meningitis is contracted through “close contact” not simple casual contact, examples of this would be: kissing, coughing, sneezing, sharing eating utensils, glasses, food or towels. Although meningitis is not transmitted exclusively through sexual intercourse, most of the above stated activities occur during sexual contact. It is for this reason that I urge anyone attending major leather events or parties such as CLAW or IML to consider getting vaccinated. There is considerable evidence which supports the idea that the LA patient was exposed during a White Party over Easter Weekend.
The New York City Health Department has suggested that gay men in New York “who regularly have intimate contact with other men through a website, digital application, or at a bar or party” might consider getting vaccinated. This simply means that this group is at higher risk for exposure to meningitis due to the activities that they are engaged in regularly.
Getting vaccinated as a precaution poses no risk to your health. It will take approximately 2 weeks from the initial date of vaccination for the full-benefits of the vaccination to be seen. Additionally individuals who are HIV positive may require a secondary booster to be fully protected. The meningitis vaccine will prevent invasive meningococcal disease from taking root but does not treat the disease if a person is already infected.

Saturday, April 13, 2013

Should you get vaccinated against a deadly meningitis outbreak?



Update April 13, 2013: Concern is growing in Los Angeles after a gay 33  y.o. West Hollywood man contracted meningitis this week and quickly went in to a coma.  He felt ill on Monday, went to the emergency room on Wednesday, and by Thursday was in a coma.  He is now brain dead.  He reportedly recently attended the White Party in Palm Springs, though it’s not known if he contracted the disease there.
A 21 y.o. University of Wisconsin-Madison senior has also died of meningitis.  The article do not indicate if he was gay.
It is unknown if either of these cases are related to the outbreak in NYC.  For the details of this latest outbreak, how you contract meningitis, and whether you need to get vaccinated, read on.  Also, I got my vaccinated in early April, cost $165 at my doctor (doesn’t look like insurance will cover it), but a friend was able to get it for half that price on his college campus, so your mileage may vary (check local public health clinics etc.).  I had zero reaction to the vaccine – it’s a dead vaccine, not even a full virus, so no risk beyond any other vaccine.
__________
April 2, 2013 – I had a great talk yesterday with Dr. Thomas Clark, an epidemiologist and meningitis expert at the US Centers for Disease Control and Prevention (CDC). Our topic: the recent deadly meningitis outbreak among gay men in New York City.
As you may recall, we’ve been reporting on increasingly scary warnings out of New York that a particularly deadly variant of meningococcal disease (bacterial meningitis) was showing up in gay men in New York. The New York authorities are now recommending vaccinations for gay men in New York City who are either HIV-positive, or HIV-negative and non-monogamous. The vaccination warning also includes men in the two categories above who visited New York City at any time since September of 2012.
As I noted in my earlier post on this topic, the warnings from both New York City and New York State on this matter have been somewhat confusing, so I sought out an expert at the CDC, Dr. Clark, to explain what’s actually going on, and who really needs to get a shot.
Let me walk you through what I learned.

Who should get a meningitis shot?

Vaccine, vaccination, shot, health care, disease, bacteria, sick, meningitis
Vaccine via Shutterstock
Anyone covered by the recommendations from NYC and NY state, if you can make sense of them.  But also, really, anyone who’s concerned enough about the outbreak.  I asked Dr. Clark if there was any downside to the vaccine, and he said no.  The vaccine carries no more risk than any other vaccine you might take.  And to further put one’s mind at ease, the meningitis vaccine does not contain a live bacteria, or even a dead one – it only contains part of the shell of the bacteria, so it’s impossible for it to give you meningitis.  Thus, Dr. Clarks’s recommendation, that if you’re worried at all, get the shot.

How is this variant of meningitis transmitted?

I was quite surprised about how the bacteria is transmitted.  As the NY warnings are targeted at gay men, and specifically at men who seek sex partners online, at a party, or at a bar, I just assumed that this was sexually transmitted.  It’s not.
The bacteria is transmitted through secretions of the mouth, nose and throat – large-sized droplets. What that means is the droplets are far too large to float in the air.  So it’s the kind of thing you’re more likely to get from French kissing, or having someone cough in your face or accidentally spit in your face while talking, or even sneezing – but regular aerosolized drops in sneezes won’t get you sicks, it’s the larger droplets that do it.  That’s why the warnings talked about “close contact.”  What they found was that people living together, even if they’re not in a romantic relationship, we’re at a “very high risk” of contracting the disease from each other.

Can meningitis be transmitted by sex? No, but…

Not only are the mouth, nose and throat instrumental for transmitting the bacteria, they’re also instrumental for receiving the bacteria.  So oral sex isn’t going to transmit it, so long as your mouth doesn’t come into contact with anyone else’s saliva – same goes for any other sex act, the key issue is your mouth (or nose) coming into contact with someone else’s saliva.  I was surprised about that, since I figured this would be transmitted similarly to an STD.  Not so, said Dr. Clark.  Even though the bacteria is a cousin of the bacteria that causes gonorrhea, while gonorrhea adapted to the genital tract as a venue of transmission, this bacteria adopted to the nose and throat.  It is also not, however, as easily spread as an STD.

You’re not at risk if you work with someone who gets sick

Because the bacteria requires prolonged face-to-face contact, simply working in an office alongside someone who came down with meningitis would not put you at risk, Dr. Clark told me.

Are people with HIV more likely to contract meningitis?

This one is tricky.  What they’ve found is that being HIV-positive does not per se put you at risk of catching this variant of meningitis, as being HIV-positive can for other infections.  So it’s not really a question of having a depressed immune system and thus being more likely to get the disease.  But, they’ve found some kind of correlation between being HIV-positive and becoming infected during this outbreak: Many of those infected are HIV-positive, but not all.
It could be something as simple as HIV-positive people in New York generally having sex with other HIV-positive people in that same community.  Thus, if someone becomes infected in that community, he is more likely to pass it to other members of that community.  So the bacteria stays within the HIV-positive community because it’s a discrete community, not because HIV makes you more prone to catch it.   That isn’t necessarily the reason HIV-positive people in NYC are coming down with this disease, but it is an example of how HIV doesn’t put you at risk of catching the disease, yet your HIV status could still be relevant to whether you’re at a heightened risk.

Will the meningitis vaccine help after you’re exposed? No.

If your doctor thinks you’ve been exposed, or you’re already showing symptoms, they will prescribe antibiotics.  The vaccine is only good before you’re exposed.

How quickly does the vaccine work, how long does it last?

The meningitis vaccine takes two weeks to fully kick in, and should protect you for three to five years.  People with HIV may not respond as well to the vaccine, so it’s recommended that they receive two doses – a booster shot, in essence – two to three months apart.  And regardless of your status, if you remain at risk, they recommend a booster after five years.

Can you be exposed and not get sick?  Yes.

Some people are exposed to meningitis and don’t get sick at all.  Others are exposed and develop an immune response to the bacteria without becoming visibly ill, and without even knowing it.  You will not, however, be a “carrier” of the disease if that happens to you.  You would only be contagious during the same time period that anyone else with the disease would be contagious. (Though I didn’t clarify with Dr. Clark how long that would be in the case of someone who didn’t show any symptoms – nonetheless, it didn’t see like a long time, as he said you wouldn’t be a carrier, and you wouldn’t be contagious once you’re body developed the immunity.)

For how long are people contagious?

The good thing and bad thing about this disease is that you generally get sick a day or two after you were exposed, though it’s possible, but unlikely, for it to take up to two weeks.  The bad news is that you can become quite ill quickly, and if you don’t get medical help you can die.  The good news is that the quick onset of the disease makes it harder to spread.  Why?  Because once you’re in bed sick as a dog, you really don’t feel like going online and hooking up, or going to a bar and drinking with your buddies.  So the disease generally only gets a chance to spread in that 24 to 48 hour window after you’re first exposed and still feeling fine, which thus limits the spread of the disease.

Is this a gay disease? No.

I mentioned to Dr. Clark that some of the readers were confused as to why the warning went out to the gay community and not the straight community as well.  How could a disease target only gay people?
He said that it’s not a “gay” disease, and that meningitis usually targets schools, college campuses, and corrections facilities – i.e., a small enclosed community.  Occasionally, the disease can hit a “virtual community,” like the gay community. By “virtual,” he means that gay men are not a geographically-confined community as are kids in the same high school building or college dorm, or men living in the same prison.   So the community is more “virtual,” as the tie isn’t immediate geographic proximity per se (though obviously it’s affecting people within a discrete geography like New York City, but that’s different than actually living together in the same building and thus you all get sick).
Also, 98% of the cases in the US every year are sporadic, they occur by themselves, rather than striking a community.  Only a small fraction turn into “outbreaks” like this one.
One more thing Dr. Clark noted was that this disease tends to strike in specific clusters, in specific communities, and it tends to stay confined to that community, without spreading to other communities.  And that’s another reason why the warnings are only being given to gay men, and only, so far, in NYC.

Just how big is this outbreak?  Not big at all, actually, but big enough to be concerned.

There was one case in 2010, four in 2011, and thirteen in 2012.  Those numbers may look small, but in public health terms, they’re not.  What has experts worried is that they keep hitting the same community, gay men in New York City, and it’s not going away.  Most outbreaks happen quickly, Dr. Clark told me, with usually just a few cases occurring at once in a short period of time, and then they go away.  This has been going on in NYC since 2010 and it’s growing, rather than going away.  Thus the concern.
I just talked to Dr. Clark about some of the comments here, and on Facebook, saying that with these low of numbers, this was blown out of proportion by the authorities in NY.  He says that’s not true at all.  Here’s why….
In public health terms, an “outbreak” is defined as 10 cases per 100,000 people within a short period of time (say, a few weeks).  When you have an “outbreak,” that’s suggestive that the disease has reached a point where it may accelerate and spread to even more people.  In public health circles, it’s their job to stop outbreaks from becoming something bigger.  To the public, these numbers sound small.  But in public health terms, these numbers are statistically significant and worthy of increased concern.
That’s why when they get 2 or 3 cases in a school of 600 kids, or a prison of a few thousand inmates, they vaccinate everyone to prevent the disease’s spread.  That’s enough cases to set off alarm bells.
In NYC, we’re talking more on the order 13 or so cases last year.  But, you might say, hey, that’s 13 cases for 8 million people, so who cares?  But that’s not really correct.  It’s not 8 million New Yorkers.  It’s gay New Yorkers.  And it’s only gay men who are getting sick, not lesbians, so now the number is cut down even fewer. And it’s not all gay men in NYC, it’s gay men in certain boroughs.  And it’s not every gay men in those boroughs, it seems to be gay men in those boroughs who are sexually active and particularly using Web sites, phone apps, bars and partys to meet guys.  That cuts down the number even further.  So you’re now a lot closer to that 100,000 figure than you were when you thought this was about 8 million New Yorkers.
The uncertainty of the size of the community exposed to this disease is part of what worries public health professionals.  It’s not possible to accurately define whether we’re talking 13 cases per 100,000, per 200,000 or per 50,000.  So they err on the side of caution because this is such a particularly deadly variant of the disease, killing 1 in 3 who get it, rather than the normal 1 in 5.   And in public health, you try to cut off disease before they become a huge problem.  Thus you have to look at small numbers, and historically what those numbers tend to mean for the future, and act accordingly.
That’s pretty much it.  I know my concerns were allayed greatly in talking to Dr. Clark.
I got my vaccination last week.  It was $165 or so at my doctor’s, a friend got his on a college campus for around $85.  At least this disease sounds like it should have a much harder time spreading than some others in our history.

Friday, April 12, 2013

West Coast City Issues Strong Warning Regarding Meningococcal Infection



City Issues Strong Warning Regarding Meningococcal Infection
Posted Date:4/12/2013
city hallThe City of West Hollywood issued a strong warning at a news conference held Friday, April 12th regarding meningococcal infection, a bacteria-caused illness that can lead to potentially deadly meningitis.

“We don't want to panic people,” said West Hollywood Councilmember John Duran. “But we learned 30 years ago the consequences of delay in the response to AIDS. We are sounding the alarm that sexually active gay men need to be aware that we have a strain of meningitis that is deadly on our hands,” continued Duran.


According to the Centers for Disease Control and Prevention, bacterial meningitis is usually severe. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss, or learning disabilities.


Infectious diseases such as meningococcal infection tend to spread more quickly where larger groups of people gather together. College students living in dormitories and military personnel are at increased risk for meningococcal meningitis as well as people with weakened immune systems such as those living with HIV/AIDS.


The germs that cause bacterial meningitis can be contagious. Some bacteria can spread through the exchange of respiratory and throat secretions (e.g., kissing). Fortunately, most of the bacteria that cause meningitis are not as contagious as diseases like the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.


Meningitis infection may show up in a person by a sudden onset of fever, headache, and stiff neck. It will often have other symptoms which include:

  • Nausea 
  • Vomiting 
  • Increased sensitivity to light (photophobia) 
  • Altered mental status (confusion)
The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within three to seven days after exposure.

The Centers for Disease Control and Prevention has been alerted about a Los Angeles County case of meningococcal infection. Tests are being conducted to determine the imprint of this strain, which is not a new one. There may be similarities to an especially deadly strain of meningococcal infection found recently in New York that has resulted in twenty-two cases, including seven fatalities since 2010. The outbreak in New York City involved a strain circulating among men who have sex with men and may be transmitted during intimate encounters including sex.

For more information visit the Centers for Disease Control and Prevention website.

Thursday, April 11, 2013

When your dick develops a habit…



My name is Aaron and I am an addict. I will be the first to admit that I love crystal, “tina”, Adderall… I have been clean for 459 days and counting but I will be an addict for life. Crystal use in the LGBT community and specifically in the kink community is alive and well! Recently I was alarmed while in Atlanta when I logged onto Grindr to pass time; the amount of guys looking to “Party” or “PnP” was staggering.  As a community we have to be honest that when it comes to drugs and alcohol, if it was not fun initially we would never have done it. There comes a point however when the novelty wears off and we are left with a habit, a habit that our dick had helped us develop.  

No one wakes up one day and decides that they are going to become addicted to drugs; we need to be very clear about that. A habit develops over time and before a person realizes it, they have reached rock-bottom. For some people that rock-bottom is worse than others. Whether it is slamming “tina” at the bathhouse and getting slammed or simply popping a few “addys” for a night on the town, we did it because it was fun. There was a certain amount of pleasure that came from that high. No one ever tells you though that you will always be chasing that first high, which is why an addict requires higher amounts of the drugs. Anyone who tells you that drugs were not fun in the beginning is either full of shit or they do not know what they are talking about.
Amphetamines cause a hyper-sense of sexuality that initially is alluring until most people figure out that they are up all night with a limp-dick. There is nothing worse than being awake in the wee-hours of the morning, endlessly searching “fuck-sites” such as craigslist, Recon, Scruff, Grindr and so forth… There is nothing worse than the emotion wreckage that a person is left to deal with as the drugs begin to leave their body and they start to withdrawal.  

A habit develops over time, slowly what began as something that was done socially becomes something that you do alone. You isolate yourself from everyone around you. Your work performance begins to slip. You begin to lie to cover up your usage. Through it all however you say to yourself... “It is recreational, I only do it every now and then… I have it under control.” Those are the famous last words of every addict; you are no more in control than other addicts. All addicts like to think that they are somehow different. At the end of the day however, your dick has helped you develop an addiction.

If there are things that you can only do when you are high on meth… should you be doing them?  Additionally how many of us have placed ourselves in extreme risk of HIV exposure or become infected while high on crystal meth, tina, Adderall or whatever you choose to call it. I can say that I did! Regardless of what your definition of kink is, there is only one definition of addiction. To all of my brothers out there that are currently dealing with an addiction that their dick helped them develop, I would say that there is help available. Nothing in your life is beyond repair and at least worth the effort to attempt to fix.

To others that are in our community that are turning a blind-eye to those that are actively using meth… wake the fuck up. You have an obligation to call people out! Do not simply look down at people or turn your back on them. That is how we are going to overcome the war that is raging with crystal meth. 

Sunday, March 24, 2013

No Place to call home: Aging with HIV/AIDS

No Place to call home: Aging with HIV/AIDS
By: Aaron M. Laxton, Blogger, Activist and HIV-Infected Queer
 
 


I remember once in a class that I was in the professor had the class address issues regarding their own mortality. For  people in their youth this can be extremely hard since this can viewed as morbid. After all, we will live forever and nothing will ever hurt us...right? Obviously as we age we begin to understand that this is not the case; life is always moving and changing. Eventually life will move on and change without us.

 

HIV risk doesn’t stop at 50. In fact, men and women over age 50 account for 17 percent of all new HIV and AIDS diagnoses in the 40 states that have long-term confidential name-based reporting.

During the plague years hospices began to form that would address the needs of those dying from AIDS. It was in these hospices where patients were not viewed as an infectious disease but rather a person who needed love and compassion. A patient covered in Karposi Sarcoma or sufferingly was severe wasting was not feared but rather embraced, held and loved. Although the end of their life was marked by the extreme pain and suffering of AIDS related complications and social stigma, the hospice provided a safe-haven in their final days.

With the advent of improved medications and our understanding of our to treat HIV the amount of people dying from AIDS slowed; as a result the hospices that we once formed to provide support for them were not needed. It is estimated that approximately 50,000 annually die from AIDS in the United States. Some of these organizations restructured to provide other services and others simple were no longer there.

In 2009, people aged 50 and older accounted for 23% of AIDS diagnoses in the United States. Yet older adults are often overlooked in the ongoing HIV/AIDS conversation. Developed for the National Aging Network and others interested in educating older adults, the U.S. Administration on Aging HIV: Know the Risks. Get the Facts. Older Adults and HIV/AIDS Toolkit contains helpful resources and materials specifically designed to inform older adults about the risks of HIV/AIDS and to encourage older adults to know their status.

Now however we have an aging population of patients living with HIV/AIDS and we must consider how to provide the best possible care for them. Anyone who works with aging populations will tell you that finding residential care facilities is a daunting task. I work as a case manager and recently had to do this for a client. This particular client did not have HIV however the task was a challenge none-the-less.

As an HIV positive patient population reaches a time where they might need a residential care facility where will they go? You might say that they can go to any residential care facility that they want. In theory you are right however the facility has the right to refuse whomever they want. Typically once an administrator determines that a patient is HIV positive they are less apt to admit that patient into their facility. This is not something that cannot be hidden since all medical records must be given to the prospective facility.

Also there is the issue of stigma within the residential care facilities. For many of these facilities is it a challenge simply being LGBT. The fear and ignorance of HIV among others residents and staff alike would make it almost impossible for a person living with HIV to live with any quality of life.

One strategy might be to develop facilities that specialize for those living with HIV but does this further perpetuate stigma and ignorance. By creating specialized facilities are we simply shuffling those living with HIV/AIDS "Out of Sight, Out of Mind". That is a slippery slope. What would be next, homes for only white people? Homes for only black people?

If we agree that specialized facilities are not the best strategy then another might be to work with policy and regulators to ensure access to services and facilities by those HIV positive patients. Creating a demand for improve transparency regarding decisions for admissions into programs? Also working with residential care facilities to help educate staff and residents about HIV/AIDS.

We have an ethical obligation to provide great care for our elders not to simply shuffle them away somewhere until they die.

Aaron M. Laxton
My HIV Journey
aaronlaxton@gmail.com






Friday, March 22, 2013

Kansas seeks to imprison HIV-infected People



Today while on Facebook, a message popped up regarding a proposal that was being made in Topeka, Kansas that sought to quarantine those infected with HIV/AIDS. While this is completely absurd, we currently have criminal statutes in 34 states that are dong this very thing.

HIV Criminal Statutes State by State Breakdown

Patients who are living with HIV are treated as second-rate citizens who seemingly have no protectin under the law. That is a fact! While everyone can see the injustice of a message calling for quarantine, there seems to be little or no outrage over current criminal statutes which are putting patients in prison. Additionally a person that is prosecuted and sentenced in one state may get a life-sentence while in another state it substantially different.

Kansas Seeks to quarantine those infect with HIV.

There is no data to support that criminalization helps to reduce rates of infection. In fact these criminalization statutes only serve to further stigmatize those who are living with HIV/AIDS and to stop people from getting tested and starting treatment. Below are comments highlighted by Sean Strub who heads up the cause of modernizing HIV criminal statues with The SeroProject.

HIV Criminalization is Bad Public Health Policy
HIV criminalization statutes are terrible public health policy because they discourage persons at risk from getting tested. Those with HIV who are aware of their HIV positive status are more responsible in their sexual behaviors than those who are unaware they have HIV ; testing is a basic tool of HIV prevention as well as an essential gateway to care.

Criminalization statutes also make it more difficult for persons with HIV to disclose their HIV status. Those who know they have HIV already suffer significant discrimination and stigma. Disclosing one's HIV status can be emotionally difficult, risking rejection from family and friends, sometimes with great insult or abuse, and often jeopardizes one's employment, housing, relationships or personal safety. Criminalization of HIV legitimizes the ignorance, homophobia, racism and sexophobia that fuels inflated fears of HIV and those who have HIV.

Criminalization undermines efforts to prevent new HIV infections and provide access to care in multiple ways: Ignorance of one's HIV status is the best defense against a "failure to disclose" prosecution, which creates a powerful disincentive to getting tested and learning one's HIV status.

Young African American men who have sex with men are among those at highest risk of acquiring HIV, yet also among the most difficult to get tested. The prospect of prosecution for failing to disclose--especially since these prosecutions often boil down to a "he said, he said" or "he said, she said" situation--is a powerful and likely growing disincentive to taking an HIV test.

Most new infections are caused by sexual contact with persons who have not been tested and are unaware that they have HIV, yet only those who have taken responsibility and gotten tested are subject to prosecution.

Prosecuting the failure to disclose one's HIV status undercuts the most basic HIV and STD prevention message: that every person must take responsibility for his or her own sexual health.

Prosecuting the failure to disclose values the "right" to an illusion of safety, for those who are HIV negative or who do not know their HIV status, over the privacy rights of those who have HIV.

A legal obligation to disclose one's viral status prior to intimate contact creates a particular inequity for those who were born with HIV. If we are all born equal, why is it that this group must carry throughout their lives a legal obligation to disclose their viral status prior to engaging in intimate contact?


Examples of Prosecutions
The most publicized HIV criminalization cases are often driven by politically ambitious prosecutors and inflammatory or hysterical media coverage. These prosecutions feed into the public's ignorance and anxiety about HIV, reinforce negative stereotypes about people with HIV, and send conflicting messages about the real risks of HIV transmission in a given circumstance.

They depict people with HIV as dangerous potential infectors who must be controlled and regulated, making it more difficult to create a safe environment for people at risk to get tested and people with HIV to disclose their status.

The Iowa case provides a sobering illustration of the problem. The person with HIV who was charged with failing to disclose his status to a sexual partner was a 34-year old gay man who had been a volunteer with a local AIDS organization. He met a male partner online and went to his house. The person with HIV was on anti-retroviral therapy, had an undetectable viral load and used a condom when anally penetrating his partner. He posed little or no risk of transmitting the virus to his partner.

When the partner later heard that the man he had been intimate with had HIV, he went to the county prosecutor and pressed charges. The person with HIV was convicted under Iowa's extreme statute and sentenced to 25 years in prison. Fortunately, advocates were successful in getting the sentencing reviewed and after serving eleven months, he was released on five years' probation.

However, he still must register as a sex offender for the rest of his life, is subject to wearing an ankle monitoring bracelet and cannot leave his home county without permission from the court. He may not be around children (including his nieces and nephews) without adult supervision. He must, for the rest of his life, take lie detector tests every six months that ask intimate questions, including whether he wears women's clothing and if he is attracted to children or animals. He is prohibited from viewing any kind of pornography or even visiting social networking sites, like Facebook.

Iowa's statute is particularly broad--in theory, it could cause a person with HIV who kissed another person without disclosing their HIV positive status to be sentenced to as much as 25 years in prison--but other state's statutes and sentencing are equally as absurd.

Texas convicted Willie Campbell, an HIV positive man, for "assault with a deadly weapon" and sentenced him to 35 years in prison after he spat on a police officer who was arresting him for public intoxication.

Gregory Smith was within a year of his release from a New Jersey prison (after serving time for burglary) when he was charged with attempted murder, assault and terroristic threats following an incident in which he allegedly bit and spat on a guard at the county jail where he was held (Smith denied the charges). An additional 25 years was added to his sentence; he subsequently died of AIDS while incarcerated.

In late 2009, Michigan charged Daniel Allen, who has HIV and was involved in an altercation with a neighbor, under laws designed to combat terrorism, including "possession of a harmful biological agent". Prosecutors equated his HIV infection with "possession or use of a harmful device."

A man in Ohio is serving 40 years for failing to disclose to a girlfriend that he was HIV positive. He claims she knew he was positive and only went to a prosecutor after he stopped dating her and moved in with another woman.

An interesting note about the cases described above: none of them resulted in anyone actually acquiring HIV.
 
 

Monday, March 4, 2013

Out of Context: "cure" of infant could lead to misuse of ARV's.


Out of Context: "cure" of infant could lead to misuse of ARV's. 
By: Aaron M. Laxton, HIV-Infected Queer, Activist & Blogger

Almost immediately upon news that a child had "cleared" the virus that causes AIDS, news stories captured everyone's attention. It is captivating due to the fact that people want so badly to have a cure and the media sensationalizes anything that can get ratings and viewership. I am not saying that the media is bad however there was one thing that stood out to me when I first read the story. A 2 1/2 year old girl that was treated within 30 hours of birth and subsequently was able to clear the virus within her immune system. How long will it be before patients get the idea that they will be able to increase their antivirals and somehow get "cured". While this may sound like a crazy thought, it can also be a deadly thought since the medications that we take are highly toxic when taken in large amounts. 

My fear is that it will only be a matter of time before we see patients that deviate from the prescribed dosages of their medications and subsequently cause catastrophic damage to their renal system as well as liver damage. I hope that my fear is unfounded and that people will not take the information provided out of context. 

The greater message that needs to be relayed to the community is that 1 in 5 people who are infected with HIV are unaware of it. HIV is well managed with early detection through testing and treatment. Additionally there is no reason why in 2013 a person is not getting tested and treated for HIV or that people progress to AIDS. In the United States there are still approximately 50,000 AIDS related deaths each year and approximately 50,000 new HIV infections. 

If you are a patient that has read the stories regarding the toddler from Mississippi and you are even considering changing your medications arbitrarily please don't. While the child was given large doses of ARV's it was done under medical supervision and this is not appropriate for all patients. The child was able to clear the HIV virus due to her immune system lacking memory T Cells that develop in a mature immune system. The report will undoubtedly impact how we treat pediatrics which will greatly reduce the 330,000 mother-to-child transmissions that occur around the world annually. 

Patients need to continue their medications as prescribed with complete compliance and adherence. I will continue to preach the gospel of "test and treat". To find a testing center near you text your zip code to "knowit" and the closest testing site will be texted to your phone. 

Sunday, March 3, 2013

What does a child "cured" of HIV mean for you?


What does a child "cured" of HIV mean for you?
By: Aaron M. Laxton, HIV-Infected Queer, Activist & Blogger

Today, 3/3/13, news came that a 2 1/2 year-old child has been considered "cured" of the HIV virus. As soon as the story hit the wire it began to bounce around via social media and other media outlets around the world. So what exactly does this mean for the those of us living with HIV? While this is great news that supports researchers ideas regarding HIV reservoirs it does not mean that the treatment for an adult currently living with HIV will change. 

The announcement regarding the child's clearance of HIV is important since it goes to the direct issue of a child's immune system versus the adult immune system. Additionally the child was treated with abnormally large amounts of ARV drugs and treatment began immediately, within 30 hours of birth; that indicates that she was most likely infected in utero. Most patients will not meet these same conditions however this supports the philosophy that early detection supports improved outcomes. 

The doctor treating the child gave higher-than-usual "therapeutic" doses of three powerful HIV drugs rather than the "prophylactic" doses usually given. In the months following treatment the child showed no signs of the virus. Due to the mother's living situation the child fell out of care and treatment was stopped. Once Mississippi state health authorities tracked the mother/child down they discovered that she had stopped giving the girl antiviral drugs six or seven month earlier. 

Doctors expected to find that the daughters immune system was showing signs of HIV infection however to their surprise they could detect no sign of the virus. Almost immediately the treating physician took steps to rule out specimen contamination and other considerations that could account for a negative test from the daughter. Since August of 2012 labs in San Diego, Baltimore and Bethesdahave ran ultra-sensation tests on the baby's blood. While intermittently pieces of HIV DNA and RNA have been found there is no indication that the virus is actively replicating in the child's cells.

The importance of this discovery is that it goes directly to theories that researchers have regarding HIV reservoirs. Since the child was treated approximately 30 hours after birth this effectively stopped HIV reservoirs from developing. 

While this research is a move in the right direction towards a cure there is a need for guarded optimism as well as context. For those of us living with HIV this news does not mean that we can stop medications or that we will be cured tomorrow. It does however mean that our understanding of HIV is improving.