AIDS Action Committee’s Blog

As someone who has lived a relatively sheltered life, I always viewed homelessness as a problem that was addressed by legislators and officials. It was a problem that never seemed to affect me personally. It had to do with money and resources, and not with me.

And then I went to hear speakers from Youth on Fire, a program that works with homeless youth. Listening to these young people talk about their lives, I was shocked by how like me they were. They were people. They were my peers.

Shunned by a society that has no system of social support in place for them, kids are being placed in danger. My generation is in danger. These people, by virtue of being homeless, are three times more likely to have any type of chronic disease, including HIV/AIDS, than are those who are not homeless (http://www.nationalhomeless.org/publications/facts/HIV.pdf).

What’s worse is the cycle: those who are homeless are at high risk for HIV/AIDS and those who are HIV+ are at high risk for becoming homeless. Without social supports in place to stop this cycle, future patterns are, unfortunately, easy to predict. There is clearly a place within this issue for the legislators, but they cannot be alone. We need a system of people caring about people, not just of laws. It is time for us as a country to care about each other and stop detrimental patterns before they grow beyond our control.

Youth on Fire (Y.O.F.), a program of Cambridge Cares About AIDS, is a drop-in center for homeless and street-involved youth in Cambridge, MA. Through Y.O.F.’s Speaker’s Bureau, members share their experiences and perspectives as well as  provide advice to youth providers and students in the hopes of improving the services offered to high risk youth in the Boston area.

Lancet study reports that HIV treatment can “normalize” CD4 counts

A recent study in the “The Lancet” medical journal found that some HIV+ people who receive antiretroviral therapy can achieve normal CD4 T-cell counts. Although this is an encouraging result, I have some concerns about the way it was reported in the popular press, particularly by the Reuters news service. 

Before I critique the Reuters article, let me give you a brief summary of the study’s main findings:

1) When HIV+ persons go on antiretroviral therapy (ART) and maintain undetectable HIV levels for long periods of time, their CD4 T cell counts often rise significantly - sometimes to the normal range. 
2)  The increase in CD4 cells can occur even in persons who start treatment with low CD4 counts.
3)  However, to protect the immune system and get the maximum CD4 boost, it’s best to start treatment before counts fall to low levels. 

Each of these three main findings has already been reported in many other studies in the years since effective ART  became available over a decade ago. Although it was fine for Reuters to report on this study, the writer should have noted that it merely confirmed the current thinking about HIV. There was nothing particularly surprising or groundbreaking about the results.

It’s also important to emphasize that, if a person with an AIDS diagnosis achieves a high CD4 count on treatment, they must stay on treatment to maintain that high count.  The Reuters article lacked this important information.

My second beef with the Reuter’s article concerns its headline: “HIV patients build normal immune strength in study.” This headline makes a claim that goes far beyond the scope of the Lancet study, and is frankly misleading. Previous research has shown that, if people stop taking their HIV meds, their CD4 counts generally drop quickly toward their lowest-ever level.  For people with an AIDS diagnosis, this means that, off treatment, their CD4 count may rapidly fall to point where they are at risk for serious illness.

This fact indicates that, even when a person’s CD4 count returns to a normal level, there is residual damage to the immune system that isn’t adequately reflected in their CD4 count.  So there’s NOT sufficient justification for the Reuters headline that HIV patients can “build normal immune strength” through long-term antiretroviral treatment. 

At present, starting effective ART before HIV infection has progressed to AIDS is the best way to protect a person’s immune system.  Ongoing research into therapies that actively boost immune function - likely used in combination with ART - may someday lead to a more complete immune recovery in people living with HIV.

According to the Our Bodies Ourselves blog CBS and Fox have both refused to air a new series of Trojan commercials because they focus on pregnancy prevention, rather than disease prevention. Isn’t pregnancy prevention the main reason some frisky farmer with no more room for little ones initially brainstormed the idea of a sheep’s intestine tied off at the end in the first place?

I am more surprised about Fox’s stance as opposed to CBS, since CBS has traditionally catered to a much older and more conservative demographic (although if you’ve seen any of the soaps on CBS you might question them as well.) But CBS aside… to think that Fox — the same network that brought us such morally and ethically questionable gems as Temptation Island and The Swan (not to mention the scrapped O.J. special) — feigns scruples around such a thing is pretty absurd. These programs have assaulted the “moral” concepts of marriage and fidelity and gratuitously furthered unhealthy image ideals while exploiting emotionally fragile women, and pregnancy prevention is where they draw the line? Does the person making these decisions actually watch their shows?

No matter the reasons, this policy is ridiculously inconsistent and should be revised. In order to make real progress in measures to protect women, children, and families, the media needs to take some chances and get these messages out. Perhaps Trojan could send Fox the commercial hidden in a giant wooden statue of Ann Coulter …

Wait… is that redundant?