HIV/AIDS: "Resetting Priorities"

This graphic from the below article provides no useful information :-)
There is a great story that can be found here on the cover of Chemical and Engineering News about the hunt for an HIV/AIDS vaccine and the reason the most recent attempts have either failed or been pulled. It's a great rundown of what's been going down and why, excactly, our two most recent "hopeful" attempts -- the 2003 AIDSVax and the more recent (2007) Merck trials -- failed and changed the way we consider the process of searching for a vaccine.

It's really a science laden article, but I think it can be easily understood from a lay perspective. But the final lines are especially poignant:

"Developing and delivering an HIV vaccine," Bernstein says, "has to be a global effort, and that's where the enterprise uniquely comes in because we're charged with bringing together people from all over the world—whether they are funders, scientists, governments, advocates, or industry—to work together."

Vaccine development has always relied heavily on empiricism. And even when successful, it has more often than not taken several decades to create a vaccine after finding the cause of a disease. "This is going to be a long haul," Bernstein says. "There are no quick wins, and we should stop thinking and planning like there are."

Anyways, check it out. Here is a break down of all the previous attempts and how they fared in FDA trials (btw --> Phase III is the final phase before general usage; Phase IV "trials" is seeing what happens in the general population...):


PS This is especially interesting in the context of this blog as I talked about the Merck failure exactly a year ago here. Weird. I can now back-quote myself.

GENERAL STUFF: Carcinogens

I don't know why I've been reading so much of Slate.com lately, but they had an interesting article about the causation of cancer how quickly people freak out about minor things whilst ignoring major solutions.

The obsession with man-made toxins not only reflects a small-minded view of cancer's causes but hints at a worrisome theme in American public health. Our scattershot approach to preventing cancer subscribes to the cult of personal responsibility, albeit with a recent eco-friendly twist: To really help themselves, goes the thinking, people must simply take charge of their health and avoid cancer-causing, artificial products. Somewhat insidiously, we're starting to believe that cancer mostly is prevented by informing individuals to change their consumption habits—not by proactive, broad-based public-health measures like widespread vaccination or agricultural reform.

I've been following the HPV vaccine, Gardasil (also mentioned in the article), fairly closely, for a couple of reasons:

1) It is only the second vaccine that's been proven effective against an STD (the other one being the Hepatitis A/B vaccine -- we're still waiting on Herpes, HIV, and Hepatitis C, remember).

2) It helps treat a really important aspect of women's health, but...

3) It is being maligned and torn apart in the political arena because of the theory that it will encourage the onset of sexuality.

To my mind, this encourages the ongoing stupefication of the American populace. Same thing with the anti-condom campaigns. No, condoms do not protect against every STD and they do not protect 100% for the ones that they do help with -- but they are the best we have. No, Gardasil does not protect against every form of HPV, and not even against every form that can cause cervical cancer -- but it is the best we have. And rather than own up to the positive benefits they cause and accept them and educate people about them, we would rather cover them up and pretend sex doesn't exist... and not admit to the drastic public health efforts necessary to continue developing comprehensive sexual education that treats people as adults rather than foolish children.

I am 100% for a freer understanding of sexuality, and I like the BDSM's community's idea of sexuality being "Safe, Sane, and Consensual," but part of consent is owning up to your behavior and understanding fully the possible ramifications of your actions. If consent is simply limited to saying yes to fucking, then it's not truly consent. In no definition or use of the word "consent" in the modern world does consent imply a lack of understanding of the ultimate possible consequences of an action. Think about it -- if you enrolled in a medical study and they didn't tell you, "BTW, you may die from this," they are not properly allowing you to consent. Rather, they are withholding information to prevent you from fully understanding the situation you are putting yourself into.

By learning about sex at all -- and sex/sexuality is fully imbued into our culture in a way that is inextricable -- without the proper educational background, we are, in essence, handing people guns and hoping they don't figure out where the trigger is. And by not ignoring the public health ramifications of denial in favor of a few persons morality -- which, btw, no one is arguing should be trumped -- we are just crossing our fingers and hoping nothing bad happens.

When it comes to sex and when it comes to the public health mandates that we rely on certain bodies to perform -- the CDC and the FDA -- we should choose to do what most social work students are taught their first year -- unconditional positive regard.

In other words, we should assume that they are attempting to help the best they can without political motivations. If we choose to start sensationalizing or politicizing basic public health principles, then we are leading to a path where the minor -- cell phones=brain tumors -- become the only knowledge of health that we have, rather than pursuing comprehensive health in the form of funding things like universal mammograms for women over 50 (Ohio's state program to offer them for free for the most needy is constantly fighting for more money and we used to regularly get notice that "we have no more money, please stop enrolling people in this program"). Because though cell phones may be linked to brain tumors, it would be silly to say that not using them is the only thing we can do. It is not entirely the individual's fault for getting XYZ...

...sometimes we, as a society, fail those individuals.

(And besides, shouldn't we be sensationalizing more important things, like il Papa or the homosexual menace?)

HIV/AIDS: Top 10 HIV/AIDS Stories from 2007

So, it's a day late (on my part), but 365Gay (owned by Viacom) posted a nice recap of the Top 10 HIV/AIDS news stories from 2007 in honor of World AIDS Day. The link can be found here .

The headlines:

1) HIV Numbers were too high -- new estimate it at 33.2 million infected in the world, with 6,800 new infections a day and 2.1m AIDS deaths a year

2) HIV infections rising among gay men -- 13% increase between 2001 and 2005 (One day I will recap my vent about the "AIDS numbers game," but the point is there... Men who have sex with men -- MSMs -- are the number one group getting HIV in this country)

3) Merck AIDS vaccine harmful -- oh yea, it increased the susceptibility to HIV/AIDS... oops

4) Conservative Protestants/Catholics taking on AIDS -- it's about time the conservative right recognized the human aspect of the disease

5) Bush asks for doubled funding for fighting world AIDS -- that would still only be $30billion, so just under a dollar per person infected... thanks, Shrub, your kindness knows no bounds

6) Democratic presidential candidates pressed to end AIDS -- supporting crazy ideas like $50billion in world funding, allowing needle exhange, comprehensive sex ed, and allowing HIV-positive foreigners to visit our country.. thanks, guys, these don't seem all that "activist" to me, I'm disappointed it took this long

7) Resurrection of virus may help us understand HIV -- using a form of HIV that was once found in ... rabbits?

8) World Health Org recommends circumcision -- after it was found that, yes, in fact, men who are circumcised are less likely to catch HIV, which is something most African prostitutes already knew

9) Washington, DC tops the list of infected cities -- to the tune of 1 in 50 people being infected (and, to add on, it is estimated, per other sites, that 1 in 7 black men in that city, I believe)

10) Homeland Security Restricts Travel for PWA -- because HIV has a lot to do with nuclear weapons

There you go. My responses came out cattier than I had expected.

HIV/AIDS: A disappointment...

Looks like the newest round of AIDS vaccines has failed. Sigh. This was one of the ones that we were really counting on as it held so much promise, but 24/741 of those receiving the vaccine became infected (3.2% -- please note, they don't become infected by the vaccine, they are not asked to change their lifestyle while on the vaccine) versus 21/762 (2.75%). Statistically insignificant difference.

Ironically, though, I wonder if the slight uptick in percentage has anything to do with people thinking they are safer after having taken it, but I'm not sure if, with such a small sample size, it really matters at all.

There was hope, btw, that even if it did not actually block HIV, that it would slow down the process of infection, making it easier for the body to fight off before seroconversion. This using.. get this... the common cold as the delivery agent???

From the article in the LATimes:

Michael Zwick, an HIV researcher at Scripps Research Institute, said the vaccine's failure was unfortunate. But he said it was too soon to know whether other vaccines using the same strategy would also fail.

"It's par for the course in the HIV field," he said of the Merck result.

The volunteers in the experiment were all free of HIV at the start. But they were at high risk for getting the virus: Most were homosexual men or female sex workers. They were all repeatedly counseled about how to reduce their risk of HIV infections, according to Merck.

In a statement, the NIH said a data safety monitoring board, reviewing interim results, found the vaccine did not prevent HIV infection. Nor did it limit the severity of the disease "in those who become infected with HIV as a result of their own behaviors that exposed them to the virus" -- another goal of the study.

Also, here's the article from 365gay.com (which clued me in this morning).

I think it's sad that this is considered "par for the course" in this line of work. It's almost... well, disappointing.