🏳️‍🌈✝️ For The Trump Administration, Anti-LGBT Stances Inform HIV Policy

AIDS UNITED

2/23/2018

_____________________________________________________________________________________ 

During their 13 months in power, the Trump administration has made it abundantly clear that they have no desire to protect the rights of the LGBT community and, if anything, are actively looking to undermine them. Last weekend, POLITICO published a report on the various ways that the Trump administration has been chipping away at Obama-era protections for LGBT Americans, especially in matters of health.  The piece highlights a series of steps taken by the Trump administration over the last year that will have a significant impact on the ability of LGBT individuals to access care. As evidence, it cites Trump administration decisions to:

• Freeze a series of LGBT-friendly rules from taking effect, including an expansion of anti-discrimination protections for transgender individuals enrolled in Medicare and Medicaid

• Reinterpret and opt not to defend the ACA’s anti-discrimination mandate (Section 1557)

• Pull questions on sexual orientation and gender identity from Department of Health and Human Services (HHS) surveys; and

• Form the new Conscience and Religious Freedom Division at HHS’ Office of Civil Rights to offer greater protections for health care workers who decide not to treat LGBT patients.

These actions by the current administration pose serious threats to the health and well being of LGBT Americans, but they also pose a threat to hundreds of thousands of Americans living with HIV. What’s more, the Trump administration’s neglect and mistreatment of the LGBT community seems to extend to our own HIV community as well. Time and again, this administration has demonstrated an indifference to the well being of those affected by the disease, pursuing policies and promoting funding cuts that would do lasting damage to efforts to end the HIV epidemic in the United States.
 

While reports that President Trump complained that all immigrants from Haiti “had AIDS” were beyond troubling, even more alarming are the steps he and his administration have taken to undermine our national progress to end AIDS. In his 2018 budget request, Trump proposed, among other things:

• Cutting HIV prevention funding at the Centers for Disease Control and Prevention (CDC) by 19 percent

• Completely eliminating the Ryan White Program’s AIDS Education and Training Centers (AETC) and Special Projects of National Significance (SPNS) programs

• Eliminating the HHS Secretary’s Minority AIDS Initiative Fund and reducing SAMHSA’s Minority AIDS Initiative programs; and

• Cutting funding for Housing Opportunities for People with AIDS (HOPWA) by $26 million

His recent FY2019 request did much of the same. 

What’s more, his administration’s strategic plan for Health and Human Services hardly referenced HIV or STDs, while completely ignoring LGBT needs, failing to include a single reference to them. He similarly failed to mention the LGBT community’s unique needs in his World AIDS Day remarks as well. This culture of silence appeared like it was expanding into official policy when reports surfaced that staff at CDC had been instructed not to use specific words when drafting their budget justification documents for Congress, including “transgender” and “evidence-based,” among others. 

President Trump also dismissed, without any warning or explanation, all remaining members of the Presidential Advisory Council on HIV/AIDS (PACHA) in December while everyone was away celebrating the holidays, and still has not announced any replacements. Perhaps equally as troubling, Trump has yet to appoint a head of the White House Office of National AIDS Policy as well.

We continue to hope that this administration will recognize that providing care and prevention services for people living with and vulnerable to HIV is both a moral and public health imperative. However, absent a 180 degree turn in White House health care policy, we will have to rely on Congress to do the right thing – a prospect that’s also far from assured. That’s why we are counting on you to register and join us for this year’s AIDSWatch in DC on March 26^th and 27^th.  Learn more about this year’s event here and join us in urging Congress to stand up to this administration’s deliberate efforts to divide us and demand fair and immediate action to protect all Americans’ health. 

Posted By: AIDS United, Policy Department - Friday, February 23, 2018

 

🏳️‍🌈✝️ Who tends to gain weight with HIV treatment?

From CATIE

January 2018

____________________________________________________________________________________ 

There has been a signal from two studies that suggest the possibility of weight gain among people who have used the integrase inhibitor dolutegravir (Tivicay and in Triumeq). However, those studies were done by looking back on data captured for another purpose. Such retrospective studies are useful for exploring an idea but firm conclusions cannot be drawn from them. That is why their results are only suggestive. Results from retrospective studies can be used to develop studies of a more robust statistical design.

To better explore the issue of weight gain among people using combination HIV therapy (ART), researchers at clinics in Milan and elsewhere in Italy conducted a large observational study, assessing health-related data drawn from more than 1,000 HIV-positive people. Participants in this study used different regimens, anchored by integrase inhibitors, protease inhibitors or non-nukes. The researchers found that participants taking common combinations of HIV drugs (not limited to integrase inhibitors) had increases in weight and body mass index (BMI, a relative measure of fatness or thinness). People who were most likely to gain weight were those who were relatively thin or older prior to starting therapy.

The Italian researchers attempted to adjust for factors that could have inadvertently biased their results and their findings are an important step up from retrospective studies. Still, observational studies, no matter how large, can never be used to draw firm conclusions, as they cannot prove cause and effect. There are several randomized, controlled studies of dolutegravir-based combinations underway. Once these studies are complete, the data can be analysed to assess trends in BMI and likely provide robust conclusions about the issue of weight gain and specific combinations of drugs.

Study details

The Italian researchers used data from a project called SCOLTA and focused on the following groups of people on certain regimens:
755 ART-experienced participants who were taking regimens with the following integrase inhibitors:

• dolutegravir – 225 people
• raltegravir (Isentress) – 382 people
• elvitegravir (in Genvoya and Stribild) – 148 people

For purposes of comparison, the researchers collected and analysed data from 145 additional participants who were taking a regimen based on the protease inhibitor darunavir (Prezista and in Prezcobix) and 218 others who were on a rilpivirine-based (Edurant and in Complera and Odefsey) regimen. Thus, there were a total of 1,118 participants in this study.
The average profile of all participants upon entering the study was as follows:

• age – 46 years
• 71% men, 29% women
• 19% had a CD4+ count below the 200 cell/mm³ mark
• 40% had a detectable viral load
• BMI is an imperfect assessment but it is relatively simple to calculate as it is based on a person’s weight and height. Participants fell into the following BMI categories: 6% were underweight, as they had a BMI less than 18.5; 61% were normal weight, as they had a BMI between 18.5 and 24.9; 27% were overweight, as they had a BMI between 25 and 29.9; and, 7% were obese, as their BMI was greater than 30.

Participants were monitored for at least one year.

Results

Among all participants, BMI increased slightly by 0.19 six months after starting their current regimen and then by a total of 0.25 one year after starting their regimen. This suggests a modest increase in weight.

To account for factors that could have had an impact on weight gain, researchers performed further analyses. Again, all regimens were associated with modest weight gain (an increase in BMI). Furthermore, there were no differences in BMI changes between participants taking a regimen anchored by an integrase inhibitor and participants who took regimens based on the protease inhibitors darunavir or rilpivirine.

Instead, researchers found an association between having the following factors at the start of the study and subsequent increase in weight:

• older age
• low BMI

Why might weight gain increase with ART?

Prior to the widespread release of ART in high-income countries in 1996, some people with HIV experienced inadvertent weight loss that in some cases could become severe. This was commonly called the wasting syndrome. When analyses were done, researchers found that affected people tended to lose muscle mass.

The causes of weight loss in untreated HIV infection are complex and may be related to intestinal inflammation and injury from infections, altered metabolism, decreased levels of hormones such as testosterone, and loss of appetite.

Once ART became available in 1996, researchers reported increased weight in patients, particularly those who had been suffering from the wasting syndrome, though this increased weight was mostly due to fat rather than muscle. Given the improved health that accompanies the use of ART, it is natural to expect some degree of weight gain over time.

Different studies

The researchers who designed the two retrospective studies that captured a signal of weight gain with dolutegravir were attempting to explore an idea to see if there was a possible trend. The next step has been done by the Italian researchers in SCOLTA, a study of an observational design. Such studies are good at finding associations but cannot prove “cause and effect”—that is, observational studies cannot prove that the use of integrase inhibitor–based regimens caused an increase in BMI.

More robust conclusions about weight gain can come from randomized, controlled studies, and several of these have been done and are underway or planned with dolutegravir-containing regimens. However, there is a possible issue with these studies. These randomized, controlled studies are meant to collect data for the licensure of dolutegravir-containing combinations. As such, participants will be young, relatively healthy people with HIV. Their findings may not be applicable to people in the community who are older and/or who have other health conditions.

Bear in mind

There are many issues that can play a role in weight gain. Some of them are listed below:

• psychological and emotional – sometimes anxiety and even depression can cause people to eat more food and not have the energy to exercise; eating disorders
• physical – injuries; osteo-arthritis affecting the joints; low back pain; not enough exercise
• poor dietary habits
• sleeping problems
• biomedical – some cases of pre-diabetes and diabetes; abnormal levels of thyroid hormones; some medicines
• aging – a general trend is that as people age they tend to gain weight

These and other factors need to be taken into account when trying to assess the impact of medicines on weight and BMI. There is much work that lies ahead to be certain about the impact of dolutegravir on weight. But, for now, the results from the Italian study suggest that a modest increase in weight can occur in people taking commonly used regimens, whether or not these regimens include integrase inhibitors.

—Sean R. Hosein

_______________________________________ 

 

REFERENCES:

1. Piantadosi S. Clinical trials: a methodologic perspective. 3rd ed. Hoboken: John Wiley & Sons; 2017.
2. Taramasso L, Ricci E, Menzaghi B, et al. Weight gain: A possible side effect of all antiretrovirals. Open Forum Infectious Diseases. 2017 Nov 3;4(4):ofx239.
3. Mankal PK, Kotler DP. From wasting to obesity, changes in nutritional concerns in HIV/AIDS. Endocrinology and Metabolism Clinics of North America. 2014 Sep;43(3):647-63.
4. Norwood J, Turner M, Bofill C, et al. Brief Report: Weight gain in persons with HIV switched from efavirenz-based to integrase strand transfer inhibitor-based regimens. Journal of Acquired Immune Deficiency Syndromes. 2017 Dec 15;76(5):527-531.
5. Menard A, Meddeb L, Tissot-Dupont H, et al. Dolutegravir and weight gain: an unexpected bothering side effect? AIDS. 2017 Jun 19;31(10):1499-1500.

More from CATIE, here

🏳️‍🌈✝️ Joint Statement on Discriminatory Proposed Healthcare "Conscious Rule"

The Proposed Rule on “Moral Exemptions & Accommodations for Coverage of Certain Preventive Services Under the Affordable Care Act” Harkens Back to the Dark, Early Days of the AIDS Epidemic”

02/20/2018

_______________________________________________________________________________________ 

  WASHINGTON, D.C. (February 20, 2018) – It is the position of the ADAP Advocacy Association (aaa+®) and the Community Access National Network (CANN) that the proposed changes put forth by the Department of Health and Human Services (HHS) and the Office of Civil Rights (OCR) are unacceptable, at best, and unconscionable, at worst. People living with HIV/AIDS have been down this path, before; our community refuses to go down this path, again.

“Under the guise of "religious freedom," HHS and the OCR have put forth a proposal that would provide broad and seemingly unfettered “protections” for individuals and entities that refuse to provide healthcare services on the basis of religious, conscientious, and/or moral objections. Both Congress and courts have, in the past, allowed conscientious exemptions to stand for specific procedures and services – abortion, sterilization, contraception, and assisted suicide. These exemptions are, according to the document put forth by the Trump Administration, not good enough. As such, they propose expanding those exemptions to include virtually any healthcare service one may find objectionable, up to and including refusing to provide services to persons whom they find objectionable. This amounts to nothing less than sanctioned discrimination by the government.”

For the past twenty years, both states and the federal government have been gradually inserting "religious exemption" privileges into our legislatures in an effort to appease the faux moral outrage expressed by a certain segment of Americans who feel they should not have to do their jobs if it means serving people they dislike or providing services that, while perfectly legal, they find objectionable. This broad overreach by the Executive Branch – a branch that is not responsible for crafting, drafting, or passing laws – allows that extreme segment the ability to deny service, so long as they evince barely a soupçon of religious, conscientious, and/or moral objection. This segment has won its exemption from reproductive and end of life services; they must not be granted carte blanche to refuse service to those most in need.

Moreover, the proposed rule goes further to suggest that those who refuse on religious, conscience, or moral grounds cannot be forced by current (and presumably future) federal agencies or state agencies to perform these tasks. If this sounds similar to clerks' refusal to provide marriage services to same-sex couples based on these objections, that’s because it is.

If the government pays individuals, then they should not be exempted from providing services for any reason other than ability or illegality. The compromise with the clerks involved allowing them to refer them to employees who were able to provide services without prejudice; the proposed rule allows objectors to refuse references to better suited healthcare providers.

We are not so far removed from when our own government, claiming it a "moral imperative," funded and instituted a program of surreptitious sterilization against the poor, people of color, immigrants, unmarried mothers, the disabled, and the mentally ill. It is no coincidence that those most likely to be impacted by these objectors are one and the same – all people who are now covered by Medicaid, CHIP, and Medicare. 

For those people who survived or lived through the HIV/AIDS epidemic in the 1980s and 1990s can attest to what happens when healthcare providers and workers refuse to treat patients on the basis of religious, conscientious, and/or moral objections – the cost is always paid in human lives. During the initial outbreak and spread of HIV/AIDS in the 1980s, many physicians and healthcare professionals refused to treat patients living with HIV/AIDS. While many ascribed their refusal to safety concerns, others spoke of their moral objections to treating patients whose “lifestyle choices” resulted in becoming infected with the HIV virus. It was unacceptable, then; it is unconscionable, now.

The proposed rule essentially provides healthcare providers and workers an "out" from having to perform routine services, so long as they protest a religious, conscientious, and/or moral objection to doing so. How far will these "protections" allow them to go? Will they be able to deny services to those whose religious or political affiliations they disagree? Will they be allowed to deny services to racial or ethnic minorities? Perhaps, they will be allowed to deny services to patients whose citizenship is in question? The document put forth by the Trump Administration does little to assuage these concerns, despite its hand wringing about the protections put in place to protect providers.

HHS, with this proposed change, attempts to make the immoral moral by allowing objectors essentially blanket authority to deny services, and does so using the Office of Civil Rights – perhaps its most egregious display of enmity. That this Administration proposes allowing providers who serve the most vulnerable populations – recipients of Medicaid, CHIP, and Medicare benefits – to deny services is unconscionable. HHS should immediately remove from consideration this proposed rule.

Those living with HIV/AIDS and any number of serious chronic medical conditions must be certain that they are always able to access healthcare services without fear of being refused treatment on the grounds of religious, conscientious, and/or more objection. As such, both the ADAP Advocacy Association and Community Access National Network vociferously oppose this proposal, and invite other organizations to do so, as well.

Website: http://www.adapadvocacyassociation.org

🏳️‍🌈✝️Trump’s Latest Threat to People With HIV

Istock (Model(s) used for illustrative purposes only)

The chair of HIV Medicine Association (HIVMA) responds to Trump’s budget proposal.

  By Melanie Thompson 

February 14, 2018


__________________________________________________________________________________ 

The budget proposal released Monday, February 12, by the Trump administration is long on talk of national safety, security and strength, but undermines funding and strategies to counter some of the most significant threats to our nation’s health, stability and well-being. The members of the HIV Medicine Association (HIVMA) call on Congress to reject the spirit and most of the particulars of the proposal.

After numerous attempts to repeal the Patient Protection and Affordable Care Act (ACA), and with enrollment levels for 2018 nearing those of 2017 in spite of cuts to enrollment assistance, the White House plan reiterates a pledge to repeal the ACA including the Medicaid expansion, again threatening to leave as many as 20 million people uninsured. Under the proposal, states would be given great authority and flexibility to develop programs with no guarantee that key protections will be maintained for people with HIV and millions of other Americans who need access to comprehensive, affordable health care.

At the same time, the White House plan continues to undermine the Medicaid program’s role in providing health care to low-income individuals and families by promoting work requirements as a condition of eligibility and looking to restrict access to medications through closed formularies. More than 40 percent of people with HIV in care count on the Medicaid program for their health care coverage. People with HIV need continuous access to treatment and care in order to maintain their health and lead productive lives, including the ability to work. Medicaid must provide access to all HIV treatments recommended by [the U.S. Department of Health and Human Services] HHS antiretroviral guidelines based on effectiveness and safety, rather than blindly restrict access based on cost. Treatment of HIV has been proven to be cost effective, and to limit treatment is short sighted for the public’s health as well as the public’s purse. That a public program like Medicaid would deny HIV care and treatment to someone who is unable to work illustrates a fundamental lack of appreciation that HIV is a public health crisis and that we must provide care to all persons with HIV to preserve their own health and to stop transmission of the virus. Creating barriers to care for people with HIV will cost lives as well as money, and will fuel the epidemic.

And while challenging access to routine health care, the proposal also threatens investments in building our capacity to address the needs of people with HIV. The plan proposes to eliminate the Ryan White HIV/AIDS Program’s Special Projects of National Significance program, which advances innovative service delivery models for challenges that include treating patients coinfected with HIV and hepatitis C and integrating medication for addiction treatment into HIV clinics. It would also eliminate funding for the AIDS Education and Training Centers, critical for building and maintaining HIV medical provider capacity at a time when we already lack a sufficient workforce to care for the increasing numbers of persons living with HIV.

While the proposal includes slight funding increases for sexually transmitted infections, viral hepatitis and tuberculosis prevention at the CDC, HIV prevention would be cut by $34.6 million and global health programs would be cut by $23 million. CDC’s overall discretionary funding would decrease by $878 million, putting many effective public health programs in jeopardy. 

While the president would maintain funding for the National Institutes of Health, he appears to propose cutting funding for the National Institute of Allergy and Infectious Diseases by $111 million at a time when biomedical answers to HIV treatment and prevention are especially promising, and urgently needed.

And while the largest generation of young people to ever walk the planet approaches their age of greatest risk for HIV worldwide, the proposal would set back the global AIDS response by cutting the Global Fund by $425 million and cutting funding for the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and global TB programs from current levels. Just when we are closer than ever to bringing the HIV epidemic under control worldwide, our country cannot afford to sabotage progress by cutting funding for essential— and effective—programs.

With a proposed $40 million to support a new Centers for Disease Control and Prevention’s Elimination Initiative to launch intensive prevention, screening, treatment and referral efforts to jointly address diseases that include HIV, viral hepatitis, sexually transmitted infections (STIs), and TB, the proposal recognizes that transmissible diseases demand coordinated and comprehensive responses. It appears that the initiative would be funded at the expense of existing HIV prevention programs, which would be counterproductive to the effort. And with a proposed $10 billion in new funding in Fiscal Year 2019 for programs across the Department of Health and Human Services to respond to the opioid crisis, the plan acknowledges the need for an urgent escalation of responses that must include expanded access to substance use treatment and prevention.

Those recognitions make the regressive approach to public health evidenced throughout the proposal all the more outrageous. 

The plan released by the White House on Monday is short-sighted, damaging, and would erode the fabric of programs that people with HIV and millions of other Americans count on for access to the care and services that prevent and treat infectious diseases. The members of the HIV Medicine Association urge Congress to reject these proposals.

The HIV Medicine Association (HIVMA) is an organization of medical professionals who practice HIV medicine. We represent the interests of HIV health care providers and researchers and their patients by promoting quality in HIV care and by advocating for policies that ensure a comprehensive and humane response to the AIDS pandemic informed by science and social justice.

---

   

More from POZ, here 

🏳️‍🌈✝️ FDA Approves Once-Daily Triple-Combo HIV Drug

A new drug has been approved for HIV-positive people, and this one might be more practical. 

By Savas Abadsidis

 

February 09 2018

 

 

___________________________________________________________________________________ 

 

 

The U.S. Food and Drug Administration has approved a once-daily, three-combination drug, Biktarvy, making it the smallest INSTI-based triple-therapy STR available, according to Gilead. 

Biktarvy combines the novel, unboosted integrase strand transfer inhibitor (INSTI) bictegravir, with the demonstrated safety and efficacy profile of the Descovy (FTC/TAF) dual nucleoside reverse transcriptase inhibitor (NRTI) backbone.  

 

The drug is indicated as a complete regimen for HIV treatment in adults who have no antiretroviral treatment history—or to replace the current antiretroviral regimen in those who are undetectable and on a stable antiretroviral regimen for at least three months with no history of treatment failure and no known substitutions associated with resistance to the individual components of Biktarvy.

No dosage adjustment of Biktarvy is required in patients with estimated creatinine clearance greater than or equal to 30 mL per minute.

Biktarvy does not require testing for HLA-B*5701, has no food intake requirements, and has no baseline viral load or CD4 count restrictions.

According to Biktarvy’s Prescribing Information, prior to or when initiating treatment with Biktarvy, healthcare providers should test for hepatitis B and renal function, and monitor renal function as clinically appropriate during therapy.

Biktarvy has a "boxed warning" in its product label regarding the risk of post treatment acute exacerbation of hepatitis B.

“In clinical trials through 48 weeks, no patients taking the regimen of bictegravir plus FTC/TAF developed treatment-emergent resistance, results that were observed both in people new to therapy and those who were virologically suppressed and chose to switch regimens,” said Paul Sax, MD, Clinical Director of the Division of Infectious Diseases at Brigham and Women’s Hospital, Boston, Professor of Medicine at Harvard Medical School and a lead clinical trial investigator. "In addition, the clinical data show that the regimen’s antiviral efficacy, tolerability profile, and limited drug interactions offer an effective new treatment option for a range of people living with HIV.”

The approval of Biktarvy is supported by data from four ongoing Phase 3 studies. These trials were comprised of a diverse population of 2,415 participants, including a wide range of adult age groups and races/ethnicities.

During 48 weeks of study, no participants in any of the four studies failed Biktarvy with treatment-emergent virologic resistance, no patients discontinued Biktarvy due to renal adverse events and there were no cases of proximal renal tubulopathy or Fanconi syndrome. The most common adverse reactions in patients taking Biktarvy were diarrhea, nausea and headache.
“Gilead is committed to improving care and simplifying therapy for people living with HIV. We continue to invest in research in next-generation treatments, including therapies that could potentially cure HIV patients,” said John F. Milligan, PhD, Gilead’s President and Chief Executive Officer. “We are pleased to offer Biktarvy, our latest triple-therapy treatment, which brings together the potency of an integrase inhibitor with the most-prescribed dual-NRTI backbone in a once-daily single tablet regimen.”

Additional clinical trials of Biktarvy are ongoing, including a dedicated study in women, as well as a study in adolescents and children living with HIV.

Gilead plans to present data from these studies at scientific conferences in 2018.

More from PLUS, here
 

🏳️‍🌈✝️ Taking a Deeper Dive into the Ryan White HIV/AIDS Program

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

02/08/2018

__________________________________________________________________________________ 

The Health Resources & Services Administration ("HRSA") HIV/AIDS Bureau at the U.S. Department of Health & Human Services ("HHS") has made available state profiles to highlight important client-level data (2015). It includes an interactive web platform, which allows users to compare states, compare states to national data, or compare data by year. The estimated number of clients served by Ryan White HIV/AIDS program providers in the United States in 2015 was 533,0361.[1]

Aside from client characteristics, other key data focuses on grant recipients, client outcomes, oral health programs, and services received. Of particular interest to stakeholders concerned about the AIDS Drug Assistance Program ("ADAP"), users can download how ADAP funds were administered in the United States in 2015. In 2015, an estimated 259,531 clients were served by ADAP in the United States. According to HRSA, new clients were served totaled 34,265.[2] 

The site shares key ADAP-related client demographics on age, gender, race, and income. For example, Florida served 56,677 clients in 2015. Males represented 75.9% of the clients served, and females represented 23.4% of the clients served. Clients who identified as transgender were 0.7%. Vermont served 595 clients, with one in four clients being male.

HRSA sharing the Ryan White program-related data is not only important because it promotes programmatic transparency (and these programs have long demonstrated to be highly effective), but also because it fosters better state-level advocacy. All too often, data on public health programs can often be quite lacking, or delayed (or both). The data included on the site will come in handy as we map a new course to protect the public health safety net!

Explore national-and state-level Ryan White HIV/AIDS Program data.

__________

[1] HRSA. Ryan White HIV/AIDS Program Services Report (RSR) 2015. *RSR data were deduplicated at the national level. Clients receiving services in multiple states were not included in state-specific totals; these clients make up less than 2% of the total RWHAP population.
[2] HRSA. Ryan White HIV/AIDS Program Services Report (RSR) 2015. 

More from ADAP ADVOCACY ASSOCIATION, here 

🏳️‍🌈✝️ When you FIRE a DOCTOR and REPORT them to the Oklahoma Medical Board

Rainbow Pastor David

02/06/2018

__________________________________________________________________________________ 

I had resolved that I was not going to do this again, however I owe it to other people in the State of Oklahoma to know what kind of Doctor Soni Zacharias really is. Soni Zacharias is a BULLY not a Doctor who cares about his patients.

I have been HIV positive for 9 years and during that time my body has gone through many changes due to the effects of HIV and the medication to control HIV. I have finally found a wonderful HIV DOCTOR who believes in being PROACTIVE when it comes to her patients health instead of being REACTIVE!!!

Over the course of the last nine years I have learned which Supplements I need to take because HIV depletes so many micro-nutrients that your body needs to function properly. Here is just a small glimpse into what micro-nutrients HIV depletes the body of: 

Micro-nutrients that are often low in people living with HIV include vitamin A, vitamin D, vitamin E, selenium, zinc, and B complex vitamins (B1, Thiamine; B2, Riboflavin; B3, niacin; B6, Pyridoxine; B12, Cobolamin; and B9, folic acid). Some research shows these low vitamin levels can lead to lower CD4 cell counts and worsening of HIV. They can also cause problems like diarrhea, neuropathy, and skin conditions.

  To learn more about supplements for HIV Positive people you can visit theBody.com, here.

My HIV Doctor has gone over ALL my SUPPLEMENTS approving them because she said they are actually having a POSITIVE EFFECT on my health. NONE of the Supplements I take have any negative effects with the medications the Doctors have me on. One example I will share with you is my liver function. Several years ago my liver function began to weaken because of the HIV medication. I talked with a long term survivor of HIV for advice on Supplements I could take to help my LIVER since the Doctor I was seeing at the time said there was NOTHING that could be done. My friend told me about the great effects of Milk Thistle for liver function. So I started taking Milk Thistle and at my next office visit with my HIV Doctor at that time I was told my liver function was normal again because of the HIV medication. NOT, the HIV medication was raising my liver enzymes putting me in danger with my health. I told that doctor that I had started taking Milk Thistle and they threw a fit saying that "NATURAL" Medicines {SUPPLEMENTS} don't work. I had just proven they do. Today several years later my LIVER ENZYMES are NORMAL and I continue to take Milk Thistle to keep it that way.

Over the years I have had to add several different Supplements to my daily pill regime to keep my body in good health.

When I started seeing this NEW Cardiologist in November 2017 he seemed very knowledgeable and it seemed he cared about his patients. That ALL CHANGED on January 18th 2018 at my last appointment with Soni Zacharias. Instead of reliving that horrific experience I am posting the letter I wrote to his office and to the State Medical Board of Oklahoma here for everyone to read.

Today is February 6th, 2018 and I just received a letter from OKLAHOMA HEART HOSPITAL  saying that NO ONE and NONE of their FACILITIES would ever TREAT ME AGAIN. I just laughed when I got this message, considering I FIRED DR. Soni Zacharias on January 28th 2018 for his HORRIFIC BEHAVIOR. Here is a copy of that letter I received today: 

I have a wonderful PCP who is taking care of ALL MY NEEDS that my HIV DOCTOR is not taking care of and they are getting me in to see a cardiologist that they like in their hospital network. 

Doctors have a responsibility to TREAT PATIENTS with DIGNITY and RESPECT. When a DOCTOR becomes a BULLY instead of a DOCTOR the PATIENT has the RIGHT to FIRE THEM. I have FIRED several Doctors over the last 9 years and I am sure this one will NOT be the last one I fire. When you are living with a disease that is destroying your body you DO NOT NEED any ADDED STRESS from DOCTORS who think they are a god and DO NOT LISTEN to the NEEDS of the PATIENT as an individual NOT a TEXT BOOK GENERALIZED CASE!!!

I pray that anyone who sees this BULLY Soni Zacharias NEVER has to have the TREATMENT that I received on January 18th 2018 from this man.

NEVER NEVER think that as a PATIENT you have to DO WHAT A BULLY of a DOCTOR tells you you have to do. YOU KNOW YOUR BODY, YOU KNOW WHAT DOES AND DOES NOT WORK for YOU. 

I will NEVER BACK DOWN and become a scared individual because some Doctor tries to intimidate me and they don't even know me. My HEALTH is MY NUMBER ONE PRIORITY and I will ONLY HAVE THE BEST of DOCTORS taking care of my HEALTH.

Blessings and Peace,

Rainbow Pastor David

🏳️‍🌈✝️ Researchers Discover A Private Place Where HIV Hides

HIV can hide inside your testicles for years and remain protected from the body's immune system, even while on treatment.  

By David Artavia

 

January 31 2018

 

 

____________________________________________________________________________________ 

 

 

New research has shown that HIV might be able to evade drug treatment by finding a home in men’s testes (or testicles), where they can remain protected from the body’s immune system for years. 

Studies around testes are difficult to undergo, mainly because the tissue itself is hard to collect. But according to Scientific American, Jean-Pierre Routy, an infectious disease clinician and researcher at McGill University in Montreal, collected samples from transgender women undergoing bottom surgery at GRS Montreal, a center that facilities over 400 surgeries a year.  

 

One of the first samples Routy collected was from an HIV-positive person, who gave their testes willingly to research after it was removed during surgery.

Since then, Routy received close to 100 testicular tissue samples from GRS Montreal to study the resistance of HIV in the body. Nearly a tenth of the samples he collected were HIV-positive. 
Routy’s research is truly groundbreaking because while we know that latent HIV often hides inside reservoirs while the person is being treated with antiretrovirals and is undetectable (as soon as the person gets off treatment, the latent virus often awakens and becomes active in the body again), data shows that because inside the testes is what’s known as an “immune-privileged” site, HIV can often find protection from the immune system — even when a person is on treatment. 

Immune privilege allows foreign invaders the same protection from the immune system as sperm. “This is because antigens from invaders also do not seem to set off an inflammatory response, unlike elsewhere in the body,” Scientific American reports. 

After examining testicular HIV-positive tissues and blood samples, Routy and his team found they all had lingering viral DNA in at least one testicle, even though they were all on treatment and were considered undetectable.

The team concluded that HIV could evade drug treatment by finding a home in the testes, though it’s still unclear how it managed to gain entry and stays without ever being detected by the immune system. 

The same idea of immune privilege is evident in the recent Zika and Ebola outbreaks. Scientific American points out that people had traces of these viruses in their semen months after they contracted the viruses, and it had been cleared elsewhere in their bodies. For one man in Italy, Zika virus was detected in his semen nearly 134 days after its symptoms were gone, though blood and saliva samples showed no trace of the virus. 

It’s cases like these that show how important it is for scientists to study testes, but samples are still hard to come by.

“If we don’t learn how [viruses] persist in the testes, then patients will continue to transmit the virus to others and put people at risk,” Routy stated.

More from PLUS, here
 

🏳️‍🌈✝️ Trump must take action to help America fight against HIV/AIDS

By David Furnish, opinion contributor — 02/02/18 

The Hill 

____________________________________________________________________________________ 

With his first State of the Union Address behind him, President Trump has a historic opportunity to help America make real and lasting progress in the fight to end the epidemic of HIV/AIDS. After years of gains in treatment and prevention, new breakthroughs and policy ideas point the clearest way forward to an AIDS-free generation since the epidemic began. Yet the risk of losing key ground is real, and new infections driven by the opioid epidemic pose a generational threat. By seizing the potential of this moment, President Trump could change the course of this fight.

In fact, taking big and meaningful action on this issue is entirely consistent with President Trump’s goal, stated in his inaugural address, of supporting “the forgotten men and women of our country.” HIV/AIDS cuts across some of our most vulnerable populations: LGBT people, people of color, and, recently and notably, people affected by the opioid crisis. In fact, without renewed action, opioid dependency and needle sharing threatens a surge in new infections. In one part of Kentucky, nearly half of all new HIV infections last year were a result of injected drugs.

We’ve come too far to lose vital ground. It would be particularly tragic to fall back because, in many ways, 2017 was a year of great progress. We saw a steady increase in the use of critical prevention measures like PrEP, a reliable and safe prophylaxis which prevents HIV transmission among those at the highest risk of infection. In Florida, a new state initiative will make PrEP costless for all by the end of this year. Meanwhile, treatment innovation is speeding up, as safer, cheaper, more effective, and more flexible medications continue to emerge thanks to critical research funded by federal dollars.

By dedicating renewed focus to this issue, President Trump could acknowledge these advancements and signal an important change in approach to the rest of the government. Last year, the White House initially recommended steep cuts to programs and services that aid the fight to end AIDS and improve the lives of those living with HIV. As of now, the administration has yet to name a director of the National AIDS Policy, and the Presidential Advisory Council on HIV/AIDS is vacant and inactive. But a new year is an opportunity for new priorities.

In fact, in some areas the federal government are already stepping up their fight. The Centers for Disease Control, after months of tireless campaigning by activists, is helping to spread the truth that HIV positive individuals with an undetectable viral load cannot transmit the disease to others. This is a critical step toward ending the social stigma that still plagues too many living with HIV, and it reflects a broader truth that trusting science, and sharing it with the general public, is our best tool to end the epidemic.

Honest, clear-eyed leadership has always made the difference in this work. Last month, we lost Mathilde Krim, a fierce activist, brilliant researcher, and pioneer who fought to expand treatment and care in the earliest days of AIDS. She was 91, but she never lost her passion for this cause. She once explained why she established amfAR, the Foundation for AIDS Research. The reason was simple: “Because I was incensed!”

We should still be incensed, but we have reason to be hopeful, too. After making nearly $9.5 million in critical grants in 2017, the Elton John AIDS Foundation will continue to support community organizations that serve key populations on the ground, helping those who live with HIV take care of themselves and others. But government has a critical role to play. The Trump administration now has the opportunity to reconstitute the Presidential Advisory Council on HIV/AIDS with a full slate of qualified members, and ensure that vulnerable populations receive affordable care through programs like Medicaid.

The State of the Union may be behind him, but President Trump stands at a moment of real opportunity in the fight against HIV/AIDS. This new year has the potential to be decisive, but the speed and strength of our progress will depend on what the White House does next. By joining the fight, President Trump can change history and save lives.

David Furnish is chairman of the Elton John AIDS Foundation.

More from The Hill 

 

🏳️‍🌈✝️ Introduce a Little Anarchy...and Everything Becomes Chaos

Brandon M. Macsata, CEO, ADAP Advocacy Association

02/02/2018 

___________________________________________________________________________________ 

In the 2008 blockbuster film, The Dark Knight, there is an infamous line by the Joker (played by the late Heath Ledger): "Introduce a little anarchy; upset the established order, and everything becomes chaos." That line by the Clown Prince of Crime pretty much sums up the last twelve months for those of us working to end the HIV/AIDS epidemic. In fact, chaotic would be an understatement.

Photo Source: The Dark Knight

The Administration's proposed budget last year was submitted to Congress late (and it will be so again this year), and it was laced with requested funding cuts to vital safety net programs. The Presidential Advisory Committee on HIV/AIDS ("PACHA") is in complete disarray between protest resignations coupled with termination of the remaining members. The Office of National AIDS Policy ("ONAP") — viewed as an important component of the White House Domestic Policy Council since 1993 — is seemingly gone. There has been no ONAP Director to coordinate the nation's response to HIV/AIDS at home, and abroad. Proposed regulations allowing healthcare professionals to deny care if it violates their "conscious" and seek to divert limited resources to organizations that refuse comprehensive strategies under the banner of religious objection. And that doesn't even scratch the surface with the countless attacks levied against the patient protections offered to people living with HIV/AIDS under the Affordable Care Act ("ACA").

On February 1st, we fired a shot across the bow at the Administration. We called on the newly minted Secretary of the U.S. Department of Health & Human Services ("HHS") to fill the vacant director position at ONAP. Now to be fair, HHS Secretary Alex Azar has no statutory authority to fill this position but he has the ear of the President who does — and that has to be worth something. Our press release is available online.

Photo Source: (AP Photo/Andrew Harnik)

It is, after all, a core responsibility of the HHS Secretary to utilize the position of influence with the President in seeking to address the public health needs of the nation. We have added our voice to the calls from numerous other advocates, legislators, and organizations that realize the vital need for this position to be filled immediately.

Since 1993 when ONAP was created the longest time period the director position remained vacant was approximately two months. It has now been twelve months since someone has led our government's response to an epidemic that has taken 35 million souls globally. It is bad public policy. It demonstrates poor leadership. And it is simply wrong!


More from ADAP Advocacy Association, here