Study Suggests Black Clergy Can Fight HIV Effectively

In the United States, black religious institutions could help turn the tide, according to a new study. Based on dozens of interviews and focus groups with 38 of Philadelphia's most influential black clergy, physicians and public health researchers found that traditional barriers to preaching about HIV prevention could give way to faith-friendly messages about getting tested and staying on treatment.

In the study, published in the journal PLoS ONE, a team of physicians and public health researchers report that African American clergy say they are ready to join the fight against the disease by focusing on HIV testing, treatment, and social justice, a strategy that is compatible with religious teaching.

“We in public health have done a poor job of engaging African American community leaders and particularly black clergy members in HIV prevention,” said Amy Nunn, lead author of the study and assistant professor of medicine in the Warren Alpert Medical School of Brown University. “There is a common misperception that African American churches are unwilling to address the AIDS epidemic. This paper highlights some of the historical barriers to effectively engaging African American clergy in HIV prevention and provides recommendations from clergy for how to move forward.”

The paper analyzes dozens of interviews and focus group data among 38 African American pastors and imams in Philadelphia, where seven in 10 new infections in the city are among black residents. With uniquely deep influence in their communities, nearly all of the 27 male and 11 female clergy said they could and would preach and promote HIV testing and treatment.

“For decades, we've focused many HIV prevention efforts on reducing risky behavior,” said Nunn, who is also based at The Miriam Hospital. “Focusing on HIV testing and treatment should be the backbone of HIV prevention strategies and efforts to reduce racial disparities in HIV infection. Making HIV testing routine is the gateway to getting more individuals on treatment. African American clergy have an important role to play in routinizing HIV testing.”

Many religious leaders acknowledged that they've struggled with how best to combat the epidemic, and said they face significant barriers to preaching about risk behaviors without still emphasizing abstinence.

“It's my duty as a preacher to tell people to abstain” one pastor told the research team, “but if they're still having sex and they're getting HIV, there has to be another way to handle this.”

Nunn and collaborators have already begun such work in the city. This year, in partnership with dozens of churches and other community leaders, she will oversee an HIV prevention campaign that includes door-to-door testing in an entire zip code of Philadelphia with high infection rates.

“Religious leaders are, in fact, willing to engage in dialogue and HIV prevention if you do it in a culturally appropriate and faith-friendly way,” Nunn said. “This means that HIV prevention should be couched in social justice and public health rather than in exclusively behavioral terms. HIV testing should be the backbone of any strategy to engage African American clergy in HIV prevention.”

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Study Shows Autoimmune Reaction to Abacavir

Potentially severe hypersensitivity reactions to the anti-HIV drug abacavir (brand name Ziagen—also included in the combination products Epzicom and Trizivir) occur through an autoimmune mechanism, resulting from the creation of drug-induced immunogens that are attacked by the body's immune system, according to a study published July 17 in the journal AIDS, official journal of the International AIDS Society. The publish-ahead-of-print article is currently available on the AIDS journal homepage and will be available in the July 17, 2012 print edition.

The study is the first to explain how hypersensitivity reactions to abacavir develop in genetically predisposed patients—and suggests that similar autoimmune mechanisms might account for other types of drug reactions related to variants in the human leukocyte antigen (HLA) system.

Lead author Dr. Michael A. Norcross of the Food and Drug Administration's Center for Drug Evaluation and Research and colleagues performed a series of laboratory experiments to examine why some patients develop hypersensitivity reactions to abacavir. Developing a few weeks after the start of treatment, the reactions cause a wide range of symptoms including fever, rash, nausea, muscle soreness, and shortness of breath.

The reactions have been linked to a gene variant called HLA-B*57:01, found in up to 8% of people of European descent (lower in other racial/ethnic groups). However, the molecular basis by which people with the HLA-B*57:01 gene develop hypersensitivity reactions to abacavir has been unclear.

In model cells expressing the HLA-B*57:01 gene, the researchers found that abacavir exposure led to the formation of new peptide molecules that bound to specific HLA-B*57:01 binding sites. The result was the creation of new drug-induced immunogens, which triggered attacks by immune cells.

These findings suggest that abacavir hypersensitivity reactions occur through an autoimmune mechanism—the immune system attacks cells it doesn't recognize as "self." This is the same basic mechanism that causes autoimmune diseases such as lupus, inflammatory bowel disease, and Type 1 diabetes.

This autoimmune mechanism helps to explain why abacavir hypersensitivity reactions can affect such a wide range of different organs and tissues. It also helps in understanding why the reactions clear up promptly when abacavir is stopped, and why more severe reactions can rapidly develop if treatment is restarted.

Dr Norcross and colleagues believe that a similar molecular mechanism could potentially explain other types of drug reactions involving HLA gene variants. It's also important to identify other factors influencing the development of hypersensitivity, since not all patients with the HLA-B*57:01 gene react to abacavir.

“This study provides important insight into why only certain people show this severe hypersensitivity to this valuable anti-HIV drug,” comments Dr J.A. Levy, Editor-in-Chief of AIDS. “The finding represents an example of how approaches to personalized medicine can identify patients who would be sensitive to this side effect of abacavir.”

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Newly Discovered Breast Milk Antibodies Help Neutralize HIV

Antibodies that help to stop the HIV virus have been found in breast milk. Researchers at Duke University Medical Center isolated the antibodies from immune cells, called B cells, in the breast milk of infected mothers in Malawi. Research showed that the B cells in breast milk can generate neutralizing antibodies that may inhibit the virus that causes HIV, according to a study that was published on May 18 in PLoS One.

HIV-1 can be transmitted from mother to child via breastfeeding, but only one in 10 HIV-positive nursing mothers is known to pass the virus to their infants.

“That is remarkable, because nursing children are exposed multiple times each day during their first year of life,” said senior author Sallie Permar, MD, PhD, an assistant professor of pediatrics and infectious diseases at Duke. “We are asking if there is an immune response that protects 90% of infants, and could we harness that response to develop immune system prophylaxis [protection] during breastfeeding for mothers infected with HIV-1.

"Our work helped establish that these B cells in breast milk can produce HIV-neutralizing antibodies, so enhancing the response or getting more mucosal B-cells to produce those helpful antibodies would be useful, and this is a possible route to explore for HIV-1 vaccine development," Permar said.

“This is important work that seeks to understand what a vaccine must do to protect babies from mucosal transmission during breastfeeding,” said Barton Haynes, MD, co-author and director of the Center for HIV/AIDS Vaccine Immunology (CHAVI), as well as director of the Duke Human Vaccine Institute (DHVI). “The antibodies isolated are the first HIV antibodies isolated from breast milk that react with the HIV-1 envelope, and it important to understand how they work to attack HIV-1.”

The findings of two different antibodies with HIV-neutralizing properties isolated from breast milk also may help researchers with new investigations into adult-to-adult transmission, in addition to mother-to-child transmission.

Permar said that most HIV-1 transmission occurs at a mucosal site in the body—surfaces lined with epithelial cells, such as the gastrointestinal tract or vaginal tissue. The mucosal compartments all have their own immune system cells.

“We're excited about this finding because the immune cells in mucosal compartments can cross-talk and traffic between compartments,” Permar said. “So the antibodies we found in breast milk indicate that these same antibodies are able to be elicited in other tissues.”

The Centers for Disease Control and Prevention (CDC) recommend against breastfeeding if a mother has HIV-1, because baby formula is a safe alternative for U.S.-born infants. The World Health Organization, however, encourages HIV-positive nursing mothers in resource-poor regions to breastfeed while mother and/or baby take antiretroviral drugs to prevent the infection in the infant, because without the nutrients and immune factors in mothers' milk, many more babies would die from other diseases.

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New Mexico Health Department Official Resigns after Pushing Condoms

A top medical official at the New Mexico Department of Health was forced to resign in May just hours after she was quoted in a television interview advocating the use of condoms, reports the Albuquerque Journal.

Dr. Erin Bouquin said she resigned as the agency’s chief medical officer under pressure after KOAT-TV aired an interview in which she urged New Mexicans to “use condoms” to combat rising STD rates. Bouquin said she agreed to the KOAT interview to discuss data showing a spike in gonorrhea and chlamydia rates. The increases include a 90% increase in gonorrhea rates among girls ages 15-19 from 2010 to 2011. Bouquin said her remarks about condoms were the most likely explanation for her dismissal from the $160,000-a-year post.

State officials responded that Bouquin’s resignation, less than four months after she was hired, had no connection to her comments in the interview. Department of Health spokeswoman Aimee Barabe said Bouquin’s dismissal was part of an agency reorganization that included several changes in top staff members.

“Any insinuation that (Bouquin’s) change in employment is related to contraception policy is false and unfortunate,” Barabe said. She added that top officials were not aware of the content of Bouquin’s interview.

Scott Darnell, a spokesman for Republican governor Susanna Martinez, said in a written statement that Martinez gave the Department of Health “no direction or involvement” about Bouquin’s employment.

“The governor is a proponent of taking a balanced and multi-pronged approach to controlling the spread of sexually transmitted diseases; there is nothing in Dr. Bouquin’s interview that would conflict with that approach,” Darnell said.

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AIDS 2012 Pre-Conference Event to Address HIV Crisis among Gay Men and Transgender People

The Global Forum on MSM & HIV (MSMGF) will hold its fifth biennial pre-conference to AIDS 2012 to sound the alarm on the unprecedented HIV crisis facing gay and other men who have sex with men (MSM) and transgender people around the world. To be held on July 21, directly preceding the International AIDS Conference in Washington D.C., the full-day event is titled “From Stigma to STRENGTH: Strategies for MSM, Transgender People, and Allies in a Changing AIDS Landscape.”

The event comes at a time when HIV rates among MSM in countries as diverse as Mexico, Jamaica and Zambia have reached 25%, 31%,  and 32%, respectively. In the United States, where the conference returns for the first time in 22 years, MSM account for nearly half of all people living with HIV and more than 60% of new infections.

“The way we handle HIV among MSM and other key populations will dictate the course of the global epidemic,” says Dr. George Ayala, Executive Director of the MSMGF and a speaker at the pre-conference. “The major shifts at the Global Fund, persistent affronts to human rights, and the advent of pre-exposure prophylaxis (PrEP) have each changed the landscape for HIV prevention and treatment. It is crucial that we now take account of these developments and their implications for MSM and transgender people.”

The event will feature plenary addresses by Congresswoman Barbara Lee, retired High Court Justice Michael Kirby, and Dr. Kevin Fenton, Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. The first annual Robert Carr Memorial Speech will be delivered by Jamaican LGBT activist Maurice Tomlinson. Program sessions will cover the latest developments in HIV prevention, treatment, research, policy, and advocacy concerning MSM and transgender people around the world.

“In the past, the International AIDS Conference has failed to adequately address issues concerning MSM and other key populations,” explains Dr. Ayala. “Following the 2010 conference, we conducted an analysis that revealed only 2.6% of sessions at AIDS 2010 focused on MSM and 1.1% focused on transgender people. Although we expect to see improvements in this year’s conference, activists are already reporting the rejection of large numbers of high-quality abstracts that address MSM and transgender concerns. The MSMGF is collecting these rejected abstracts to be featured in a new publication that will be released at the pre-conference event.”

More details can be found here.

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AIDS Alliance Partners with The AIDS Institute

Beginning this summer, the new home of AIDS Alliance for Children, Youth & Families (AIDS Alliance) is with The AIDS Institute under the leadership of Michael Ruppal, Executive Director of The AIDS Institute. 

AIDS Alliance, founded in 1994, will continue and expand its advocacy and program work in its new home. Current Executive Director Carole Treston will be working with The AIDS Institute over the coming months to ensure continuity of advocacy and program services. Combining administrative operations will maximize and increase the resources dedicated to programs and services. Together, the two organizations will forge a new alliance that will have an even greater impact in the fight against HIV/AIDS, and will also maximize organizational effectiveness and efficiency for women, infants, children, and youth, as well as donors and funders.

The AIDS Institute is committed to continuing the legacy of AIDS Alliance. “Together we have a lot of work to do towards achieving the goals of the National HIV/AIDS Strategy for women, children, youth and families living with and affected by HIV/AIDS. The synergy between the two national organizations will make for a successful future as we blend the expertise of the leadership shared between the two groups.  AIDS Alliance will continue its vision, values and identity in its new home.  The AIDS Institute will ensure that the work and programming of AIDS Alliance, along with its own programs, will appropriately support our respective missions,” stated The AIDS Institute.

Learn more about the AIDS Alliance for Children, Youth & Families here. 

Visit The AIDS Institute’s website here.

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The Qu to Host Benefit for Lambda Legal

Founded in 2011, The Qu is an LGBT news and entertainment website known for its exclusive video content, special editorials, and creative events.

As a kickoff to Gay Pride Month, The QU is presenting The Ultimate Burlesque Brunch on June 3 from noon to 3:00 pm at Sidetrack, 3349 N Halsted in Chicago. The event is co-sponsored by The L Stop, your one-stop everything Lesbian.

The Ultimate Burlesque Brunch’s performers include “Chicago’s own community chest,” Cruel Valentine, performing alongside the talented and musically-inclined Kyle Greer. Also on the bill is Tito Bonito, “the Cuban Missile Crisis,” the adorable sci-fi chick Holly Deck, and Po’ Chop. The entire event is hosted by the hilarious and lively Xandra Fairlawn.

Lambda Legal is a national organization committed to achieving full recognition of the civil rights of lesbians, gay men, bisexuals, transgender people, and those with HIV through impact litigation, education, and public policy work.

“Burlesque has a long history of entertainment through body-positive, empowering performance,” said Joey Grant, co-founder of The Qu. “We’re really happy to put together a fun, creative event to benefit Lambda Legal, a very important LGBT organization.”

Tickets are available here  for $25 in advance and $30 at the door and include food, cocktails, and entertainment. Check out the Facebook invite and the promo video!

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Legislation Watch

The Senate overwhelmingly passed a major Food and Drug Administration reauthorization on May 24 after defeating more controversial amendments designed to lower the price of prescription drugs.

The bill, the Food and Drug Administration Safety and Innovation Act (S.3187), sponsored by Senators Mike Enzi (R-Wyo.) and Tom Harkin (D-Iowa), creates a user-fee program for biosimilar and generic drugs to speed up FDA approval of those drugs.

There’s also broad bipartisan support for the House version, which cleared the Energy and Commerce Committee by a voice vote and is awaiting a vote on the floor.

Illinois Legislature Passes $1.6 Billion in Medicaid Cuts

Hundreds of thousands of poor Illinoisans would lose health coverage as part of $1.6 billion in budget cuts the Illinois General Assembly approved on May 24, according to a report in the Chicago Tribune. Among the estimated big-ticket savings: $350 million through tighter screening that could remove hundreds of thousands of people from Medicaid coverage; $49.8 million by reducing the number of people eligible for Family Care; and $72.2 million from eliminating a state-paid pharmacy assistance program called Illinois Cares Rx, which provides discount drug coverage for 180,000 low-income seniors and people with disabilities, including HIV.

Kevin Bernal, Total Care Portal Manager at Test Positive Aware Network (TPAN) said that clients who are now on Medicare Part D and enrolled in Illinois Cares Rx should immediately apply for the AIDS Drug Assistance Program (ADAP) to ensure continuity of coverage .

Before the vote, the AIDS Foundation of Chicago (AFC) urged AIDS service organizations to flood the offices of legislators with calls, emails, and even personal visits urging them to defeat the bill.

Several state legislators, including HIV community allies Representatives Greg Harris and Kelly Cassidy and Senator Heather Steans, worked hard, but were ultimately stymied when the House voted 94-22 to approve the measure, and the Senate later approved it 44-13.

AIDS advocates in Illinois encourage HIV-positive people and their allies to call the governor’s office and urge him not to sign the bill.

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