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Positively Aware, The HIV News Journal published by the Test Positive Aware Network

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Number of people on the ADAP waiting list

A Day with HIV Hits the Airwaves

Click below to listen to the full interview in your browser.
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Listen here to Jeff Berry on The Morning Jolt

On Wednesday, September 19, PA Editor Jeff Berry was interviewed on SiriusXM OutQ’s Channel 108 on The Morning Jolt with Larry Flick. Berry spoke about A Day with HIV and how it aims at bringing people together, regardless of their HIV status, to put  faces on the epidemic. For more information on the campaign or how to submit your photo, go to adaywithhiv.com. You can hear the entire interview above.

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Simplified Application Form Now Available for All PAPs

The Common Patient Assistance Program Application (CPAPA), announced by Health and Human Services (HHS) Secretary Kathleen Sebelius at the International AIDS Conference in July, went into effect on September 12 and is now available here or at hab.hrsa.gov/patientassistance/index.html.

This single common application allows uninsured individuals living with HIV and/or their providers/caregivers to use one application to apply for multiple patient assistance programs (PAPs) that together provide an entire course of antiretroviral therapy.

HHS, working collaboratively with the National Alliance of State and Territorial AIDS Directors (NASTAD) through a cooperative agreement with the Health Resources & Services Administration’s (HRSA) HIV/AIDS Bureau, seven pharmaceutical companies, and key community stakeholders, took the lead in developing the application form. The form collects the necessary information required by all seven companies’ PAPs. Company PAPs that will now accept the common application form include:  Abbott Laboratories, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Inc., Johnson & Johnson (Janssen Therapeutics), Merck, and ViiV Healthcare.

For more information about the common PAP application form, visit the NASTAD resources page on PAPs or contact Murray Penner, NASTAD’s Deputy Executive Director, at mpenner@NASTAD.org.    

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RV144 Vaccine Efficacy Increased Against Certain HIV Viruses

Scientists used genetic sequencing to discover new evidence that the first vaccine shown to prevent HIV infection in people also affected the viruses in those who did become infected, according to a Bio-Medicine report on September 10. Viruses with two genetic "footprints" were associated with greater vaccine efficacy. The results were published September 9 in the online edition of the journal Nature.

Researchers examined HIV genome sequences from 110 volunteers who participated in the Thai HIV vaccine trial, RV144, and who subsequently became infected with HIV. Results indicate that the HIV viruses infecting trial participants were different in people who received vaccine compared to those who received placebo.

Analysis was then focused on the V2 portion of the HIV virus after a study published earlier in 2012 found that antibodies specific to the V1V2 region of the HIV genome correlated with lower risk of infection. This new genetic sequencing study showed that the viruses that broke through or escaped from these immune responses have genetic differences in the same V2 region, indicating that the vaccine exerted pressure in this region.

“This is the first time that we have seen pressure on the virus at the genetic level due to an effective HIV vaccine,” said Morgane Rolland, PhD, a scientist at the U.S. Military HIV Research Program (MHRP) and lead author of the study. The analysis revealed evidence of a vaccine-induced immune response on two sites of Env-V2 region located on HIV's outer coat. For viruses carrying these two particular signatures, the vaccine efficacy increased to 80%.

“These findings reinforce both the RV144 result and the previous study showing that antibodies directed at the V1V2 region reduce the risk of infection. Taken together the work suggests that the Env-V2 region could be a critical target for future HIV vaccines,” noted Colonel Jerome Kim, senior author on the study.

“This study underscores the realistic optimism you see in the HIV vaccine research field today. We are making substantive progress in understanding what it will take to develop a more effective HIV vaccine which will ultimately help us end this pandemic,” said Colonel Nelson Michael, director of MHRP.

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Data from Vacc-4x Study Presented at AIDS Vaccine 2012

In more vaccine news, researchers from the Vaccine Immuntherapy Center at the Lausanne University Hospital presented immunological data from the Phase 2 study with Vacc-4x during an oral session on September 11 at the AIDS Vaccine 2012 conference in Boston. Vacc-4x is an investigational vaccine to treat patients with HIV, developed by Bionor Pharma. The data from immunological analysis, which was carried out at the Swiss laboratory, was presented by Kim Ellefsen-Lavoie, CTU (Clinical Trials Unit) Coordinator, Vaccine and Immunotherapy Center, University Hospital, Lausanne, Switzerland.

The data show that patients carrying a genetic variant (HLA B-35) associated with rapid disease progression of untreated HIV infection are just as likely to respond to Vacc-4x as other patients. This supports Bionor’s intention for the vaccine to function across broader patient populations. Complete findings from the analysis will be submitted for publication.

“Immunological data from the Phase 2 study with Vacc-4x are providing insight on how this therapeutic vaccine could lead to the observed reduction in viral load,” said Professor Giuseppe Pantaleo, MD, Chief of the Division of Immunology and Allergy, University Hospital, Lausanne, Switzerland. “The results from this study will be valuable for the further development towards a potentially new class of HIV treatment and combination therapies.”

AIDS Vaccine 2012 webcasts all sessions for viewing and archiving within 24 hours of their presentation. Webcast will be available on this page.

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Scientists Develop Technique to Decipher Dormant HIV Concealed in Cells

Scientists at the Gladstone Institute have gotten one step closer to understanding and overcoming latency, one of the least-understood mechanisms of HIV, by devising a method to precisely track the life cycle of individual infected cells, according to a September 12 report in ScienceDaily.

In a paper being published online in Lab on a Chip, Gladstone investigator Leor Weinberger, PhD, announced the development of a device that can pinpoint and track HIV inside CD4 T-cells. This development is particularly important for understanding HIV latency, a state in which the virus goes dormant after the patient begins standard antiretroviral treatment. Current antiretroviral drugs do not kill HIV—they only keep it at bay—meaning that those with HIV must continue a lifetime of drug treatment so as not to develop AIDS. If they discontinue the drugs, the latent virus "wakes up" within just a few weeks and begins an onslaught against the body's immune system.

The breakthrough comes as the HIV/AIDS research community is speaking publicly about the possibility of a cure for the disease. Understanding and interrupting HIV latency is a key element in the effort to discover a cure.

“HIV latency is perhaps the single greatest obstacle to eradicating HIV/AIDS in the 34 million people who live with the disease worldwide,” said Dr. Weinberger, who is also an associate professor of biochemistry and biophysics at the University of California, San Francisco (UCSF), with which Gladstone is affiliated. “Existing techniques that try to uncover the cellular and viral mechanisms behind HIV latency are inefficient at studying very rare cells and cells housing the latent HIV virus are one-in-a-million. Our technique presents a clear path towards understanding how HIV latency is regulated within a single cell, by tracking the individual cells that traditionally had been difficult to monitor.”

Singe-cell, time-lapse microscopy—a state-of-the-art technique that scientists have lately used to track some viral infections and map antibiotic resistance to drugs—has not worked for tracking the HIV infection cycle in CD4 T-cells, especially in the latent state. This is because these cells are notoriously evasive. They spontaneously move around, attaching and detaching from their neighbors, making it nearly impossible to monitor individual HIV-infected cells over time.

However, Dr. Weinberger's team devised a clever system that essentially guides and suspends HIV-infected T-cells into tiny finger-like channels, reducing their ability to move or detach from neighboring cells.

“First, we load the T-cells into a small well, allowing them to settle into the bottom which is filled with nutrients that keep the cells well-fed and stress-free,” explained the paper's lead author Brandon Razooky, a Gladstone and UCSF graduate student. “Next, we tilt the device and the cells slide into microscopic finger-like channels that are attached to the well. Finally, we return the device to its upright position, locking about 25 T-cells inside each channel and essentially 'freezing' them in place.”

The device has several advantages over current methods. First and foremost, individual cells stay in place so investigators can follow them over time with single-cell, time-lapse microscopy. Second, the fact that each T-cell is suspended in nutrients in close physical contact with other cells results in near optimal conditions for keeping the infected cell alive for the virus' entire life cycle.

“This means that we now have the potential to analyze the entire course of an HIV infection in an individual cell—especially during the crucial latency stage—[about] which we know so little,” said Dr. Weinberger. “In the future, we plan to expand the device's design to include a larger number of wells and channels to track HIV infection on a larger scale. We want to use the information gleaned here to finally unravel the mechanisms behind HIV latency. With that knowledge, we hope to devise a treatment to bring the latent virus out of hiding in order to flush it from a patient's system, once and for all.”

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How to Survive a Plague Opens September 21

The new, critically-acclaimed documentary How to Survive a Plague will open in Chicago, New York, San Francisco and Los Angeles this week.  

This powerful film tells the story of the brave young heroes of ACT UP New York and Treatment Action Group (TAG) as they fought for their lives at the dawn of the AIDS epidemic. 
Whether you were there when it happened or are just hearing the story for the first time, the release of this mainstream documentary film provides a look at one of the most significant periods of activism in U.S. history, as well as the opportunity to spark new activism.
Find showtimes here.  Find upcoming screenings in your area using this website
After the mainstream release, the film will become available for limited community use.  Contact info@surviveaplague.com if you are interested in learning more.
 Learn more about the film and the Learn Fight Love Alliance at surviveaplague.com.

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Nation’s Largest Annual AIDS Conference Set for September 30

To mark its 25th anniversary, the National Minority AIDS Council (NMAC) is bringing the U.S. Conference on AIDS (USCA), the largest annual AIDS-related gathering in the country, to Caesar’s Palace in Las Vegas from September 30-October 3, 2012. For more than 15 years, USCA has sought to increase the strength and diversity of the community-based response to the HIV/AIDS epidemic through education, training, new partnerships, collaboration, and networking.

This year, USCA will work to highlight the changes that have brought the dream of ending the epidemic closer than ever. The program will address ways that the Affordable Care Act will improve access to care for people living with HIV/AIDS, the future of the Ryan White Program, High Impact Prevention and biomedical advances that will help an AIDS-free generation become a reality. Presenters will include high-level government officials and leaders from the national HIV/AIDS community, including Substance Abuse & Mental Health Services Administration (SAMHSA) Administrator Pam Hyde. Also appearing will be Jamar Rogers from NBC’s The Voice and Mondo Guerra, of Project Runway fame.

For more information, visit 2012usca.org. Positively Aware is once again a proud media sponsor of the United States Conference on AIDS. Be sure to visit us at booth #122 for your free gift!

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Justice Department and Hershey School Settle for $715,000 in ADA Violation Suit

The Justice Department announced on September 12 that it and the AIDS Law Project of Pennsylvania have reached a settlement with the Milton Hershey School of Hershey, PA, to resolve allegations that the school violated the Americans with Disabilities Act (ADA) by refusing to enroll a child, known by the pseudonym Abraham Smith, due to the fact that he has HIV.

Under the settlement agreement, the school is required to pay $700,000 to Smith and his mother, adopt and enforce a policy prohibiting discrimination and requiring equal opportunity for students with disabilities, including those with HIV, in the school’s programs and services, and to provide training to staff and administrators on the requirements of the ADA.The school must also pay a $15,000 civil penalty to the United States.

“Children should not be denied educational opportunities simply because they have HIV,” said Thomas E. Perez, Assistant Attorney General for the Civil Rights Division. “This settlement sends a clear message that unlawful discrimination against persons with HIV or AIDS will not be tolerated.”

The Department of Justice provides a webpage specifically dedicated to information about the ADA and HIV. Those interested in finding out more about these settlements or the obligations of public accommodations under the ADA may call the Justice Department’s toll-free ADA information line at 800-514-0301 or 800-514-0383 (TDD), or access its ADA website.

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Legislation Watch

By Sue Saltmarsh

The return of Congress to Washington after the national conventions promises to be rife with clashes between the parties. Sequestration and the debt ceiling deal will be one of the top priorities. We should all be paying attention to this issue, since it’s quite possible that HIV/AIDS funding could be cut even further than the 10% across-the-board that sequestration requires.

On September 10, Florida Republican Allen West introduced H.R 6365, the National Security & Jobs Protection Act as an alternative to the sequestration plan agreed to during the debt ceiling debate. However, it specifically addresses the mandated cuts to defense spending and suggests restoring the major cut to defense by cutting even more from non-defense spending.

For an extensive (and hopefully easily understood) explanation of sequestration, see my upcoming online extra “Debt Ceiling Dealing” at positivelyaware.com around October 24.

One big issue that was dealt with in the House on the 13th is the continuing resolution (CR) that will keep the government running for the next six months. Members easily approved the spending resolution in a 329-91 vote, with 70 Republicans and 21 Democrats voting against it.  The Senate is set to vote on way in advance of the October 1 start of fiscal year 2013. Though the CR will keep the government from shutting down, it will be up to the lame duck Congress to hammer out the sequestration question.

One co-sponsor was added to HR 3053, the REPEAL Act. Democrat James Moran of Virginia became the 37th co-sponsor on September 10.

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