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Widespread Civil Disobedience Launches South African Campaign

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A<br />

THE MONTHLY PUBLICATION OF<br />

May/June 2003<br />

“We are diverse people living with HIV, united to promote self-empowerment<br />

and enhanced quality of life for HIV affected individuals through<br />

advocacy, education, peer support, and treatment activism.”<br />

<strong>Widespread</strong> <strong>Civil</strong> <strong>Disobedience</strong> <strong>Launches</strong><br />

<strong>South</strong> <strong>African</strong> <strong>Campaign</strong><br />

Compiled by Jeff Graham<br />

fter months of calling on the <strong>South</strong> <strong>African</strong> government to sign and<br />

implement a national AIDS treatment and prevention plan, including<br />

access to antiretrovirals, <strong>South</strong> Africa’s Treatment Action <strong>Campaign</strong> (TAC) was<br />

forced to begin escalating their campaign.<br />

This carefully considered decision was made after the persistent refusal of<br />

the government to support access to antiretroviral treatment for the 5 million<br />

<strong>South</strong> <strong>African</strong>s living with HIV, of whom 600 die each day. The campaign itself<br />

was launched on March 20 when 600 TAC members converged at police stations<br />

in Durban, Sharpeville, and Cape Town to charge the <strong>South</strong> <strong>African</strong> Minister of<br />

Health and the <strong>South</strong> <strong>African</strong> Minister of Finance with homicide for denying<br />

people with HIV access to antiretrovirals. TAC then called on police to arrest the<br />

Ministers.<br />

The response to<br />

these actions was<br />

anything but nonviolent.<br />

Police in<br />

Durban, using water<br />

cannons, tear gas and<br />

batons brutilized<br />

protestors. Several<br />

TAC members are<br />

currently hospitalized<br />

as a result of police<br />

brutality.<br />

These protests<br />

were set to coincide<br />

“We cannot wait any longer for a visible and dynamic response<br />

from the government, business and international community. We<br />

do not need any more reports to tell us what we already know -<br />

HIV/AIDS is killing 600 people a day in this country and ruining<br />

lives and hopes. But with will and commitment this does not have<br />

to happen. With leadership from business and government,<br />

together with labour and communities, it is still possible to save<br />

lives and restore hope.”<br />

— Treatment Action <strong>Campaign</strong><br />

with <strong>South</strong> <strong>African</strong> Human Rights Day, a national holiday that commemorates<br />

the 1960 peaceful uprising in which thousands of black <strong>South</strong> <strong>African</strong>’s turned<br />

themselves over to police custody for the apartheid-era crime of leaving their<br />

passes at home.<br />

On March 25, TAC members disrupted a speech on public health by the Minister of<br />

Health, Dr. Manto Tshabalala-Msimang,<br />

to deliver a statement: “...You have<br />

deceived, misrepresented, delayed and<br />

denied for too long. We hope you will<br />

prove us wrong by making an<br />

unequivocal and irreversible<br />

commitment to anti-retroviral therapy.”<br />

In late April, the next wave of actions<br />

took place including public burials for two<br />

TAC leaders, Edward Mabunda and Charlene<br />

Wilson, and an international day of action on<br />

April 24 and a Health Workers Day of Action<br />

on May 5 and 6.<br />

Some 4.7 million <strong>South</strong> <strong>African</strong>s — one<br />

in nine — are HIV positive, more than any<br />

other country in the world. TAC hopes its<br />

campaign will help prod the government into<br />

committing to provide its people with AIDS<br />

drugs. The government has said it would be<br />

too expensive to provide all infected <strong>South</strong><br />

<strong>African</strong>s with the drugs. Sparking debate, the<br />

government has also questioned the<br />

effectiveness of treatment. <br />

In This Issue of Survival News<br />

PRIDE Activities ................................................................................................. 3<br />

Making Change ..................................................................................................... 4<br />

SARS and HIV ....................................................................................................... 9<br />

SARS Timeline ...................................................................................................... 10<br />

Living With HIV: ThePrice..........................................................................12


I<br />

Living Well<br />

Gerry Hoyt<br />

ghoyt@aidssurvivalproject.org<br />

Yet Another ‘Costume<br />

Change’<br />

t was two years ago that I began as editor of Survival News. As I re-read my first<br />

editorial, “A New Hat and a New Pair of Shoes”, I am reminded how fortunate I am to be<br />

a part of this place we call ASP. I began as a volunteer peer counselor in 1996. In 1997, I was<br />

hired as the program manager of what was Operation: Survive! (Now, THRIVE! Weekend).<br />

I have had the opportunity to also work with the Peer Counseling Program as well as Advocacy<br />

before becoming editor of this publication. As a matter of fact, I think I have possessed some<br />

five or six different extension numbers while here.<br />

Soon I can be reached at extension 19, as the Treatment Education Program Manager. My<br />

colleague, Dan Dunable has decided to take care of himself and has chosen to volunteer instead<br />

of work in the Treatment Resource Center. It is comforting to me, and I am grateful to know,<br />

that in addition to Dan’s presence as a volunteer, I will have the opportunity to work with<br />

George Burgess who is one of my heroes. This new position will also allow me to read and learn<br />

more about HIV-related treatment issues and have more contact with those utilizing the TRC.<br />

Along with a “costume change” for me will soon come a new office space for ASP, AIDS<br />

Treatment Initiatives and Positive Impact. If all goes as planned, we hope to be in our new space<br />

by June 16 th . This more comfortable and creative space is only two doors up from our present<br />

building on Ralph McGill Boulevard. So, if you would like to help with this move, I am sure<br />

Jeff Smith would love to hear from you! As we get closer to the move date, we will send out<br />

more detailed information. Also, you will notice that this is the May/June issue. So look for<br />

the July/August issue in your mailbox sometime in early July. With all the change going on<br />

here at ASP, we decided to combine these issues at least for the summer.<br />

As I put this last “baby to bed” as editor, I want to thank the folks who make this publication<br />

possible. I will begin by thanking each staff who has a by-line. I have been witness to some<br />

of the most creative and informative articles. I especially want to thank our newsletter<br />

volunteers. I have so enjoyed reading David Salyer’s articles. I consider him one of the best<br />

writers in the HIV Community. Ernie Evangelista who bring us the Chronicles each month is<br />

one of those volunteers who works quietly in the background. However, without his<br />

Enjoy delicious nights out<br />

to benefit<br />

AIDS Survival Project<br />

at Atlanta’s hottest new eaterie<br />

Every Sunday night, May 11 – July 27,<br />

4 pm to 11 pm<br />

20% of your food bill will go to<br />

AIDS Survival Project<br />

Cut out this ad and give it to your<br />

server<br />

(Make a copy of the ad & come back<br />

every week<br />

for the same great offer!)<br />

Thank you to all the folks at<br />

Front Page News &<br />

Tijuana Garage<br />

353 Moreland Ave.<br />

Great Mexican food and drink in a fun atmosphere<br />

(Ample free parking in the buildingand adjacent<br />

lots)<br />

contribution there would not be about fourpages<br />

of national and international HIV-related<br />

news in each SN! Chris Companic is a<br />

fabulous cartoonist who has given us a laugh<br />

at the end of each issue.<br />

Our most recent volunteer, Bob<br />

Brown, is married to Mary Lynn Hemphill<br />

(bet you didn’t know that!). Bob has kindly<br />

(and thoroughly) corrected the errors of many.<br />

Even an editor needs an editor. His delightful<br />

wife and my office mate, Mary Lynn, has<br />

been a source of strength and gentleness as I<br />

type away and talk to myself for at least one week<br />

a month. I appreciate the fact also, that she is not<br />

given to violence since I am sure I am not the<br />

easiest person with whom to share an office!<br />

Thanks to John, Derek and Tran at Printing<br />

Concepts, who have been so patient as I learned<br />

how to produce this publication. Thanks to Rob<br />

and Andrea at Gates Marketing who get SN in the<br />

mail each month.<br />

Finally, I want to thank you, our<br />

membership, who support and read this<br />

publication. Survival News was the first<br />

publication that gave me hope to live again when<br />

I was diagnosed in 1991. It is bittersweet to say<br />

goodnight to this “baby” this time. May we all<br />

continue to live well! <br />

Circulation: 4,000<br />

Gerry Hoyt, Editor<br />

Volunteers and Contributors<br />

Chris Companik Bob Brown<br />

Ernie Evangelista David Salyer<br />

Please direct all correspondence to:<br />

AIDS Survival Project<br />

159 Ralph McGill Blvd NE, Suite 500<br />

Atlanta, GA 30308<br />

Phone: 404-874-7926, Fax: 404-524-2462<br />

TTY: 404-524-0464<br />

Toll Free: 1-877-AIDS-444 (877-243-7444)<br />

Website: www.aidssurvivalproject.org<br />

e-mail: asp@mindspring.com<br />

Member of:<br />

Survival News is produced and published by<br />

AIDS Survival Project which is solely responsible<br />

for its content. If you have articles you would like<br />

to submit, please contact the ASP office during<br />

regular office hours.<br />

PLEASE NOTE: News and resources included in<br />

this publication are for informational purposes only<br />

and do not constitute any endorsement or<br />

recommendation of, or for, any medical treatment<br />

or product by AIDS Survival Project. With regard<br />

to medical information, AIDS Survival Project<br />

recommends that any and all medical treatment you<br />

receive or engage in be discussed thoroughly with a<br />

competent, licensed, and fully AIDS-informed medical<br />

practitioner, preferably your personal physician.<br />

Opinions expressed in various articles of this pulication<br />

are not necessarily those of AIDS Survival Project<br />

members. Any individual's association with AIDS<br />

Survival Project or mention of an individual's name<br />

should not be considered an indication of that person's<br />

health status. Please contact AIDS Survival Project for<br />

permission to duplicate any of the information contained<br />

within this publication. Members can have their issues<br />

sent to them in a sealed envelope by contacting our<br />

office to have this arranged.<br />

Board of Directors<br />

Executive Committee:<br />

Eddie Young, President<br />

Susan Cornutt, Vice-President<br />

Greg Jesse, Treasurer<br />

Joan Campitelli, Secretary<br />

Scott H’Doubler, Member-at-Large<br />

Michael Baker Judi Clark<br />

Jacqueline Muther Barron Segar<br />

Larry Sheldon Mark Tatro<br />

AIDS Survival Project Staff<br />

Jeff Graham, Executive Director<br />

Jeff Smith, Associate Director<br />

Sarah Biel, THRIVE! Weekend<br />

George Burgess, Treatment Resource Center<br />

Dan Dunable, Treatment Resource Center<br />

Greg Carraway, Development Director<br />

Mary Lynn Hemphill, Peer Counseling<br />

Sheryl Johnson, Community Outreach<br />

Rob Nixon, Development Assistant<br />

Share Project Staff<br />

Chauncey Cherry, Project Director<br />

James Austin, Research Associate<br />

Webster Luke, Research Associate<br />

Brenda Ward, Research Assistant<br />

Jackie Cherry, Reseach Assistant<br />

2 SURVIVAL NEWS


The The LiveWell LiveWell Fund<br />

Fund<br />

“Unique individuals and businesses who<br />

know that life is precious and worthy of<br />

unusual gifts...prolonging and enhancing<br />

people’s lives with significant donations to<br />

support education and information access<br />

programs at<br />

AIDS Survival Project:”<br />

Gold Gold LiveWell LiveWell<br />

LiveWell<br />

Sponsors<br />

Sponsors<br />

$5,000 $5,000 - - $9,999<br />

$9,999<br />

Anonymous<br />

Pride Medical<br />

Silver Silver LiveWell<br />

LiveWell<br />

Sponsors<br />

Sponsors<br />

$2,500 $2,500 - - $4,999<br />

$4,999<br />

Lee Anisman, M. D.<br />

James M. and<br />

Ruth E. Wilder Foundation<br />

Bronze Bronze LiveWell<br />

LiveWell<br />

Sponsors Sponsors<br />

Sponsors<br />

$1,000 $1,000 - - $2,499<br />

$2,499<br />

Joel Black<br />

Lora Bohannon<br />

Martha Brewer<br />

Kenneth Britt<br />

Joan F. Campitelli<br />

Bill Crawford &<br />

Lisa Swenson<br />

Richard Glass<br />

Deby Glidden<br />

Jeanne & Stephen Gura<br />

Scott H’Doubler<br />

Roy Hill<br />

Richard Hudson, M.D.<br />

Don King<br />

Susan Levy<br />

Jesse R. Peel, M. D.<br />

Larry Sheldon &<br />

Len Greenough<br />

Dr. Tom Sparkman<br />

Mark Tatro<br />

Marty Thompson &<br />

Dr. David Morris<br />

Edward Young<br />

AIDS Survival Project Marks<br />

15 Years at Pride<br />

The days are longer, the sun’s getting<br />

more intense – it’s the time of year for<br />

Atlanta Pride, and AIDS Survival Project is<br />

once again a proud sponsor of the <strong>South</strong>’s<br />

largest lesbian, gay, bisexual, transgender<br />

celebration. We have a particular reason for<br />

pride this year as we mark our anniversary<br />

– 15 years of Advocacy, Self-Empowerment,<br />

and Partnership, bringing vital programs<br />

and services to the community as well as<br />

providing the opportunity for those affected<br />

by the AIDS epidemic to be a powerful<br />

voice for equitable and rational public policy.<br />

As we look back on our history of struggle<br />

and significant accomplishments, we<br />

recognize that although AIDS was never a<br />

disease confined exclusively to gay men, it<br />

is equally important to acknowledge the<br />

significant toll HIV has had upon the LGBT<br />

community. It’s also vital that we never<br />

forget it was this community, before all<br />

others, that banded<br />

together to fight the<br />

epidemic.<br />

Thousands of people<br />

have volunteered<br />

their time, talents and<br />

resources to this<br />

cause and to make the<br />

agency what it is<br />

today. We hope you<br />

will join them, and<br />

us, as we mark this<br />

important milestone in our history and look<br />

ahead to the crucial work we face in the future.<br />

So we hope to see you in Piedmont Park, June<br />

27 – 29, as the 2003 Atlanta Pride festival<br />

celebrates the “Freedom to Be.”<br />

Freedom to Remember<br />

Pride is a time for celebration of our<br />

sexual identity and a chance to revel in the<br />

spirit of community. This year, AIDS Survival<br />

Project, in conjunction with the Atlanta Lesbian<br />

Cancer Initiative, is sponsoring a new event to<br />

kick-off the weekend. The Pride Vigil is an<br />

opportunity for all members of our community<br />

to come together to reflect, remember and<br />

celebrate the contributions of our friends and<br />

family members who are no longer with us.<br />

While the epidemics of AIDS and cancer<br />

continue to take a disproportionate toll on the<br />

LGBT community, both agencies want to pay<br />

tribute to the memories of all whose presence<br />

will be missed at Pride this year. Combining<br />

readings, reflections, and music from the<br />

By Rob Nixon<br />

Atlanta Feminist Women’s Chorus, the Pride<br />

Vigil will take us back to the time before<br />

Stonewall and up to the present day.<br />

The evening promises to be an<br />

opportunity to cherish the memories of loved<br />

ones and celebrate the everyday people<br />

whose strength and commitment have<br />

brought hope to us all. Join us on Friday,<br />

June 27, 7:30 p.m., in Piedmont Park at the<br />

Verizon Acoustic Stage (near the Charles<br />

Allen entrance). If you would like to<br />

volunteer with the Vigil, please contact Gerry<br />

Hoyt (404-874-7926, ext. 13;<br />

ghoyt@aidssurvivalproject.org).<br />

Freedom to Reach Out<br />

The Pride Market is a great place to<br />

shop, eat, meet friends old and new, but it’s<br />

also a great place to learn and to educate.<br />

Every year, thousands of individuals gain<br />

information on community resources as they<br />

walk through the<br />

market. The AIDS<br />

Survival Project<br />

booth will have<br />

materials on our<br />

programs and<br />

services, how to<br />

become an effective<br />

advocate for yourself,<br />

and ways to volunteer<br />

to help us continue<br />

with strength into the<br />

future. We’ll also have a fun display honoring<br />

our history and all those who have been a part<br />

of AIDS Survival Project over the years. If<br />

you would like to assist us with setting up the<br />

booth, staffing it, and greeting all those who<br />

stop by to learn about us, please contact Jeff<br />

Smith (404-874-7926, ext. 20;<br />

jsmith@aidssurvivalproject.org) to sign up<br />

for a volunteer shift.<br />

Freedom to Strut Your Stuff<br />

On Sunday, June 29, we are inviting our<br />

friends and supporters to march with us in the<br />

Pride Parade and celebrate the spirit of<br />

community empowerment and dedication<br />

displayed by people living with HIV and their<br />

supporters. We will gather at the Civic Center<br />

MARTA station on West Peachtree at 11:30<br />

am. Individuals can choose to march or ride<br />

on our float. And we’ll have some fun anniversarythemed<br />

hand fans to keep you cool! Volunteers<br />

are needed to decorate the float – if you can help<br />

out, contact Jeff Smith. <br />

May/June 2003 3


Peer<br />

Counseling<br />

Perspecives<br />

Mary Lynn Hemphill,<br />

LMSW<br />

mlhemphill@aidssurvivalproject.org<br />

Making Change<br />

Most of us would like to make some<br />

changes in our lives. New Year’s resolutions<br />

are the most common acknowledgement in<br />

our culture of the acceptability and value of<br />

seeking to improve our behaviors and life<br />

situations through conscious change. Spend<br />

an hour watching television or reading a<br />

popular magazine or newspaper and you<br />

will be inundated with advertisements and<br />

articles that promise you a change in your<br />

life through a particular product or service.<br />

Advertisements for credit cards that buy<br />

you “priceless” happiness, cars that<br />

bestow acceptance into the social<br />

group of your choice and<br />

pharmaceuticals that make you<br />

happier, thinner or more buff, more<br />

active and younger promise<br />

immediate change in your or your<br />

loved ones lives.<br />

While quick, stress-free<br />

change looks appealing and easy<br />

(if you have enough money) the<br />

truth is that change does not come<br />

easily to most people. Often, we<br />

don’t feel like we get to select change –<br />

instead we feel like change happens to us<br />

and then we react to it. As it’s been said,<br />

some people change when they see the light,<br />

others when they feel the heat. Medical<br />

problems often cause us to consider the<br />

need for some change in our lives. The<br />

change may sound simple, such as taking<br />

one antibiotic pill a day for seven days or it<br />

may sound much more complex, like taking<br />

combination antiretroviral therapy plus<br />

interleukin injections with frequent<br />

bloodwork for treatment of HIV and hepatitis<br />

C. Medical consumers, health care<br />

advocates, public health educators and<br />

medical professionals all try to understand<br />

how to facilitate behavior changes that allow<br />

us to be healthier. Whether we like change<br />

or not, it’s built into our lives. What<br />

behavioral science has learned about how<br />

successful changes occur is of value to each<br />

of us.<br />

Basic counseling skills training for peer<br />

counselors at AIDS Survival Project teaches<br />

us that what we are really learning is to<br />

understand what our members want to<br />

change in their lives and how to then be<br />

helpful in the development of a plan to make<br />

that change appropriate, effective and long<br />

lasting – not a simple task! The model we<br />

use is called the Stages of Change Theory.<br />

It was developed specifically in response to<br />

the need to promote lifelong changes in<br />

health-related behaviors. It is useful for a<br />

peer counselor working with someone trying<br />

to adhere to a complicated treatment<br />

regimen, a friend or family member<br />

struggling to deal with an addicted person or<br />

for us to reflect on when we want to make a<br />

change in any aspect of our own life. I invite<br />

you to consider a change you’ve consciously<br />

made in your life or one you would like to<br />

create in the framework of this theory. It<br />

can provide encouragement, a map and grace<br />

if you feel impatient about the speed or<br />

success of the change that you seek.<br />

The Stages of Change Theory as<br />

described by Prochaska, DiClemente and<br />

While quick, stress-free change looks appealing and easy<br />

(if you have enough money) the truth is that change does<br />

not come easily to most people. Often, we don’t feel like<br />

we get to select change – instead we feel like change<br />

happens to us and then we react to it. As it’s been said,<br />

some people change when they see the light, others when<br />

they feel the heat.<br />

Norcross has five stages. The length of the<br />

stages and the process of moving from one<br />

to the other (including sometimes back to an<br />

earlier one!) vary from one person to another.<br />

The first stage is Precontemplation. During<br />

this period a person does not identify<br />

themselves as having a particular problem<br />

(although others around them might), so the<br />

person has no thoughts or intention of<br />

change. In the period of Contemplation a<br />

person realizes that there is something they<br />

want or need to change. Now the person<br />

begins to think about what the problem is<br />

and how they feel about it. Their awareness<br />

is heightened and they are sensitive to<br />

information related to a certain behavior.<br />

From here a person may move to Preparation<br />

for Action, when they come to a decision to<br />

make a change in a relatively short period of<br />

time (around a month) and may begin to<br />

make plans of how they will enact a new<br />

behavior. When someone moves into the<br />

Action stage they are consistently engaging<br />

in the behavior that they want to have become<br />

a new part of their life. The Maintenance<br />

stage is reached when the person is fully<br />

carrying out their new behavior for longer<br />

than six months.<br />

Few changes in our lives go quite as<br />

smoothly as this very, very simplified<br />

description of the theory might seem to<br />

imply. If you’ve ever tried to quit smoking,<br />

for instance, you’ve probably experienced<br />

every one of these stages, plus one called<br />

Recycling, where you’ve returned to an<br />

earlier stage, such as smoking again (but<br />

feeling more guilty!). Many people struggle<br />

with a behavior such as smoking throughout<br />

their lives, moving throughout these stages,<br />

each time a little differently. In terms of<br />

smoking cessation, people often try different<br />

techniques in the Preparation and Action<br />

stages, such as using a nicotine patch,<br />

aversion therapy, positive reinforcement or<br />

limiting the number of cigarettes or the<br />

places where they smoke.<br />

Understanding that behavior changes<br />

occur through stages can be enlightening to<br />

people managing their HIV infection.<br />

As people infected or affected by<br />

HIV we can give each other and<br />

ourselves the support we need to<br />

make constructive, long lasting<br />

changes by providing time, support,<br />

knowledge and encouragement to<br />

develop healthier habits. The<br />

practice of consistent adherence to<br />

medication schedules, safer sex<br />

--Mary Lynn Hemphill techniques, good nutrition, stress<br />

relief, recovery from addictions and<br />

healthy self-care skills do not emerge<br />

fully formed. These practices take time,<br />

patience and resilience because they develop<br />

through change. Next month this column<br />

will share some of the methods that<br />

encourage conscious change. <br />

The Grady Infectious Disease<br />

Program (IDP)<br />

has a new<br />

Client Advisory Committee.<br />

Any IDP client is invited to<br />

participate.<br />

Meetings are held on the first<br />

Thursday of each month at<br />

1:00 p. m. in the P- 40<br />

Conference Room.<br />

The IDP is located at 341<br />

Ponde de Leon Avenue,<br />

Atlanta, GA<br />

For further details call<br />

Carla Johnson at<br />

404-616-9740<br />

4 SURVIVAL NEWS


The Resource<br />

Train<br />

Sarah Biel-Cunningham,<br />

MSW<br />

sbiel@aidssurvivalproject.org<br />

A system of support is crucial for<br />

individuals living with HIV to strengthen<br />

their coping strategies when dealing with<br />

this disease. This support is often provided<br />

by informal caregivers who give individuals<br />

living with HIV with physical, emotional<br />

and spiritual care in dealing with the effects<br />

of HIV on their daily lives. These informal<br />

caregivers include significant others, parents,<br />

siblings, children and friends. Being a<br />

caregiver can be a most rewarding<br />

experience. There is a feeling of fulfillment;<br />

which comes from being able to support the<br />

HIV-positive person during<br />

difficult times. This shared<br />

experience makes the hardships<br />

of the process more bearable. We<br />

recognize the importance of social<br />

support system for individuals<br />

living with HIV, however there is<br />

also a necessity to understand the<br />

need for asuch a system for the caregiver.<br />

Providing care for someone with HIV can<br />

be a stressful experience making a network<br />

for caregivers a crucial component of<br />

buffering the process of giving care.<br />

Social support is an important buffer<br />

for caregivers of people living with HIV/<br />

AIDS. In an article entitled “Caregivers’<br />

Experiences of Informal Support in the<br />

Context of HIV/AIDS”, the research<br />

explores aspects of the caregivers’<br />

experiences and identifies that stress for<br />

caregivers is a result of not fully<br />

understanding the changes that occur with<br />

HIV. Caregivers do not necessarily<br />

understand the impact HIV can have on the<br />

body. This lack of information can create a<br />

potentially stressful situation between the<br />

person being cared for and the person giving<br />

care. The research acknowledges that this<br />

directly results in withdrawal of the caregiver<br />

from his or her social network because of<br />

what is perceived by the caregiver as a<br />

stigma surrounding HIV/AIDS and fear of<br />

discrimination and ostracism.<br />

Unfortunately, there are only a limited<br />

number of resources specifically designed<br />

to help the caregiver deal with the effects of<br />

HIV. Many of the support systems available<br />

deal broadly with caregivers in general and<br />

are not specifically related to individuals<br />

who are caregivers for people living with<br />

The Support Needs of Caregivers<br />

HIV. According to “The Impact of HIV on<br />

Caregivers”-- an article discussing the<br />

support needs of caregivers working with<br />

individuals who are living with HIV--often<br />

information and resources from Alzheimer’s<br />

organizations were applied to caregivers of<br />

individuals who are HIV-positive. While<br />

this is important information for those who<br />

need a basic understanding of being a<br />

caregiver, the generalization from other<br />

populations to individuals living with HIV<br />

is not always appropriate. For example,<br />

there is a marked difference in age among<br />

the two groups. Individuals living with<br />

HIV/AIDS most are often younger than<br />

those who suffer from Alzheimer’s. Also,<br />

medical information about HIV changes<br />

more frequently than medical information<br />

Social support is an important buffer for caregivers of people<br />

living with HIV/AIDS.<br />

--Sarah Biel-Cunningham<br />

related to Alzheimer’s making it difficult<br />

for a caregiver to stay abreast on the new<br />

medical information available. Another<br />

factor inhibiting generalization is HIV/AIDS<br />

also carries a stigma not attached to other<br />

diseases. There are several reasons why<br />

support networks for caregivers working<br />

with individuals who are HIV-positive must<br />

be developed to specific account for these<br />

issues specific to HIV.<br />

Limited choices for accessing the external<br />

support means there is no support system<br />

which addresses the needs of caregivers<br />

working with individuals who are HIV. For<br />

this reason, many caregivers are turning<br />

towards an informal system made up of one or<br />

two confidants whom they feel can be trusted<br />

with the stresses happening within their lives.<br />

The need to model a community care system<br />

has become necessary. The support of a<br />

community in which a caregiver may feel<br />

accepted and comfortable will allow them<br />

to access the support needed to buffer the<br />

stresses experienced from such a role.<br />

Through the support of a community<br />

individual caregivershave the opportunity<br />

to become educated about HIV; thus helping<br />

dispel some of their fears about HIV and<br />

allowing them to become more open in<br />

other parts of their lives. Such community<br />

support has the potential to broaden the<br />

informal support network.<br />

I would be remiss if I didn’t take an<br />

opportunity to mention one resource for<br />

caregivers that is available within our<br />

community. THRIVE! Weekend is an<br />

educational weekend the goal of which is to<br />

inform to the community about HIV while<br />

providing an open and accepting environment<br />

for individuals to their informal support<br />

network. The information provided during<br />

THRIVE! Weekend is not only meant for<br />

individuals living with HIV. We encourage<br />

family, friends, caregivers and community<br />

members to experience our educational<br />

weekend to learn more about HIV/AIDS.<br />

As mentioned above, one of the leading<br />

causes of stress for caregivers is not<br />

understanding HIV, the effects HIV has on the<br />

body and not knowing what one can do to help<br />

counteract these effects.<br />

During the weekend, there is<br />

also the opportunity to meet<br />

other individuals who may<br />

be in the same position as<br />

you. There is a breakout group<br />

called Family, Friends, and<br />

Caregivers with a underlying<br />

theme of helping caregivers care for themselves<br />

so that they can better care for other. This is a<br />

prime opportunity to help caregivers that realize<br />

there is an informal support network out there<br />

in that community which understands and<br />

works to help those who are living with HIV.<br />

I encourage you to come to THRIVE! to<br />

experience the support available to help<br />

everyone, even those caring for others! <br />

Common Ground<br />

1053 Juniper Street<br />

Atlanta, GA 30309<br />

Daily Group Session<br />

11:00 a.m.until Noon<br />

with lunch following<br />

&<br />

Tuesdays<br />

1:00 p.m.<br />

Group Psychotherapy<br />

with Dr. Jennifer Smith<br />

&<br />

Thursdays<br />

2:00 p.m.<br />

LaGender Group for Transgendered<br />

and those interested.<br />

&<br />

Fridays<br />

10:00 a.m. - 2:00 p.m. individual<br />

Counseling Sessions<br />

by Dr. Lewis Myers<br />

For further information call:<br />

Michael Brunson at<br />

404-874-6425<br />

May/June 2003 5


Reaching<br />

Out!<br />

Sheryl Johnson<br />

sjohnson@aidssurvivalproject.org<br />

May is the time of year we celebrate all<br />

mothers and this month I want to talk about<br />

some issus surrounding HIV/AIDS that have<br />

particular relevance for mothers. Recently,<br />

the U.S. Centers for Disease Control (CDC)<br />

announced a new strategy urging HIV testing<br />

for all pregnant women. Dr. Julie Gerberding<br />

has said in a recent interview that “with the<br />

number of new HIV cases hovering around<br />

40,000 annually. . .it is time for physicians<br />

to screen for HIV in the same way they do<br />

for other [chronic] conditions such as<br />

diabetes or hypertension”. Dr. Anthony<br />

Fauci, director of the National Institute of<br />

Allergy and Infectious Diseases notes, “the<br />

guidelines represent a much more aggressive<br />

approach toward HIV prevention, nationally.<br />

We know that the majority of people,<br />

when they know they’re infected will<br />

become much more careful with their<br />

sexual partners. Testing is the gateway<br />

to a realization of the problem” (New<br />

York Times, April 17, 2003)<br />

These guidelines represent a<br />

current trend toward focusing on<br />

women and their particular treatment<br />

issues. Perinatal transmission is not<br />

the only issue that concerns women and<br />

especially those infected with HIV/AIDS.<br />

Other topics that are currently under<br />

investigation include: transmission of HIV<br />

through breastfeeding, Co-infection of HIV<br />

and Herpes Virus 8 (HHV-8), immune<br />

responses to an HIV vaccine in infants born<br />

to infected mothers, inflammation in the<br />

female genital tract and vaginal HIV viral<br />

shedding, and bone mineral density in HIVinfected<br />

women. In addition, there is a<br />

growing campaign to bring attention to the<br />

potential development of microbicides for<br />

use in vaginal protection against HIV<br />

infection.<br />

Investigation of this subject alone is turning<br />

the contraceptive world on its ear as women see<br />

the opportunity to have a greater say in protecting<br />

themselves from getting infected.<br />

With statistics regarding infection rates<br />

from heterosexual contact steadily on the<br />

rise, researchers are paying more attention<br />

to factors such as; viral load level of the<br />

male partner, the presence of sexually<br />

transmitted diseases (STDs) and genital<br />

ulcers in either partner, trauma during<br />

intercourse, cervical ectopy and<br />

circumcision status of the male partner. The<br />

question of whether or not oral<br />

contraceptives increase the risk for infection<br />

is also being examined. How HIV is affected<br />

by the aging process, including the onset of<br />

menopause is yet another question for which<br />

there are no set answers.<br />

With all this to consider, there is a<br />

woman here in Atlanta, who has taken on as<br />

her mission the task of educating people,<br />

especially those of <strong>African</strong> descent, with<br />

the goal of decreasing HIV statistics and<br />

promoting healthy life choices. I am<br />

speaking of Zina Age and her nonprofit<br />

company, ANIZ, Inc. (that’s Zina spelled<br />

backwards). Zina established her<br />

organization as a 501c3 entity that would<br />

empower children and adults, providing<br />

professional support and therapeutic<br />

intervention. A primary goal of ANIZ is to<br />

be a resource to <strong>African</strong>-Americans as well<br />

as other underserved populations and to<br />

those organizations dedicated to meeting<br />

their needs. ANIZ maintains that “as<br />

<strong>African</strong>-American mental health<br />

professionals, we know the needs, we<br />

understand the barriers and we know how to<br />

affect change within our community”.<br />

ANIZ’s programs include ROSHA:<br />

Reaching Out to Sisters with HIV/AIDS;<br />

AFLASH: Adolescent Females Learning<br />

About Healthy Living; MOHSS: Men of<br />

Hope Social Service Program; Mental Health<br />

Services; Substance Abuse Supportive<br />

Services; Screening and Assessment; groups<br />

for HIV infected/affected youth; children’s<br />

education, risk reduction and therapeutic<br />

intervention; case management services;<br />

respite care for children; health education<br />

information; grief and loss services and<br />

program development. They have also<br />

recently started a support group initiative<br />

for members of the transgendered<br />

community and their supporters.<br />

Although I would like to highlight them<br />

all, I must adhere to space considerations.<br />

However I would like provide detailed<br />

ANIZ Offers Support<br />

A primary goal of ANIZ is to be a resource to <strong>African</strong>-<br />

Americans as well as other underserved populations and<br />

to those organizations dedicated to meeting their needs.<br />

--Sheryl Johnson<br />

information about a few of ANIZ’s<br />

programs;<br />

AFLASH is a gender-specific HIV/<br />

AIDS prevention/risk reduction program<br />

for females at risk for HIV/AIDS and other<br />

sexually transmitted diseases. AFLASH<br />

touches the lives of young women through<br />

intensive risk reduction education and<br />

intervention. The program encompasses<br />

individual counseling, focused small group<br />

sessions, risk assessment and HIV testing to<br />

provide the support young women need to<br />

identify and alter behavior that puts them at<br />

risk of contracting HIV and other sexually<br />

transmitted diseases.<br />

ROSHA is an innovative program<br />

created by Aniz to support HIV positive<br />

<strong>African</strong> American women dealing with<br />

substance abuse and mental health issues.<br />

ROSHA’s no cost, integrative substance<br />

abuse and mental health program is offered<br />

three days a week. Free childcare for minor<br />

children is provided when necessary.<br />

“We Want to Know” is a six-week<br />

prevention education program designed<br />

to increase HIV/AIDS knowledge and<br />

awareness among youth ages 5-16. “We<br />

Want to Know” operates on the premise<br />

that young people have a right to know<br />

the truth about this devastating disease<br />

and it’s potential to rob them of their<br />

health and their youthful innocence.<br />

Groups for HIV Infected/Affected<br />

Youth - these are support groups specifically<br />

designed to provide a safe haven for HIV<br />

infected/affected youth. Children (ages 5-<br />

12) and teenagers (ages 13-17) gather to<br />

discuss the challenges presented by HIV,<br />

receive critical HIV/AIDS education and<br />

offer support to one another. Professional<br />

staff facilitate emotional support and<br />

guidance to youth seeking a safe and<br />

supportive environment in which to grow<br />

and heal.<br />

Finally, as an organization focused on<br />

HIV/AIDS, ANIZ fully understands the<br />

importance of facing grief and loss. Their<br />

grief and loss program includes supportive<br />

therapy for individuals and their families.<br />

Therapy and pre-planning support helps<br />

individuals and families cope with a terminal<br />

illness and with death. Family, individual<br />

and group therapy is also effective for<br />

working with and through the grief that<br />

comes after the death of a loved one. ANIZ’s<br />

grief and loss services address the additional<br />

stress that loss places on individuals living<br />

with HIV/AIDS and substance abuse. <br />

6 SURVIVAL NEWS


Cruising with<br />

Lazarus<br />

David Salyer<br />

cubscout@mindspring.com<br />

Rolling Stone is an odd magazine –<br />

sort of a rock/pop/rap biweekly featuring<br />

music news and interviews along with<br />

regular investigative reports on subjects<br />

as diverse as heroin use and presidential<br />

elections. It’s always been a publishing<br />

hybrid in search of relevancy and prestige,<br />

not unlike Playboy – a magazine that’s<br />

really all about naked women and sex<br />

despite regular bits of serious journalism.<br />

Some men claim to read Playboy for the<br />

articles; how lucky for them that the words<br />

are squeezed between photos of airbrushed<br />

babes in their<br />

birthday suits.<br />

Similarly, Rolling<br />

Stone tends to feature<br />

pop and hip-hop stars<br />

wearing next-tonothing<br />

while<br />

simultaneously<br />

running articles<br />

designed to give the<br />

magazine an illusion of substance and<br />

depth. It’s a rather calculated pitch for<br />

relevance that, more often than not, reeks<br />

of desperation.<br />

Take Rolling Stone’s February 6th<br />

issue, for instance. Shania Twain graces<br />

the cover. Directly to the right of her<br />

exposed navel and slightly higher than<br />

her awfully short skirt, is a little graphic<br />

touting a special report on “bug chasers,”<br />

gay men who say they want to get infected<br />

with HIV. Yes, these men exist. It’s a<br />

minor phenomenon of the last decade.<br />

It’s real. It’s controversial. HIV<br />

prevention advocates and public health<br />

officials acknowledged “bug chasers” at<br />

least four years ago. Credible studies<br />

estimate that one to two percent of infected<br />

gay men sought out infection, nearly<br />

always in rash behavioral decisions that<br />

they later regretted. Oops. That sage<br />

medical journal, Rolling Stone, doesn’t<br />

care much about any of that…unless<br />

twisting and distorting it can generate<br />

greater newsstand sales.<br />

Rolling Stone’s bug chaser article was<br />

written by Gregory A. Freeman, a married<br />

freelance writer and former Associated<br />

Press employee currently living in<br />

H I VIEWPOINTS<br />

Chasing Bugs or the Truth?<br />

Roswell, Georgia. According to<br />

Freeman’s bio, he’s “an award-winning<br />

writer with 20 years experience in<br />

journalism and historical nonfiction.” A<br />

graduate of the University of Georgia and<br />

author of two books, his publicist asserts<br />

that “Freeman’s books are scrupulously<br />

researched and entirely factual, yet they<br />

read more like novels because he weaves<br />

the personal stories of his subjects into a<br />

compelling narrative.” Hmmm.<br />

According to Freeman’s Rolling<br />

Stone article, a mind-boggling 25 percent<br />

of new gay male HIV infections are due to<br />

bug chasing. And Freeman bases that<br />

astonishing statistic on one doctor’s<br />

completely unsubstantiated estimate. That<br />

doctor, Bob Cabaj, is a psychiatrist and<br />

Freeman’s story has completely fallen apart. How many actual bug chasers did he<br />

interview? A grand total of two, one of who is undeniably mentally disturbed and quoted<br />

under a pseudonym – hardly representative of a trend.<br />

--David Salyer<br />

Director of Behavioral Health Services<br />

for San Francisco County. Within days of<br />

publication, Cabaj denied giving Freeman<br />

the 25 percent figure. Admitting he has<br />

conducted no studies on the matter and<br />

has no hard data, Cabaj told Newsweek,<br />

“That’s totally false. I never said that.” Is<br />

there a study to support that 25 percent<br />

figure? Nope.<br />

It gets worse. Dr. Marshall Forstein<br />

of Boston, quoted by Freeman as saying<br />

that “bug chasers are seen regularly in the<br />

Fenway health system, and the<br />

phenomenon is growing,” declares the<br />

quote “is entirely a fabrication.” Forstein<br />

reports he actually told Freeman, “We<br />

have seen a few cases, but we have no idea<br />

how common this is.” Who do we believe?<br />

Conveniently, Freeman did not tape his<br />

conversations with the doctors, suggesting<br />

maybe his memory and his notes aren’t as<br />

specific as he’d like the general public to<br />

believe.<br />

Freeman’s story has completely fallen<br />

apart. How many actual bug chasers did<br />

he interview? A grand total of two, one of<br />

who is undeniably mentally disturbed and<br />

quoted under a pseudonym – hardly<br />

representative of a trend. Freeman’s article<br />

consists of one anonymous source; one<br />

named source; two doctor’s completely<br />

unsubstantiated remarks; and lurid details<br />

from some Internet websites (the kind of<br />

websites where virtually all gay men are<br />

hot and generously endowed). When the<br />

only two medical professionals you quote<br />

both claim to have been grievously<br />

misquoted and none of the major AIDS<br />

and gay activists interviewed agree that<br />

bug chasing is a major phenomenon, let<br />

alone responsible for 25 percent of all<br />

new HIV infections, you don’t have a<br />

story. Appa rently, that did not deter<br />

Gregory Freeman from making one up.<br />

That aside, Freeman’s estimate of the<br />

number of bug chaser-related cases of<br />

HIV infection ultimately discredits him.<br />

The Centers for<br />

Disease Control<br />

(CDC) reports that<br />

there are roughly<br />

40,000 new HIV<br />

infections in the<br />

United States each<br />

year. For his<br />

calculations,<br />

Freeman uses the<br />

made up 25 percent figure and merely<br />

applies it to the CDC’s 40,000 statistic.<br />

From that, he concludes that 10,000 gay<br />

men a year are deliberately getting infected<br />

with HIV.<br />

Apparently, Freeman failed to realize<br />

the 40,000 statistic is for all people, male<br />

and female, regardless of sexual<br />

orientation. According to the CDC, maleto-male<br />

infections only make up 42 percent<br />

of the overall 40,000, or roughly 16,800.<br />

Not only does Freeman’s 25 percent figure<br />

have no basis in reality, but he also applies<br />

it to a statistic he doesn’t even understand.<br />

America’s mainstream media has<br />

never been very good at reporting on HIV.<br />

Gregory Freeman’s Rolling Stone article<br />

on bug chasers is a vivid example of how<br />

not to write a story about HIV, and yet it’s<br />

typical. The interpretation of HIV<br />

statistics requires scientific precision;<br />

Freeman is all about buzzwords, faulty<br />

number crunching and groundless<br />

conclusions.<br />

Note to Mr. Freeman: In the future,<br />

tape your interviews, leave the stories<br />

about HIV and gay men to qualified<br />

continued on page 8<br />

May/June 2003 7


Bugs, continued from page 7<br />

journalists and consider writing about<br />

cars or sports or Victoria’s Secret models<br />

from now on…unless your goal is to<br />

develop a reputation as a unethical,<br />

homophobic dumb ass.<br />

Why would Rolling Stone print such<br />

a shamefully distorted article full of<br />

fabricated quotes and fake science?<br />

Having already lost its identity and now<br />

losing readers to hipper publications,<br />

Rolling Stone is using shoddy journalism<br />

and semi-naked pop stars to generate<br />

interest. Bug chasers are real and the<br />

phenomenon deserves scrutiny. Who<br />

are these guys that want HIV in their<br />

bodies? Are they confused individuals<br />

who put too much faith in today’s HIV<br />

treatments? Or desperately lonely guys<br />

who would trade their health for any<br />

kind of intimacy or sense of belonging?<br />

Do they believe HIV infection is<br />

inevitable anyway and have given up<br />

on safer sex? Are they self-loathing?<br />

Mentally ill? Why would they<br />

knowingly put themselves in harm’s<br />

way? Are they hedonistic guys who just<br />

EMORY UNIVERSITY SCHOOL OF MEDICINE<br />

FOR WOMEN ONLY<br />

VOLUNTEERS NEEDED FOR HUMAN<br />

PAPILLOMAVIRUS (HPV) RESEARCH STUDY<br />

Are you:<br />

• HIV positive?<br />

• Age 18 or older?<br />

• Someone never having been on HIV drugs but<br />

willing to start witrhin<br />

14 days of entering the study?<br />

• without a history of cirvical cancer?<br />

Women with HIV often have another virus called the human<br />

papillomavirus (HPV), which can cause genital infections,<br />

warts and cervical cancer.<br />

You are invited to participate in a 3-5 year research study to learn if<br />

taking HIV drugs will affect the HPV in women who have just started<br />

taking Highly Active Antiretroviral Therapy (HAART) for the first time.<br />

If you have HPV now, the study will look to see if your HIV drugs have<br />

any effect on the amount of HPV in your body. If you do not have HPV<br />

now, the study will look to see if you get HPV while taking HIV drugs.<br />

Pap smears will be done at each study visit and volunteers will be<br />

compensated for their time.<br />

For more information contact:<br />

Dale P. Maddox, LCSW<br />

404/616-6333<br />

Ponce IDP Center<br />

341 Ponce de Leon<br />

3 rd Floor<br />

Atlanta, GA 30308<br />

don’t care about anything beyond their<br />

next orgasm? Rolling Stone was not<br />

compelled to explore those possibilities.<br />

The editor and publisher opted to print a<br />

preposterous, wildly exaggerated piece of<br />

crap that could only be relevant to right<br />

wing, fundamentalist, gay-hating crazies<br />

looking for a new opportunity to denigrate<br />

homosexuals and call for AIDS funding<br />

cuts.<br />

Note to Rolling Stone: stick to<br />

reviewing CDs and interviewing boy band<br />

members – or better yet, let’s hear you<br />

expound upon whatever lurid logic or<br />

compulsion makes pop divas like Shania<br />

Twain and Britney Spears tart themselves<br />

up like hookers for an appearance on<br />

your cover. Sounds juicy! <br />

David Salyer is an HIV-positive<br />

journalist and AIDS educator living in<br />

Atlanta, Georgia. He is a Georgia cochair<br />

of the Global <strong>Campaign</strong> for<br />

Microbicides, leads safer sex<br />

presentations for men and has facilitated<br />

workshops for people infected or affected<br />

by HIV since 1994. Reach him by e-mail at<br />

cubscout@mindspring.com.<br />

AIDS<br />

SURVIVAL<br />

PROJECT<br />

EMORY UNIVERSITY SCHOOL OF MEDICINE<br />

Are you:<br />

• HIV Positive?<br />

• 18 years of age or older?<br />

• Been on anti-HIV drugs for at least one year ?<br />

• Have taken a protease inhibitor for at least 12 weeks ?<br />

• HIV viral load is greater than 5000 copies?<br />

• Not taken both Agenerase and Kaletra?<br />

The Emory AIDS Clinical Trials Unit is studying three different HIV drug combinations to<br />

see which one works better to fight HIV. One drug regimen contains three<br />

protease inhibitors (PI) and the others contain two PI’s. Each<br />

combination will be taken with one or two nucleoside drugs (NRTIs) that<br />

are chosen by your doctor. The NRTIs are not provided by the study.<br />

Volunteers will receive either:<br />

1) Kaletra + Viread (tenofovir) and one or two other nucleoside<br />

drugs.<br />

2) GW433908 +Norvir (ritonavir) +Viread + one or two other drugs.<br />

3) Kaletra + GW433908 + Viread + one or two other drugs.<br />

NOTE: GW433908 is a new form of amprenavir (AgeneraseTM) that<br />

includes smaller and fewer pills than the current AgeneraseTM, but it has<br />

not been FDA-approved.<br />

This 48-week reseach<br />

study is now seeking<br />

volunteers to enroll!<br />

For more information<br />

contact:<br />

Dale P. Maddox, LCSW<br />

404/616-6333<br />

Ponce IDP Center<br />

341 Ponce de Leon<br />

3 rd Floor<br />

Atlanta, GA 30308<br />

8 SURVIVAL NEWS


Treatment<br />

News<br />

Dan Dunable<br />

ddunable@aidssurvivalproject.org<br />

SARS and HIV<br />

SARS, or severe acute respiratory<br />

syndrome, is a respiratory illness that<br />

has been reported in 28 countries as of<br />

press time for this issue of Survival<br />

News. At this time there have been over<br />

5000 probable cases of SARS reported,<br />

with 321 deaths believed to be caused<br />

by this illness.<br />

SARS has not yet been associated<br />

with HIV, however it is logical to assume<br />

that individuals with compromised<br />

immune systems will be more<br />

susceptible to SARS should they become<br />

exposed to it. Luc Montagnier, the<br />

French biologist who was the joint<br />

discoverer of HIV, and the president of<br />

the World Foundation for<br />

AIDS Research and<br />

Prevention, spoke about<br />

SARS during a press<br />

conference in Tokyo on April<br />

21, where he expressed fear<br />

that the death rates from<br />

SARS will be much higher<br />

among people who also have<br />

HIV/AIDS. Montagnier also<br />

suggested that people exposed to the<br />

virus should reinforce their immune<br />

system with antioxidants and immunostimulants.<br />

Ray Yip, head of AIDS prevention<br />

for the UNICEF China office has said<br />

that if SARS hits areas populated with<br />

high rates of HIV-infected individuals,<br />

those individuals who are HIV-positive<br />

will quickly die from the combined<br />

viruses. Hu Jia, executive director of<br />

the Beijing-based AIDS prevention<br />

group, Aizhixing Institute of Health<br />

Education has stated that the death rates<br />

from SARS may be approximately 4%<br />

(as of mid-April), but if it gets to AIDS<br />

villages in China, it could jump to as<br />

high as 30-40%.<br />

How is SARS Spread?<br />

It is currently believed that SARS is<br />

spread by close person-to-person<br />

contact, with most cases of SARS<br />

involving people who care for or live<br />

THE TREATMENT PAGES<br />

with someone with the illness, or who<br />

had direct contact with infectious<br />

materials from a person who has SARS.<br />

According to the CDC, potential ways<br />

in which SARS can be spread include<br />

touching the skin of other people or<br />

objects that are contaminated with<br />

infectious droplets and then touching<br />

your eyes, nose or mouth.<br />

So far, it is believed that people<br />

who have SARS are most likely to be<br />

infectious when they have symptoms,<br />

such as fever and/or cough. However,<br />

it is not known how long before or after<br />

these symptoms occur that patients<br />

might be able to transmit the disease to<br />

other individuals.<br />

In the United States, most cases of<br />

SARS are directly attributable to people<br />

who have either traveled to one of the<br />

countries having the highest number of<br />

suspected cases of SARS, most notably<br />

China, or having come in direct contact<br />

with an infected person.<br />

SARS has not yet been associated with HIV, however it is<br />

logical to assume that individuals with compromised immune<br />

systems will be more susceptible to SARS should they become<br />

exposed to it.<br />

--Dan Dunable<br />

What are the symptoms of SARS?<br />

SARS usually begins with a fever<br />

greater than 100.4 degrees Fahrenheit,<br />

sometimes accompanied by chills,<br />

headache, general feeling of discomfort<br />

and body aches. After 2 to 7 days,<br />

SARS patients may also develop a dry,<br />

non-productive cough. In a small<br />

percentage of these cases, 10 – 20<br />

percent, patients may progress to a point<br />

where insufficient oxygen is getting to<br />

the blood and they require mechanical<br />

ventilation.<br />

What is the cause of SARS?<br />

It is believed that a type of virus<br />

called a coronavirus is the cause of<br />

SARS. Coronaviruses are a common<br />

cause of mild to moderate upperrespiratory<br />

illness in people. Scientists<br />

have found a new coronavirus in<br />

patients with SARS, and this is currently<br />

believed to be the cause of SARS,<br />

however other viruses are still under<br />

investigation as possible causes of<br />

SARS.<br />

How is SARS treated?<br />

Currently, it is not known what the<br />

best treatment is for SARS. Some areas<br />

have tried antivirals such as oseltamivir<br />

or ribavirin, but with no clinical trials to<br />

date, the effectiveness of these regimens<br />

are still unknown. Early information<br />

reported by the CDC suggests that<br />

ribavirin does not inhibit virus growth.<br />

Additional laboratory testing of<br />

ribavirin and other antiviral drugs is<br />

being done. Many researchers and<br />

laboratories that have been dedicated to<br />

HIV treatment research are now being<br />

used for research into the treatment of<br />

SARS.<br />

How can we protect ourselves form<br />

SARS?<br />

The main protection is to avoid close<br />

contact with someone who already has<br />

SARS. Cases of SARS are reported<br />

primarily among people who<br />

have direct close contact with<br />

and infected person, such as<br />

those sharing a household and<br />

health-care workers caring for<br />

those infected. There are now<br />

standard infection control<br />

procedures recommended for<br />

health-care workers to avoid<br />

further transmission of the virus.<br />

Transmission has frequently<br />

occurred in those people who have<br />

traveled to areas where SARS is in<br />

higher numbers, primarily Hong Kong,<br />

Hanoi, Singapore and Mainland China.<br />

There have been numerous travel<br />

advisories recommending that travelers<br />

postpone all nonessential travel to these<br />

areas. For additional information about<br />

travel advisories and alerts, visit the CDC<br />

and WHO websites listed below .<br />

(Also, see SARS Timeline on page 10)<br />

For Further<br />

Information:<br />

Centers for Disease Control SARS<br />

site http://www.cdc.gov/ncidod/<br />

sars/<br />

World Health Organization SARS<br />

site /en/” http://www.who.int/csr/<br />

sars/en/.<br />

May/June 2003 9


November 16, 2003<br />

The first case of an atypical pneumonia is reported in<br />

<strong>South</strong>ern China.<br />

February 26, 2003<br />

The first case of an unusual pneumonia was reported<br />

in a hospital in Hanoi, Vietnam.<br />

March 10, 2003<br />

A World Health Organization (WHO) officer, Carlo<br />

Urbani, MD, reports to the main office of the WHO that<br />

there have been an unusually high number of healthcare<br />

workers (approximately 20) becoming sick with similar<br />

symptoms in the hospital in Hanoi. The pneumonia is<br />

now beginning to be referred to as Severe Acute<br />

Respiratory Syndrome (SARS).<br />

March 11, 2003<br />

Similar outbreaks are reported in<br />

health care workers in Hong Kong.<br />

March 12, 2003<br />

WHO issues a global alert about<br />

cases of atypical pneumonia in<br />

Vietnam and China.<br />

March 15, 2003<br />

WHO issues an emergency travel<br />

advisory for SARS. They state<br />

that cases have been reported in<br />

Canada, China, Hong Kong Special Administrative<br />

Region of China, Indonesia, Philippines, Singapore,<br />

Thailand, and Vietnam. WHO also presents a case<br />

definition of SARS in this advisory.<br />

March 24, 2003<br />

The Centers for Disease Control and Prevention (CDC)<br />

announced that a previously unrecognized virus from<br />

the coronavirus family is the leading candidate for the<br />

cause of SARS.<br />

March 27, 2003<br />

WHO issues an update recommending new screening<br />

measures relating to international travel to reduce the<br />

risk of further spread of SARS.<br />

April 2, 2003<br />

WHO issues a travel advisory recommending that<br />

persons traveling to Hong Kong Special Administrative<br />

Region and Guangdong Province, China postpone all<br />

but essential travel.<br />

April 4, 2003<br />

President of the United States George W. Bush added<br />

THE TREATMENT PAGES<br />

SARS Timeline<br />

The Coraona Virus<br />

SARS to the list of quarantinable communicable<br />

diseases, the first addition to the list since 1983.<br />

April 14, 2003<br />

The Centers for Disease Control and Prevention (CDC)<br />

announced that it has sequenced the genome for the<br />

coronavirus believed to be responsible for SARS.<br />

April 18, 2003<br />

Researchers in the Emory School of Medicine in Atlanta<br />

announced that they have demonstrated the validity of<br />

a rapid laboratory test capable of determining whether<br />

a patient has SARS.<br />

April 23, 2003<br />

WHO extends SARS-related travel advice to Beijing<br />

and Shanxi Province in China and to Toronto, Canada,<br />

recommending that persons planning<br />

to travel to these destinations<br />

postpone all but essential travel.<br />

April 24, 2003<br />

Wall Street Journal reports that AIDS<br />

researcher David Ho, who runs the<br />

Aaron Diamond AIDS Research<br />

Center in New York and was a key<br />

driver of AIDS treatment approaches<br />

now in use, said he has agreed to<br />

conduct work on potential therapy<br />

and vaccine approaches for SARS.<br />

April 28, 2003<br />

WHO removed Vietnam from the list of affected areas,<br />

making it the first country to successfully contain the<br />

SARS outbreak.<br />

April 28, 2003<br />

More than 5000 cases worldwide; as of this date, a<br />

cumulative total of 5050 probable SARS cases with 321<br />

deaths having been reported from 26 countries.<br />

June 17-18, 2003<br />

WHO plans to hold an international scientific meeting in<br />

Geneva to review the epidemiological, clinical<br />

management and laboratory findings on SARS and to<br />

discuss global control strategies. A report of the meeting<br />

will be posted on the WHO website (www.who.int)<br />

following the meeting.<br />

Sources: World Health Organization (WHO), Centers<br />

for Disease Control CDC), Emory University School of<br />

Medicine, Wall Street Journal. <br />

1 0 SURVIVAL NEWS


Many folks—particularly young folks—think that HIV/AIDS<br />

has become a manageable condition. Many think that they don’t<br />

really need to worry about getting infected with HIV. If they do<br />

get infected, they just start taking pills and everything will be fine.<br />

I doubt that those with this mindset really understand the true<br />

price of living with HIV.<br />

I have been living with HIV for nearly 21 years. I was<br />

infected in 1982. To look at me one would have no idea that I was<br />

infected with HIV. It doesn’t “show” at all. There is nothing<br />

obviously physical that would give it away.<br />

I am alive and quite healthy, no infections, no illness, pretty<br />

much a “normal” life. But it’s a normalcy that comes with a price,<br />

and that price presents itself in many forms.<br />

There’s the price of just living with HIV, not knowing for how<br />

long or how much longer, not knowing whether I will be stricken<br />

with an opportunistic infection… just plain not knowing. (Although<br />

many can rightly claim that none of us knows our fate.)<br />

There’s the price of stigma. Some will not date people who<br />

are infected with HIV. Others don’t want to be around people<br />

with HIV—true even after more than two decades of HIV in the<br />

world.<br />

There’s the price of being a survivor. That brings a degree<br />

of guilt: Why am I still here when so many others have died? The<br />

other side of the price of surviving is losing those dear to you who<br />

did not survive. So grief also becomes part of the price of living<br />

with HIV.<br />

There’s the price of living with the regimen of medications<br />

I have to follow each day. Remembering to take three HIV<br />

medications in the morning… remembering which ones I can<br />

take with food, which I must take with food, which I can’t take with<br />

food. Remembering to take another round of medications at<br />

bedtime. Again, which with food, which without, which can,<br />

which can’t. Just remembering carries a price. What if I don’t<br />

remember? What if I take something twice?<br />

There’s the price of the side effects of the medications. Is<br />

what I am feeling because of the meds? Why does my stomach<br />

hurt? Why doesn’t food taste right? And then I end up taking<br />

another five medications every day to counteract the side effects<br />

of the HIV meds. What’s the impact on my body of all of this?<br />

How long will any of it last? If these stop working, what is<br />

available to replace them? Some of the drugs I once took I can<br />

no longer take. What happens when there aren’t any left that I<br />

can take?<br />

Finally, there’s the monetary cost of living with HIV. The<br />

three HIV medications I take cost $3,538.87 for a three-month<br />

THE TREATMENT PAGES<br />

Living with HIV: The Price<br />

By: E. Bruce Garner<br />

159 Ralph McGill Blvd. NE, Suite 205<br />

Atlanta, GA 30308-3311<br />

Phone: 404-659-2437 (404-659-AIDS)<br />

Toll-Free: 888-874-4845<br />

Fax: 404-659-2438<br />

Email: info@aidstreatment.org<br />

Website: www.aidstreatment.org<br />

supply of each. That’s $14,155.48 a year just for the three HIV<br />

medications. That doesn’t include the other drugs to supplement<br />

or counteract the effects of those medications. If I didn’t have<br />

excellent insurance coverage, where would I be? Who would pay<br />

the price for those medications? My visits to the doctor every four<br />

months average over $1,000.00 each. The cost of lab work alone<br />

is astronomical. But I have to have that lab work done for the<br />

doctor to know if the medications are still working or if we need to<br />

make a change.<br />

Sure, the marvels of medical science make living with HIV<br />

easier these days, but look at the price. Wouldn’t it be a lot cheaper<br />

to have never gotten infected? That wasn’t really an option when<br />

I became infected… we didn’t even know what was out there.<br />

You know what’s out there. What’s your excuse? Is it going<br />

to be worth the price for you? Is it worth the price for someone you<br />

love? Is it worth the price of a condom?<br />

It’s still worth the price of a condom for me to make sure I don’t get<br />

any further infection from HIV or give HIV to someone else. I wish<br />

the only price I had to pay was just for that condom. <br />

—Bruce Garner is a member of ATI’s Board of Directors<br />

FOCAT Discussion Group<br />

(Focus on Complementary Alternatives)<br />

facilitated by Guy Pujol and Jim Faulkner<br />

Where: Treatment Resources Center<br />

AIDS Survival Project<br />

When: 2nd Wednesday of May, June, July.<br />

May 14, 2003<br />

5:30 to 7:00 P.M.<br />

Skin Problems, Rash, Wounds and Mouth - Gum<br />

Problems<br />

June 11, 2003<br />

5:30 to 7:00 P.M.<br />

AIDS/HIV, Weakened Immune System, Herpes virus,<br />

Shingles,Bells Palsy and Cancer.<br />

July 9, 2003<br />

5:30 to 7:00 P.M.<br />

Headache, Pain, Migraine, Fibromyalgia,<br />

Angina and Backache<br />

May/June 2003 11


Chronicles<br />

(from the CDC NPIN For<br />

AIDS, STDs and TB)<br />

compiled by<br />

Ernie Evangelista<br />

Call for Review of AIDS Vaccine. AIDSVAX, the<br />

AIDS vaccine developed by VaxGen Inc. and reported<br />

to potentially have benefits for some minorities,<br />

continued to trigger debate as the company presented<br />

further analysis at the Keystone Symposia in Canada<br />

on Monday, March 31. AIDS activist groups are<br />

calling on the National Institutes of Health to<br />

independently review the company’s claim that the<br />

vaccine could hold promise for blacks and other<br />

minorities, while it failed for the mostly white study’s<br />

participants. Controversy over AIDSVAX’s results<br />

highlights not only scientific validity but also social<br />

impact. Some minorities and other groups rejected<br />

statements that the vaccine was a failure simply<br />

because it did not work for white participants. Several<br />

AIDS groups said the company was irresponsible to<br />

interpret data based on such a small group of minority<br />

participants. A coalition of seven AIDS groups support<br />

an NIH review to determine whether further studies of<br />

AIDSVAX should proceed. They also want VaxGen<br />

to release its proprietary vaccine data to an outside<br />

NIH panel to address statistical criticisms of the<br />

EMORY UNIVERSITY SCHOOL OF MEDICINE<br />

CLINICAL TRIAL FOR<br />

PREGNANT WOMEN ONLY<br />

Sometimes HIV positive pregnant women have an increase<br />

in the amount of HIV in their blood (viral load) AFTER<br />

their baby is born.<br />

The Emory AIDS Clinical Trials Unit (ACTU) invites you<br />

to participate in a clinical research trial that will try to find<br />

out how often this happens and look at some of the reasons<br />

why.<br />

Are you:<br />

•HIV Positive?<br />

• Female at least 18 year of age?<br />

• Between 22 AND 30 weeks pregnant?<br />

• Planning on taking HIV drugs for at least 8 weeks before delivery?<br />

• Willing to take HIV drugs after your baby is born?<br />

For more information contact:<br />

Dale P. Maddox, LCSW<br />

404/616-6333<br />

Ponce IDP Center<br />

341 Ponce de Leon<br />

3 rd Floor<br />

Atlanta, GA 30308<br />

company’s assertion that the vaccine may benefit<br />

certain racial groups. In a letter to Dr. Anthony<br />

Fauci, director of the NIH’s National Institute of<br />

Allergy and Infectious Diseases, coalition members<br />

called for further research should the results be<br />

proven real, but “if they are the result of an artifact,<br />

the public needs to be informed of this expeditiously<br />

so researchers and the affected communities can<br />

move on to explore more promising vaccine<br />

approaches.” Calling for a “very, very thorough,<br />

unbiased good look” at the VaxGen data, Fauci said<br />

he will assemble a panel that complies with activists’<br />

requests for significant minority representation.<br />

Should the panel find potential benefits, funding of<br />

another trial would be discussed. VaxGen<br />

spokesperson Lance Ignon said that the March 31<br />

unveiling would be one of many chances for the<br />

scientific community to review AIDSVAX data, and<br />

he added that the company would comply with an<br />

NIH review.<br />

Merck and Aventis Combine AIDS Drugs. Merck<br />

& Co. and Aventis SA are combining their AIDS<br />

vaccine candidates in a joint human test in the<br />

United States that will begin later this year. For<br />

reasons neither company understands, monkeys<br />

that were injected first with the Merck vaccine and<br />

then later with the Aventis medicine achieved a<br />

EMORY UNIVERSITY SCHOOL OF MEDICINE<br />

ARE YOU HIV-POSITIVE<br />

AND HAVE NEVER TAKEN HIV MEDICATIONS?<br />

The Emory AIDS Clinical Trials Unit is enrolling volunteers for a<br />

2 to 3 year research trial to study three different HIV drug<br />

combinations.<br />

The purpose of this study is to compare three different anti-HIV<br />

drug regimens as first-time treatments for HIV infection. The<br />

study will look at the effectiveness and safety of the three drug<br />

regimens and how well these regimens are tolerated.<br />

Are you:<br />

HIV positive?<br />

18 years of age or older?<br />

Never taken HIV drugs?<br />

With a viral load of 2000 or<br />

greater?<br />

better immune response than monkeys given either<br />

vaccine separately or in reverse order. “It’s very<br />

clear that there’s a certain order of these candidates<br />

that’s preferred,” said Dr. John Shiver, Merck’s HIV<br />

vaccine program head. Aware that hopes for vaccine<br />

candidates have been raised and dashed numerous<br />

times, Shiver warned that the Merck and Aventis<br />

vaccine programs and newly combined effort are<br />

still in their early stages. Merck’s vaccine candidate<br />

is a modified version of a cold virus, while the Aventis<br />

candidate comes from the pox family. Merck called<br />

the French-German company to see if they could<br />

test them together. Late last year, data started to<br />

develop that a certain combination seemed to work<br />

well, Shiver said. “This is not a sign of desperation”<br />

that the companies are testing their vaccine<br />

candidates together, said Shiver. Both companies<br />

are also continuing vaccine development<br />

independently. Merck is now testing a vaccine in<br />

1,300 HIV-positive and HIV-negative volunteers in<br />

70 clinical sites.<br />

AIDS Drug in Halted Trial Is Less Effective Taken<br />

Alone. The US National Institutes of Health halted<br />

the trial of GlaxoSmithKline’s AIDS drug Trizivir after<br />

it proved less effective than when used in combination<br />

with another AIDS drug, the company said. A Glaxo<br />

spokesperson said the NIH’s AIDS clinical trial<br />

Volunteers will receive either:<br />

1. Kaletra + Sustiva<br />

2. Kaletra + Zerit XR (extended<br />

release)<br />

(or AZT) + Epivir<br />

3. Sustiva + Zerit XR (extended<br />

release)(or AZT) + Epivir<br />

For more information contact:<br />

Dale P. Maddox, LCSW<br />

404/616-6333<br />

Ponce IDP Center<br />

341 Ponce de Leon<br />

3 rd Floor<br />

Atlanta, GA 30308<br />

Note: Only Kaletra, Sustiva and<br />

Zerit XR will be provided by the<br />

study.<br />

1 2 SURVIVAL NEWS


Chronicles, continued from page 12<br />

conducted three studies in parallel, one of which<br />

tested patients taking just Trizivir. In two further<br />

studies, some patients took a combination of the<br />

Bristol-Myers Squibb Co. drug Sustiva with Trizivir,<br />

while others took a combination of Glaxo’s drug<br />

Combivir with Sustiva. NIH decided to stop the<br />

Trizivir-only trial because only 74 percent of patients<br />

had a viral load of less than 200 after 48 weeks. In<br />

the other two trials, 89 percent of patients achieved<br />

a viral load of less than 200.<br />

Software for AIDS Virus Research Has <strong>South</strong>ern<br />

Louisiana Roots. The National Science Foundation<br />

has awarded $100,000 to a Louisiana-based<br />

company that has developed software that provides<br />

real-time access to changes in complex genetic data<br />

for the research and treatment of HIV. With quick<br />

access to genetic data on both the patient and virus<br />

affecting the patient, clinicians can better evaluate<br />

how each responds to various treatments, said<br />

Susanna LeFleur, founder of Gene Johnson Inc.,<br />

maker of the software. “What we’re doing is creating,<br />

for clinical researchers, clinical data and genetic<br />

data in a relational system,” LaFleur said. Analysis<br />

of genetic data in HIV research that used to take two<br />

weeks can be done in 10 minutes with the software<br />

HIVbase, said Gene Johnson Chief Management<br />

Officer Luke Dunlap. Most HIV researchers use a<br />

system that generates paper printouts of genetic<br />

sequences, and one patient can easily generate<br />

enough data to fill a 4-inch-thick binder in just a few<br />

years, he said. Data in that form is hard to access<br />

and manipulate, Dunlap said. “With a system like<br />

[HIVbase], you can easily see the [genetic] mutations<br />

and responses,” Dunlap said. “It’s instantaneous<br />

and it’s at your fingertips.” HIVbase is not the only<br />

software that tracks genetic information, but it is<br />

unique in that it gives researchers new ways to<br />

analyze data. The software can instantly compute<br />

hundreds of thousands of bits of information that<br />

comprise genetic codes and can operate on standard<br />

personal computers, Dunlap said. Gene Johnson<br />

Inc. plans to develop software for hepatitis C, called<br />

HCVbase. LaFleur said she expects to begin selling<br />

HIVbase to government, university and<br />

pharmaceutical research facilities in May. NSF is<br />

also considering an additional $750,000 award for<br />

HIVbase.<br />

Clues to How Men Exposed to HIV Stay Virus-<br />

Free. According to researchers, men who have sex<br />

with HIV-positive women but remain virus-free carry<br />

relatively high levels of antibodies that specifically<br />

fight HIV infection in the tissue that first encounters<br />

the virus. These antibodies may help protect people<br />

exposed to the virus from becoming infected. Study<br />

author Dr. Mario Clerici of the University of Milan in<br />

Italy explained that people become infected with HIV<br />

during intercourse when the virus binds to proteins<br />

in genital tissue, allowing HIV to penetrate mucosal<br />

cells, after which it eventually spreads in the body.<br />

But in a small number of people exposed to the virus,<br />

this process does not occur, Clerici said. The study<br />

“Mucosal and Systemic HIV-1-Specific Immunity in<br />

HIV-1-Exposed but Uninfected Heterosexual Men,”<br />

published in the journal AIDS (2003;17:531-539),<br />

compared 14 HIV-negative men whose female<br />

partner was HIV-positive with seven men infected<br />

with the virus and seven men without any known risk<br />

factor for HIV infection. All of the virus-free men had<br />

been having unprotected sex with an HIV-positive<br />

women for at least four years. On average, the<br />

couples said they had unprotected sex 14 times per<br />

year, the most recent time being within the four<br />

months before they enrolled in the study. The authors<br />

found that 11 of these 14 men carried relatively high<br />

levels of the antibody known as IgA that specifically<br />

targets HIV in their seminal fluid. These “good” HIVtargeted<br />

antibodies were not present in the seminal<br />

fluid of the men who were at low risk of HIV exposure,<br />

according to Clerici. In addition, the concentration of<br />

these antibodies tended to be highest in men who<br />

had recently had unprotected sex with their infected<br />

female partner. Scientists have shown that IgA<br />

helps protect the body against HIV by changing its<br />

shape and barring its entry into target cells. Previous<br />

studies have also detected the presence of IgA<br />

targeted to HIV in secretions from commercial sex<br />

workers in Africa and Thailand, who have a high risk<br />

of having been exposed to HIV. Clerici said studies<br />

underway in mice and monkeys are seeking to<br />

reproduce such natural mechanisms for an HIV<br />

vaccine.<br />

Study Looks at How HIV May Spread Through<br />

Oral Sex. Laboratory studies of mouth tissue suggest<br />

that unprotected oral sex does have the potential to<br />

transmit HIV, but one expert said it is still less risky<br />

than other routes of transmission. Dr. Xuan Liu of<br />

Charles R. Drew University of Medicine and Science<br />

and colleagues at the University of California-Los<br />

Angeles obtained oral tissue samples from over 50<br />

healthy, HIV-negative patients and exposed the<br />

tissue to three different types of HIV. They found that<br />

two of the types could infect and reproduce within<br />

keratinocytes that line the mouth’s surface, and then<br />

transfer the infection to adjacent white blood cells.<br />

However, the level of infection in the mouth cells was<br />

much lower than that seen in white blood cells -<br />

approximately one-fourth to one-eighth lower. “HIV<br />

is able to get into [keratinocytes], but it reproduces<br />

less than it would in blood cells... because saliva<br />

contains an HIV inhibitor,” said Liu. Researchers<br />

found that keratinocytes have two receptors that<br />

bind to HIV. However, when the team used inhibitors<br />

to block HIV from attaching to those receptors, they<br />

noticed that they did not completely block<br />

transmission, suggesting that the cells may have<br />

lower levels of other receptors used by the virus.<br />

Further research is necessary to determine if the<br />

laboratory results mimic what actually happens in a<br />

living patient, Liu said. Dr. Jeffrey Laurence, senior<br />

scientific consultant for programs at the American<br />

Foundation for AIDS Research and director of AIDS<br />

Virus Research at Cornell’s Weill College of Medicine,<br />

said that keratinocytes lack two of the most common<br />

receptors for HIV transmission - CD4 and the CCR5<br />

co-receptor. An effective vaccine would likely have<br />

to block these two primary receptors, which are<br />

found in cells that line the vagina and rectum.<br />

Laurence believes the findings indicate there is “no<br />

reason for altering safer sex guidelines that have<br />

been talked about for over 15 years.” Laurence said,<br />

“No exchange of infected bodily fluids is absolutely<br />

safe, but kissing has been shown to be of no risk, and<br />

oral sex is of much lower risk than the other traditional<br />

factors known to spread HIV.”<br />

HIV’s Ability to Rapidly Evolve Occurs Quicker<br />

than Thought. HIV evolves more rapidly than<br />

previously thought, according to a new finding that<br />

underscores challenges to developing an effective<br />

vaccine. HIV has long outwitted both scientists and<br />

the body’s own defenses with its rapid ability to<br />

adapt. The virus’ protective envelope is a hotbed of<br />

variability, according to a new study by researchers<br />

at the University of California-San Diego and<br />

ViroLogic Inc., a <strong>South</strong> San Francisco biotechnology<br />

company. The virus mutates its protective coating<br />

“at an incredibly rapid rate” to stay one step ahead<br />

of neutralizing antibodies produced by the immune<br />

system, said Dr. Douglas Richman, the study’s lead<br />

author. The full report, “Rapid Evolution of the<br />

Neutralizing Antibody Response to HIV Type 1<br />

Infection,” appeared in the March 18 online edition<br />

of the Proceedings of the National Academy of<br />

Sciences (10.1073/pnas.0630530100). The study<br />

provides the closest look yet at how HIV evades the<br />

body’s powerful efforts to churn out antibodies that<br />

can render it ineffective. ViroLogic’s work is part of<br />

an increasingly successful effort to describe the<br />

battle between antibodies and HIV in detailed<br />

molecular terms, said Gary Nabel, director of the<br />

vaccine research center at the National Institute of<br />

Allergy and Infectious Diseases. “It’s been our biggest<br />

challenge to developing drugs or vaccines,” he said.<br />

In recent years, HIV has been tamed in infected<br />

individuals by retroviral and other drugs that disrupt<br />

its ability to replicate, but stopping infection in the<br />

first place is more difficult. Richman said his group’s<br />

findings and methods may open a path toward more<br />

effective vaccine strategies, such as vaccines that<br />

target portions of the virus that are unable to undergo<br />

rapid changes.<br />

Insurance Fights Grow on ‘HIV Retirement.’ Since<br />

the development of a new class of HIV drugs in the<br />

mid-1990s, many people who had gone into “HIV<br />

retirement,” as their nonworking status is often<br />

referred to, are in limbo. They once assumed they<br />

would die an early death, but the drug regimens<br />

have allowed them to survive longer than they ever<br />

thought possible. This means that insurance<br />

companies that once approved AIDS-related<br />

disability claims, expecting that the payments would<br />

end in a year or two, may have to support patients for<br />

decades. Winthrop Cashdollar, a disability expert at<br />

the Health Insurance Association of America, a<br />

trade group of Washington, acknowledged that<br />

insurers had to change their policies about reviewing<br />

HIV-related claims to correspond to the new medical<br />

continued on page 14<br />

May/June 2003 13


Chronicles, continued from page 13<br />

reality. “Until fairly recently, AIDS was an imminent<br />

death sentence, so claims tended to be approved<br />

quickly and paid,” Cashdollar said. “And perhaps<br />

there was no review to speak of. Now there has to<br />

be, because HIV/AIDS has become manageable,<br />

like some other diagnoses.” The trade association<br />

does not keep statistics on how many HIV-positive<br />

people are receiving long-term disability. But Per<br />

Larson, a New York financial analyst for HIV-positive<br />

people, estimated that the figure was easily in the<br />

tens of thousands. Doctors who treat people with<br />

HIV/AIDS are frequently caught in the middle. Dr.<br />

Stephen Becker, a San Francisco primary care<br />

physician, said the time he spends defending<br />

disability claims has increased markedly in the last<br />

three years. And many disability insurers he has<br />

dealt with, he said, seemed to resist the notion that<br />

patients who are HIV-positive can remain disabled<br />

even though their lab-test results may improve. One<br />

problem is that some symptoms caused by HIV and<br />

the drugs used to treat it can be harder to measure<br />

objectively. And the disability companies, he added,<br />

scour medical records for signs that the person can<br />

work again. “If the person doesn’t note a symptom in<br />

the charts every time, the insurers construe that<br />

absence as a sign that the person is better,” Becker<br />

said. “I think they’re playing hardball.”<br />

Hospital Worker Sentenced to Jail for Forging<br />

AIDS-Drug Prescriptions. A former employee of<br />

Montefiore Medical Center received up to five years<br />

in prison Monday, March 24, for forging AIDS drug<br />

prescriptions and selling the drugs on the black<br />

market. Enrique Rojas, an HIV education coordinator<br />

at the Bronx hospital, was sentenced and ordered to<br />

pay more than $1.7 million in restitution, said New<br />

York Attorney General Eliot Spitzer. Rojas, of<br />

Bronxville, N.Y., pleaded guilty to grand larceny in<br />

the first degree in July. Rojas had faxed hundreds of<br />

forged prescriptions for the drug Serostim to out-ofstate<br />

pharmacies for a nine-month period, Spitzer’s<br />

office said. Believing the prescriptions to be<br />

legitimate, the pharmacies then filled them, sent the<br />

drug to addresses Rojas provided, and billed<br />

Medicaid, which reimbursed providers $6,300 for a<br />

month’s supply of Serostim. Rojas admitted to selling<br />

Serostim on the black market. Spitzer said a month’s<br />

supply of the drug carries a street value of $3,000-<br />

$3,200.<br />

Woman Charged with Criminally Transmitting<br />

HIV to 200 Partners. A Jacksonville, Fla., woman is<br />

facing charges that she criminally transmitted HIV to<br />

at least 200 unprotected partners. Melissa Jernigan,<br />

24, told police that she tested positive for the virus in<br />

1999 and continued to have unprotected sex. It is a<br />

third-degree felony in Florida, punishable by five<br />

years in prison, for an HIV-positive person to have<br />

sex with a partner without first informing them about<br />

the diagnosis. “This crime is actually in the area of<br />

attempted murder,” said Sgt. H.R. Atkinson of the<br />

Duval County Sheriff’s Office sex crimes unit.<br />

Jernigan was being held Friday at the John E.<br />

Goode Pre-Trial Detention Facility in Jacksonville.<br />

UN <strong>Launches</strong> First Comprehensive Web Site on<br />

Gender and HIV/AIDS. In an effort to place gender<br />

equality at the center of the fight against HIV/AIDS,<br />

the UN has launched its first comprehensive Web<br />

site that promotes understanding, knowledge and<br />

action on the epidemic as a gender and human<br />

rights issue. “By bringing knowledge and information<br />

to the global community, we are able to empower<br />

women,” said Noeleen Heyzer, executive director of<br />

the UN Development Fund for Women (UNIFEM).<br />

Designed to be user-friendly, informative and<br />

interactive, the site offers research, training materials,<br />

surveys, advocacy tools, current news and opinion<br />

pieces by leading experts. “This online resource<br />

center is a practical step forward by UNIFEM and<br />

UNAIDS together, designed to improve the support<br />

for the millions of women around the world living with<br />

HIV and affected by the epidemic,” according to<br />

UNAIDS Executive Director Peter Piot. Visit the Web<br />

site at: http://www.genderandaids.org.<br />

Half of HIV Cases Spread Heterosexually in<br />

Europe. The number of women being diagnosed<br />

with HIV in Europe is quickly catching up with men,<br />

raising the risk of more babies being born to infected<br />

mothers, researchers warned Wednesday, March<br />

19. ISIS Research Plc, a health care market research<br />

agency, said its analysis of HIV figures showed just<br />

how fast this was happening in Europe, even though<br />

in the United States<br />

homosexual<br />

transmission remains<br />

the dominant route of<br />

infection. ISIS analyzed<br />

3,000 European<br />

patients on HIV therapy<br />

from July-October 2002<br />

and found 308 patients<br />

had been newly<br />

diagnosed with HIV<br />

earlier that year. Of<br />

these, 51 percent were<br />

infected through<br />

heterosexual contact<br />

and only 36 percent as<br />

a result of homosexual<br />

contact. Yet, ten years<br />

ago, the transmission<br />

routes were 28 percent<br />

heterosexual and 38<br />

percent homosexual.<br />

ISIS examined 3,000<br />

US patients and found<br />

that new HIV diagnoses<br />

were 51 percent<br />

homosexual and 31<br />

percent heterosexual by<br />

route of infection. ISIS<br />

analyst Amanda<br />

Zeffman said that<br />

numerous factors,<br />

including different ethnic<br />

origins and awareness<br />

campaigns, account for the differences in the<br />

epidemic between Europe and the United States.<br />

The gap is narrowing, however, as more US<br />

heterosexuals become infected. The number of<br />

European females being diagnosed with HIV is “fast<br />

catching up with the number of males,” said the<br />

report, with the consequent risk of more babies<br />

being born to infected mothers. The question arises<br />

of “which treatments to use or avoid during pregnancy<br />

and at the time of birth to prevent” mother-to-child<br />

HIV transmission. On a positive note, the report said<br />

initiatives to supply sterile needles to drug users<br />

seemed to be effective, with HIV transmission via<br />

intravenous drug use now almost eradicated in<br />

France, Germany and the United Kingdom and<br />

significantly reduced in Spain and Italy. However, in<br />

the United States, where initiatives are less<br />

widespread, infection rates have dropped less.<br />

In Sweden, a Proposal for Nationwide Needle-<br />

Exchange for Drug Addicts. Sweden’s drug policy<br />

coordinator said Wednesday, March 5, that it should<br />

follow international examples and permit nationwide<br />

needle exchange programs. Such programs are<br />

credited with curbing the spread of HIV and hepatitis<br />

C in other countries, although Sweden has been<br />

reluctant to implement a national needle exchange<br />

policy. In his proposal to the center-left Social<br />

Democratic government, drug policy coordinator<br />

Bjoern Fries said that two trial programs in the<br />

continued on page 15<br />

Positive Impact, Inc.<br />

presents:<br />

Women’s Issues Group<br />

co-facilitated by Debbie Pottinger<br />

starting:<br />

Tuesday, May 13<br />

5:30 - 7:00 PM<br />

159 Ralph McGill Boulevard<br />

6th Floor<br />

Atlanta, GA 30308<br />

404-589-9040<br />

This is a drop-in group for all women living with HIV,<br />

from those newly diagnosed to long-term survivors,<br />

who are looking for support from other women. The<br />

group addresses adjusting to new diagnoses,<br />

relationship issues, treatment question and other<br />

issues relevant to HIV-positive women.<br />

POSITIVE IMPACT, INC.<br />

Our mission is to facilitate culturally sensitive mental health<br />

and prevention services for people living with HIV.<br />

1 4 SURVIVAL NEWS


Chronicles, continued from page 14<br />

southern cities of Malmoe and Lund showed positive<br />

results. He added that they should be expanded on<br />

a nationwide scale, only if local authorities offer full<br />

drug treatment programs, including detoxification<br />

and counseling. The Health Ministry would not<br />

comment on the proposal until it faces expert review,<br />

spokesperson Kicki Maehler said.<br />

World Health Organization Hopes to Double<br />

AIDS Treatment in Latin America. The World<br />

Health Organization hopes to double the number of<br />

people receiving AIDS treatment in Latin America by<br />

2005, Bernard Schwartlander, head of WHO’s HIV/<br />

AIDS department, said on March 12. Schwartlander<br />

said WHO would like to see 400,000 people receiving<br />

a cocktail of AIDS drugs by 2005. About 1 million<br />

people in Latin America are infected with HIV, but<br />

only 200,000 receive the life-extending drugs. Brazil<br />

provides AIDS drugs free to anyone who needs<br />

them, and about 125,000 Brazilians now receive the<br />

AIDS cocktail. Annual AIDS deaths in Brazil have<br />

fallen from 11,024 to 4,136 in just four years, thanks<br />

largely to the free medicine. But Brazil makes its own<br />

InfectedAffectedNegativePositiveLongTermSurvivorNewlyDiagnosedInfected<br />

AIDS drugs, ignoring patents issued before 1997,<br />

when the country signed an intellectual property law<br />

to join the World Trade Organization. Brazil also<br />

threatened to break more recent patents unless<br />

drug companies granted large discounts on the<br />

AIDS drugs they produce. They complied, and Brazil<br />

has so far respected newer patents. Schwartlander<br />

was vague about the source of the money to pay for<br />

the treatments in this largely poor continent. “The<br />

increase [in coverage] depends fundamentally on<br />

the governments of the countries and funding from<br />

institutions like the World Bank and the Global<br />

Fund,” said Schwartlander. Paulo Teixeira, the<br />

coordinator of Brazil’s AIDS program, said WHO<br />

had failed to use its muscle to reduce the price of<br />

AIDS drugs. “Unity among different countries has<br />

shown itself to be fundamental in reducing the price<br />

of medications. However, these results would be<br />

very much better if there was clear leadership from<br />

the WHO and other international bodies,” Teixeira<br />

said. “From the multilateral organization there is a<br />

lack of action on the question of patents, regional<br />

funds, local drug production and quality control for<br />

generics,” he said.<br />

InfectedAffectedNegativePositiveLongTermSurvivorNewlyDiagnosedInfectedAffectedNegativePositive<br />

THRIVE! weekends are free, interactive gatherings organized<br />

by AIDS Survival Project and led by men and women<br />

living with HIV. Join us for two full days of candid group<br />

discussions and empowering presentations on HIV/AIDS.<br />

Professional childcare and meals provided. ASL by request.<br />

2003 THRIVE! Weedkend Dates:<br />

May 17 & 18, 2003<br />

July 19 & 20<br />

September 20 & 21<br />

November 8 & 9<br />

To register call 404-874-7926 TTY 404-524-0464<br />

or toll free at 1-877-243-7444<br />

HIV Increase Brings Renewed Warning. New<br />

Zealanders are being cautioned against<br />

complacency following an increase in the number of<br />

men infected with HIV. The number of HIV cases<br />

among men who have sex with men last year was<br />

the highest since 1996, according to the AIDS<br />

Foundation. Executive Director Kevin Hague said<br />

50 men tested positive for HIV, a rise from a stable<br />

number of about 35 over each of the previous four<br />

years. Hague said this was a cause for concern,<br />

although the numbers were still small and just a few<br />

additional cases could mean a big percentage<br />

change. HAART therapy and “the decreasing public<br />

visibility of AIDS” may lead many uninfected gay<br />

men into believing that HIV was no longer a threat,<br />

speculated Hague. He also added as the third decade<br />

of the AIDS epidemic approached, the risks<br />

associated with any one occasion of unprotected<br />

sex had increased. “It’s therefore important for people<br />

not to assume that their sexual partner is HIVnegative,”<br />

said Hague.<br />

More Than 300,000 Chinese to Contract HIV<br />

During 2003. State Media. Statistics printed in state<br />

continued on page 16<br />

PositiveBeginnings<br />

BeingYourOwnAdvocate<br />

IssuesForLongTermSurvivors<br />

WomensHIVMedical<br />

SaferSex<br />

Antiretrovirals<br />

FamilyFriendsCaregivers<br />

ClinicalTrials<br />

Disclosure<br />

SocialSecurity<br />

DentalCare<br />

SubstanceUse<br />

SaferUsing<br />

FoodSafety<br />

Legal<br />

HIVOverview<br />

Nutrition<br />

OpportunisticInfections<br />

FromSurviveToTHRIVE!<br />

ComplementaryTherapies<br />

Funded in part by the Fulton County Board of Commissioners under the guidance of the Fulton County Human Services<br />

Grants Program, Broadway Cares/Equity Fights AIDS and the Bristol-Myers Squibb Company.<br />

InfectedAffectedNegativePositiveLongTermSurvivorNewlyDiagnosedInfectedAffectedNegativePositive<br />

May/June 2003 15<br />

InfectedAffectedNegativePositiveLongTermSurvivorNewlyDiagnosedInfectedAffectedNegative


Chronicles, continued from page 15<br />

media Wednesday, March 26, show that more than<br />

300,000 Chinese will contract HIV during 2003.<br />

According to health ministry data reported in the<br />

China Daily, China had more than 1 million HIV<br />

cases last year - a figure projected to increase by<br />

more than 30 percent annually. Previous reports<br />

indicate that about 100,000 Chinese have AIDS, and<br />

this number is estimated to double over the next five<br />

years. The paper said the government has put<br />

together a task force on AIDS vaccine research and<br />

welcomes foreign pharmaceutical companies and<br />

research institutes to participate in the Chinese<br />

search for a vaccine, although human trials are not<br />

permitted. If a foreign company’s efforts achieve a<br />

breakthrough and it desires to use locals for a<br />

vaccine study, it must seek permission through a<br />

local partner, the paper said.<br />

Walk Raises $500,000 to Fight AIDS. An estimated<br />

7,500 people helped to raise more than $500,000 in<br />

the Sunday, March 9 AIDS Walk Houston, organizers<br />

said. Money raised during the 14th annual downtown<br />

walk will help fund AIDS Foundation Houston and 13<br />

other agencies that provide education, counseling,<br />

housing, food and medical care to thousands. Kelly<br />

Rowland of the Houston-based R&B group Destiny’s<br />

Child appeared at Sunday’s event to focus the black<br />

community’s attention on preventing HIV/AIDS.<br />

According to the city’s Health and Human Services<br />

Department, about 57 percent of new HIV infections<br />

occur among blacks, a proportion more than double<br />

Houston’s percentage of black residents. AIDS<br />

Foundation Houston estimates that about 22,000<br />

people in the city have HIV or AIDS.<br />

Walkers Step Out to Boost AIDS Awareness.<br />

About 200 people turned out for Saturday’s AIDS<br />

Walk (on March 8) at the Myrtle Beach, S.C., Pavilion<br />

to promote HIV/AIDS awareness and raise money<br />

for CARETEAM, a nonprofit social services agency.<br />

CARETEAM Executive Director Valerie Harrington<br />

said Saturday’s walk was a success, and at least five<br />

new volunteers were registered. “We are thrilled<br />

with the participation we had this year,” said<br />

Harrington. CARETEAM offers comprehensive case<br />

management services to those with HIV/AIDS,<br />

including housing assistance, counseling and<br />

medical help. Harrington said that there are currently<br />

about 1,800 known HIV cases in Horry, Georgetown<br />

and Williamsburg counties; she could not estimate<br />

how many unreported cases there may be in the<br />

area. By promoting prevention, Harrington hopes to<br />

stymie the increase in new HIV/AIDS cases among<br />

females, which she attributes to growing<br />

complacency. “It is not in the public eye like it should<br />

be. And people are not aware that it’s in this<br />

community,” she said. “Many women still think it’s a<br />

problem for the gay man.” <br />

We will pick up your<br />

unwanted clothes,<br />

furniture and other<br />

items and donate a<br />

portion of the<br />

proceeds to<br />

AIDS Survival<br />

Project!<br />

Best Buy<br />

Thrift Store<br />

Call-404-361-2352<br />

1 6 SURVIVAL NEWS


Name<br />

Address<br />

POSITIVELY PERSONAL<br />

City/State/Zip<br />

Daytime Phone # ( )<br />

Seeking (circle one): Men Women TV/TS Bisexual<br />

Ad should say (35 words or less):<br />

To: Personals,159 Ralph McGill Blvd., Suite 500, Atlanta, GA 30308<br />

SURVIVAL NEWS CLASSIFIEDS<br />

Seeking Men<br />

• GWM, 40’s, masculine, musclar, 5’, 5”, 135, Atlanta house and<br />

50 acre farm north of Gainsville. Into outdoors, travel, ISO masculine,<br />

versatile, self-confident, independent 30-50 y. o., 5’,6” - 5’, 11”, under<br />

175 lbs. Jason 706-776-7400. (05/03)<br />

• HIV+, 40 y. o. seek friends in the field of helping persons newly<br />

released from prison. Not seeking relationships, funds or games.<br />

Friends who can help with info on housing and real friendships wanted<br />

and needed. George K. Pitts, EF 232663, BSP, P. O. Box 1700, D3-<br />

41, Hardwick, GA 31034-1700 (05/03)<br />

• WM, 35, seeks LTR. Easy going, good sense of humor, 5’, 7”,<br />

170 lbs., Brn. hair, grn. eyes., Soon to be released from prison, will send<br />

photos with response. Johnny Tanner, EF 308763 - I-C-72, Scott State<br />

Prison, P. O. Box 417, Hardwick, GA 31034-0417. (05/03)<br />

Seeking Women<br />

• Italian, 6’ 2”, 200 lbs., poz for 18 years and I need a woman to love<br />

me. I love sports, scuba diving, camping and dancing. Will answer all<br />

responses. Tony Raposa, <strong>South</strong>east Probation Dentention Center, P. O.<br />

Box 869, Claxton, GA 30417 (05/03)<br />

• SBM, 37, newly dx HIV+, caring, passionate, handsome, healthy,<br />

seeks nice caring female to share, friendship, race/age unimp. Robert<br />

Pullin, BK# 0222815, 3 S 400, 901 Rice St., Atlanta, GA 30318 (06/<br />

03)<br />

• WSDM, 32, sks nice lady, 25-40, country boy, Danny Scott<br />

Spillers, EF 421293, Bostwick State Prison, P. O. Box 1700, Hardwick,<br />

GA 31034 (05/03)<br />

Roommates<br />

• ASAP! Quiet and employed, GWM roommate wanted to share<br />

large 2 bedroom/2 bath apartment with sunroom, laundry, off street<br />

parking. Quiet neighborhood in Lawrenceville. $450.00 per month<br />

including utilities except cable and long distance. !st and last month’s<br />

rent required. Sorry no pets. Contact: Ron DeNardom 770-931-0489<br />

ortherubdownmqn@msn.com (07/03)<br />

DONATIONS<br />

• “Buying Your Home is not a Science...It’s an ART!<br />

Art Auerbach (Paris & Associates Realty) Long time volunteer<br />

and old friend of AIDS Survival Project will donate the equivalent of<br />

25% of the commisssion he receives for each buyer or seller referred<br />

from AIDS Survival project. If you are ready to buy or sell a home or<br />

condo, call Art at 404-321-1930 or on the web at<br />

www.TheARTofAtlantaHomes.com. You will receive great real<br />

estate assistance and ASP will benefit from a generous donation! Be<br />

sure to tell Art you are an ASP referral!<br />

SERVICES<br />

• Graded Benefit Whole Life Insurance Policy. Available with<br />

no questions asked for ages 40 -80, face amounts $1000 - $25,000.<br />

Permanent protection for your whole life. Premiums never increase<br />

call Brian Freeman at 404-233-5411, ext. 231 for further information.<br />

(02/02)<br />

Use the form below to place your own Positively Personal ad!<br />

All Classifieds are printed free of charge. Roommates, Jobline,<br />

Services, and Misc. listings are usually run for one month only,<br />

Personal ads for two months. To place ad, send written copy to<br />

159 Ralph McGill Blvd., Suite 500, Atlanta, GA 30308; Personal<br />

ads should use the form below, and be clearly marked as<br />

"PERSONALS." Do not call our office to place an ad, unless<br />

correcting a mistake. Deadline for all ads is the 1st workday of<br />

the previous month. AIDS Survival Project reserves the right to<br />

edit ads as necessary, and is not responsible for the content or<br />

credibility of any ad.<br />

SERVICES, continued<br />

• JongHoo Therapeutics • Ron Denardo (ment) 404-435-7064<br />

• therubdownman@msn.com• You get your first visit @ 50% off<br />

($25 instead of $50) at our Sandy Springs location • We offer<br />

reflexology, neuromuscular therapy, teiki, therapeutic-message, shiatsu<br />

and more.<br />

• Cadillac House Cleaning Serv., basic residential: apts,<br />

townshouses, condos, houses, very resonable, reliable, friendly,<br />

excellent references, call today - Larry Patrick, 404-377-9612, also<br />

house sitting, and assisting with sick.<br />

The AIDS Survival Project is incorporated in the state of<br />

Georgia as a 501(c)3 nonprofit corporation. All donations are<br />

tax-deductible. A large percentage of our annual budget is<br />

funded solely by your contributions, the rest is supplemented by<br />

grants solicited from private foundations.<br />

We are happy to provide the newsletter to people who<br />

cannot afford to purchase a subscription; however, we ask that<br />

anyone who can afford to subscribe, do so.<br />

I am a person living with HIV/AIDS and want to<br />

be a member of the AIDS Survival Project.<br />

Enclosed is $30.00 for a one year subscription.<br />

I cannot afford to pay for a subscription. Please enter my<br />

free subscription.<br />

Please send me information on how I can include AIDS<br />

Survival Project in my will or planned giving.<br />

Name:<br />

Address:<br />

City, State, Zip:<br />

Phone Day:________________ Evenings: _________________<br />

e-mail:<br />

Please contact me about volunteering for the following:<br />

Survival News Committee<br />

THRIVE! Weekend<br />

Peer Counseling<br />

Treatment Advisory Committee<br />

Advocacy Committee<br />

Special Events Committee<br />

I have other special skills I would like to offer:<br />

I would like to make a donation in Memory of:<br />

I would like to make a donation in Honor of:<br />

Please acknowledge this donation to:<br />

Name:<br />

Address:<br />

City, State, Zip:<br />

Please send this form to: AIDS Survival Project, 159 Ralph<br />

McGill Blvd, Suite 500, Atlanta, GA 30308. Thanks!<br />

May/June 2003 17

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