National Latino AIDS Awareness Day

October 15th was National Latino AIDS Awareness Day (NLAAD). A day that hopes to bring HIV awareness to the Latino community: a community that is three times more affected by HIV than their White counterparts. NLAAD is a national community mobilization effort that aims at uniting the Hispanic/Latino (H/L) communities to increase HIV awareness, prevention, education, and (perhaps, most importantly) testing. In recognition of NLAAD and this week's Latino Commission on AIDS publication, The State of HIV/AIDS Among Hispanics/Latinos in the US and Puerto Rico, let us take a look at how the H/L has been and continues to be disproportionately affected by HIV. 

The State of HIV/AIDS among Hispanics/Latinos in the US and Puerto Rico (1)

With an estimated US population of 55 million, the H/L community currently is the largest and fasted growing minority group in our country. Thus, it is important to our national health to focus on the health concerns and disparities that face the increasing H/L community. In 2013, the H/L community made up only 17% of the US population while accounting for 23% of the new 50,000 HIV infections for that year.

The Black community continues to be the hardest hit ethnic/racial community nationally and internationally; however, with the staggering population growth within the H/L community, this community is quickly approaching similar critical mass. At this point, the rate of new HIV infections among H/L males is three times greater than white males. If the current trend in HIV infections within the H/L community continues, 1 out of 36 males and 1 out of 106 females will be diagnosed with HIV at some point within their lifetime.

Within the H/L community, Men who have sex with Men (MSM) continue to have the highest rates of new HIV infections by 72%, whereas, heterosexual males and females account for 21% of new HIV infections. At the end of 2012, close to 203,000 H/L individuals were living with HIV in the US. Since the beginning of the AIDS epidemic, there have been more than 250,000 AIDS diagnoses and over 125,000 deaths due to AIDS-related deaths.

In terms of H/L individuals living with HIV and the care continuum, the Latino AIDS Commission reports that approximately 80% have been linked to care. This 80% does not mean that all stay in care, receive HIV treatment/medications, or obtain and maintain an undetectable diagnosis (viral suppression). Out of the 80 linked to care, only 54% have been retained in care, 44% are receiving treatment, and only 37% are virally suppressed (undetectable). 

The cumulative statistics above (from rates of infection to viral suppression) reflect the persistent need for such HIV/AIDS Awareness Days. As our youth (ages 13-25) and ethnic/racial communities continue to be the most devastated groups affected by HIV, critical and accurate HIV information and education must be disseminated and HIV testing must be normalized and made universally accepted in hopes of reducing the stigma surrounding testing. Care and compassion for those of us living with HIV needs to exist and extend beyond HIV/AIDS Awareness days and events until every day is an HIV Awareness day.

Guillermo Chacon, President of the Latino Commission on AIDS and founder of the Hispanic Heath Network, stated, "We hope to contribute to a better understanding of the complex challenges we face as community members, and the urgent need to develop comprehensive and culturally-responsive strategies to address HIV, access to quality healthcare, and other health conditions disproportionately impacting our community."

ABOUT THE LATINO COMMISSION ON AIDS

The Latino Commission on AIDS is a nonprofit membership organization founded in 1990 dedicated to meet the health challenges and addressing the impact of HIV/AIDS. The Commission is the leading organization coordinating National Hispanic Hepatitis Awareness Day (May 15), National Latino AIDS Awareness Day (October 15), Latinos and the Deep South, and other prevention, research, capacity building, and advocacy programs across the United States and its territories. The Latino Commission is the founder of the Hispanic Health Network, dedicated to eliminate health disparities in our communities.

Join the Las Vegas HIV/AIDS Awareness Consortium Group and our supporters this Saturday, October 17th, from 10:00 am until 3:00 pm for our local NLAAD event. The event is free and will be held at The Center. Community resource and health fair, offering FREE HIV testing and flu shots, among other health-related screenings.

To read the full report by the Latino AIDS Commission: http://www.latinoaids.org. 

For more information regarding NLAAD: http://www.nlaad.org/

Bryan Heitz

Risk Reduction Specialist

(1) http://www.latinoaids.org

HIV Medication: From AZT to the 'One Pill A Day' in 3 Decades

The first six years of AIDS (1981-1987) saw more than 40,000 deaths and 50,000 new infections without any FDA approved drug therapy. In 1987, Azidothymidine (aka AZT or Retovir) became an answer to the staggering numbers of deaths from AIDS and new HIV infections over the last several years. AZT had a previously pharmaceutical use as an early anti-Cancer fighting agent known decades earlier as Compound S. AZT was hurried through the FDA hoops and hurdles in an unprecedented 25 months and “marked the introduction of the first effective weapon against the virus [HIV] and AIDS itself, what eventually would become a key element of the multi-drug cocktail of HAART itself.” (1)

AZT is not without its controversy that cannot be overlooked. In short, thousands of people were suffering and dying from AIDS in such short periods that a drug therapy had to be offered. AZT offered no cure and little to more than a year or so prolonged life to those suffering; consequently, its cost was astronomical at $10,000 dollars for a year’s therapy. AZT’s efficacy is a double-edged sword. The drug helps to prevent the HIV virus from invading, genetically altering T cells; however, the drug at high doses inhibits healthy cell division creating a myriad of health concerns. Drug resistance to AZT is common and is not tolerated well by most.  AZT as a singular drug therapy is rarely prescribed since the introduction of HAART (highly active antiretroviral therapy).  (1)

HAART

In 1996, fifteen years into the AIDS crisis, HAART revolutionized the HIV era by presenting multiple drug regimens meant to enhance the healing effects of AZT (often listed in drug cocktails as Retovir). HAART has expanded to include six classes of drugs that stops the genetic replication of the HIV viron, lowering the viral load to an undetectable level, as well as, decreases the ability for the virus to continue to alter itself into more strains than already identified. 

Since the introduction of HAART, the classes of drug therapies continue to become more robust than ever with more than 30 approved drugs in 6 different classes. With such a large selection of therapies to test and try, it helps to deal with those who build up drug resistance. Along with a wide selection of drug therapies the more recent additions have decreased side-effects and less strict dosing provisions. The most exciting is the ‘One Pill a Day’ options (All in One Combination Tablets), which is a HAART cocktail in one pill and taken once a day. This is a blessing to those of us whom have never had to take anything other than one pill a day and those who have had to take common cocktails of 5 to 10 pills throughout the day on a strict schedule. 

Currently Approved Drugs for HIV

HIV is a retrovirus: a virus that needs a host to invade and, through genetic mutation, replicate itself.  HIV drug therapies are called antiretrovirals because they attack the HIV retrovirus and they are highly effective (active). HAART drugs have a corresponding stage of HIV replication in which the drugs in that class target. The six classes of HAART are (as of March 2015):

• 4 All in One Combination Tablets (Multiclass Combination Products)
• 11 Protease Inhibitors (PIs)
• 11 Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
• 5 Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
• 2 Early Inhibitors including Fusion Inhibitors
• 2 Integrase Inhibitors

The connection between the phase of HIV replication and corresponding HAART drug needs an understanding of the 8 stages of the HIV replication process, which will be discussed in another blog. This should, if anything else shows the progression from a poisonous cancer fighting drug that often did more damage than good, to multiple all in one tablet options, and, hopefully, the cure will be in our future. To find a comparative chart of FDA approved drugs: CLICK HERE.

Bryan Heitz
Risk Reduction Specialist

 

(1)   http://motherboard.vice.com/read/happy-birthday-to-azt-the-first-effective-hiv-treatment

(2)  http://www.aidsmeds.com/articles/DrugChart_10632.shtml