HIV and ID Observations

Some quick HIV and ID Observations (better blog title anyone?) for this 2011 World AIDS Day:

• Through meticulous, painstaking research that took me all of 10 seconds, I’ve learned that the first World AIDS Day was in 1988. What ever did we do before the internet?
• Looks like New York City’s health department  is following San Francisco’s lead in recommending that all people with HIV get treated — for personal and public health benefit. Important for many reasons, but these two in particular: 1) New York has by far the largest number of people living with HIV of any US city, and 2) It doesn’t appear that this policy change means an infusion of new funding.  Not surprised, but let’s face it — more people on treatment  is initially going to cost more (meds, providers, outreach). Well worth it, in my opinion.
• Of course people can’t get treated if they’re not in care, and this MMWR report paints a pretty bleak picture of what proportion of all HIV patients in the United States are virologically suppressed — only 28%! Here’s the key finding: “Of the estimated 942,000 persons with HIV who were aware of their infection [out of an estimated 1.2 million with HIV total], approximately 77% were linked to care, and 51% remained in care.” In other words, those diagnosed and not in care greatly exceed those undiagnosed — and saying it’s important to get them back into care and on treatment is kind of like saying that people who smoke should quit. Everyone agrees, but how do we make it happen?
• As a card-carrying member of the AIDS Clinical Trials Group (ACTG — the cards they give us are really nice), I must point out that 25 years ago tomorrow — December 2, 1986 — Margaret Fischl enrolled the first patient in the first-ever ACTG study, Study 002. Lots accomplished since then by the ACTG, and there have been lots of study numbers. But here’s something you might find reassuring — no one can keep them all straight!
• Speaking of Margaret, here’s a terrific interview she did a few years back about the early days of the HIV epidemic — highly recommended.
• Finally, is anyone else bothered by the fact that coformulated medications are increasingly being written in alphabetical order? That is, “emtricitabine-tenofovir” instead of “tenofovir-emtricitabine” (as it has been for years) or, very strangely, “emtricitabine-rilpivirine-tenofovir”, which splits the NRTIs with the NNRTI in the middle. The first time I saw it was in the iPrEx study, and now it’s happening more and more. What’s up with that?

Sorry I haven’t been able to post images recently — I was quite fond of this one — but at least I can still link to them. And though it has absolutely nothing to do with World AIDS Day, here’s a personal favorite.