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Good News and Good-bye

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The end of one era is the beginning of another

by Kelly A. McCann

I have much news to share. Good news. For starters, there is a promising new microbicidal gel being studied in South African women. The gel contains Tenofovir, an antiretroviral drug found in several commonly prescribed HIV medications. Researchers recently reported at the XVIII International Conference on AIDS in Vienna that women who used the vaginal gel before and after intercourse were 39 percent less likely to contract HIV!

This study is just the first to produce results among several investigations into the safety and effectiveness of biomedical HIV-prevention approaches. Other studies will hopefully yield equally encouraging outcomes in the coming months, even if formal FDA approval could be three or more years away. Still, these studies give us hope about possible new weapons in the battle to reduce HIV transmission.

Second, a new editorial published in the August 14 edition of the medical journal The Lancet suggests an achievable way to reduce HIV transmission. The authors cite the ineffectiveness of current prevention strategies, and hypothesize that rates of HIV transmission could be reduced within a community by simply launching aggressive testing initiatives and treating all people found to be HIV-positive with antiretroviral drugs, regardless of their current CD4 (T-cell) counts. The idea is that treatment lowers viral load (the number of viruses in the body), which in turn renders HIV-positive persons less infectious.

Their proposed plan offers hope because it does not require us to wait years for the development of a vaccine or more effective biomedical methods. Rather, it calls for utilization of tools already at our disposal—testing and treatment. However, their idea of early treatment is still controversial because it carries risks of increased medication resistance and intensified side effects among patients, so further study is required.

In a similar vein, HIV-prevention experts and scientists from the CDC and Johns Hopkins have concluded that sharply increasing current prevention efforts could cut new HIV infections by almost half. Their study, which was published online in the Journal of Acquired Immune Deficiency Syndromes, declares that an immediate investment in prevention could forestall hundreds of thousands of new infections. While they admit the plan would be an expensive one, they claim it could ultimately save the U.S. billions of dollars in future health-care costs. Saving lives and money. That sounds like good news to me.

Given some of the goals of our country’s comprehensive National HIV/AIDS Strategy—a 25 percent reduction in new HIV infections by 2015, identification of the 21 percent of HIV-positive people who are unaware of their infection, and successful linkage of newly-diagnosed persons to care and treatment—these proposed test and treat plans seem to be on target. I strongly support these approaches, and I am putting my money where my mouth is…so to speak.

At the end of September, I will be leaving my post as chief executive officer for AIDS Foundation Houston in order to head up an HIV testing initiative being launched in our city by a pharmaceutical company. Like the test and treat programs touted by researchers, the goals of this new initiative are right in line with the National HIV/AIDS Strategy.

In my new position, I will be working with doctors, hospitals, clinics, community-based organizations, faith-based entities, politicians, and other thought leaders to bring more widespread HIV testing opportunities to Houston. In the end, I hope my efforts will result in fewer citizens becoming infected with HIV.

I am excited about this new venture, but it is tinged with sadness because it means I am leaving AIDS Foundation Houston, an organization I love and believe in.

After nine years with AFH (four years as vice president of community resources and five as CEO), I have seen the organization grow and make many positive contributions to our community. We’ve developed nationally recognized prevention strategies targeting incarcerated populations. We’ve increased the numbers of beds and housing programs available to homeless and chronically ill persons in our city. We’ve created a leadership program for HIV-infected youth so they can learn how to become healthier, more responsible, and more independent HIV-positive adults. We’ve convened many successful fundraising events including Texas’ first and only $1 million AIDS Walk. And we’ve received clean audits and four-star ratings from Charity Navigator for our fiscal responsibility and good stewardship of donor dollars.

While I am pleased with what we have achieved, I am especially proud of the work we do each and every day to prevent new infections and ease the suffering of men, women, and children living with, and affected by, HIV/AIDS. It has been my absolute honor to lead this outstanding organization and its compassionate and dedicated staff members. I will continue to support AFH and the vital work they do, and I hope you will too.

Finally, after almost four years, this will be my last AIDS Watch column. It has been my privilege to write for OutSmart, and I am grateful for the opportunity it afforded me to share HIV information and my passion with you. Be safe. Get tested. Live well.

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