In Tens: 10 Things to Be Ready For

[ 10 ]Harnessing Mobile Media BlackBerry. iPhone. Text messaging. Wireless computer access. The past decade has seen an explosion in the growth and capabilities of mobile media, and AIDS activists will increasingly be exploiting these powerful tools. Services already exist that send text messages to HIVers reminding them to take their meds and deliver e-mails to sex partners potentially exposed to HIV and other STDs, and they'll become ubiquitous as wireless technology improves. As a recent pilot program launched by students at the University of Georgia has shown, providing HIV information to hard-to-reach young people may be as simple as sending the messages directly to their personal mobile devices. [ 9 ]Eradication Although this avenue may ultimately prove as disappointing as vaccine research, scientists have made several advancements toward flushing the virus out of the reservoirs where it hides in the body, protected from current anti-HIV meds. More intensive research aims to purge the reservoirs and ultimately eradicate HIV from the body. Research is only beginning to gain traction, but if successful, this could dramatically alter the view of treatment possibilities. [ 8 ]Back to Condoms With once-promising vaccine candidates proving increasingly ineffective, HIV prevention advocates are pinning future hopes on vaginal microbicides (gel-like compounds, many of which use existing antiretroviral drugs as active ingredients, that act as a sexual barrier to the virus). But with microbicide research still in early human tests and scientists only beginning to analyze puzzling new study results'including data suggesting that men may benefit more from the products than women and that sporadic use could create resistance in the user to the active anti-HIV drugs'prevention pros are being forced to renew their emphasis on a tried-and-true prevention tool: the condom. [ 7 ]Targeting the Market Past prevention campaigns, particularly those of decades prior, were pretty generic and concluded with the 'use condoms' mantra. Today, we've already seen the beginnings of culturally sensitive initiatives, and they're going to become even more highly focused for such groups as young minority men who have sex with men, heterosexual women, crystal meth users, etc. Even HIVers will not be spared as targets as 'prevention for positives' campaigns'not a new idea'get used more and more to get them on the bandwagon to help stop the spread of the virus. [ 6 ]Visitors Welcome Just before press time the U.S. Senate voted to lift the ban that criminalizes travel by HIVers to the United States. Originally tacked on to a bill in 1987 by the late senator Jesse Helms in a time of prejudicial fear, the ban was codified by Congress in 1993 after President Clinton tried to eliminate the regulation by executive order. Advocates were outraged after an HIV educator was jailed in 1989 for entering the country to attend the international retrovirus conference, and since then no other international conference has been held here. Expectations are high that the repeal of the law will make it to the president and that he will sign it. [Editors note: On July 28, just after we went to press, President Bush signed the repeal of the ban into law.] [ 5 ]A Simple Routine More than 20 years since the first HIV antibody test became available in 1985, a majority of Americans still have not been screened for HIV infection, according to national surveys. Federal data suggest that between a fourth and a third of all HIV-positive Americans are unaware they carry the virus. So how do we boost testing rates? By including HIV tests in routine physical exams, say advocates working toward this goal, thereby making testing as common as having one's blood pressure checked. It's an aim the public seems to support: A recent Test for Life survey showed two thirds of Americans support testing as part of a routine health checkup. [ 4 ]The More Things Change... While new data show HIV transmissions are dropping among almost every U.S. risk group, they also reveal a troubling parallel to the earliest days of the pandemic: Gay and bisexual men are infecting one another at high and increasing rates. According to data from 33 states with consistent names-based reporting from 2001 to 2006, the HIV infection rate rose 1.5% each year among all men who have sex with men, 12.4% among MSM ages 13 to 24, and 14.9% among young black MSM. Where infections go, prevention programs follow, so expect HIV campaigns of the next few years to sound as aggressive as those from the 1980s. [ 3 ]Gene Therapy Will we be able to prime the body's immune defenses to fight HIV on their own? By altering a key gene that creates a protein on the surface of immune system cells that HIV uses to attach itself to and invade the cells, researchers have been able to boost the cells' ability to resist the virus in animal studies. Potential therapies won't be ready for years, but this is an area of study to keep an eye on. [ 2 ]Visibility and Openness Historically there were few programs for HIVers outside of the typical private support groups and organizations that offer care, case management, and other services. But in the past few years we've seen a boom in organizations and social groups (like Strength in Numbers and Hope's Voice with its 'Does HIV Look Like Me?' campaign). There's going to be a lot more of these to come'and a lot less isolation for HIVers as a result. [ 1 ]Thriving'Not Just Surviving With vaccine studies continuing to fail (and new research indicating that HIV might overwhelm the immune system more quickly than experts previously believed), the critical path for HIVers will be to give added attention to health and wellness plans. A study in the July 26 edition of The Lancet documents a nearly 40% drop in the mortality rate from the virus among HIVers in high-income countries between the period of 1996'1999 to 2003'2005, and as most HIVers continue to do well on meds and have long life spans, a revamped regimen will have to go beyond meds and include exercise and eating right to help keep the body in top form, build lean muscle tissue, and stave off stress and some side effects. Wellness plans will also have to include regular checkups with a primary care doc to monitor cofactors of aging, meds, and the virus itself'like diabetes, blood fat levels, and heart risks'that can wear the body down.