Washington Blade - November 11, 2005

LOS ANGELES - The cognitive functions of people with HIV remain vulnerable even as drug cocktails help HIV-positive individuals live longer, neurologists who study AIDS now know, the Los Angeles Times reported. A study published last month by the National Academy of Sciences showed, via 3-D brain scans, up to a 15-percent tissue loss in the centers of the brain that regulate movement and coordination. Researchers also found erosion of the brain's language and reasoning centers in people with HIV. Neurologists who study the disease already have known that drug cocktails that extend lives do not protect the brain from the virus. The new study proves what many feared. "As people are living longer, the major risk of HIV is not the immune system anymore, but the brain," Dr. Paul Thompson, professor of neurology at the UCLA School of Medicine and author of the brain scan study, told the Times. "People who are doing well with HIV, living with it for over 10 years, have this progressive damage going on in the brain, well before symptoms are obvious." This damage could be reflected in people with HIV via everything from minor problems with memory to the possibility of early-onset dementia, officials said.

Calif. study: Crystal meth use among gay men starts to wane

SAN FRANCISCO (AP) - Crystal methamphetamine use among gay and bisexual men in San Francisco appears to be falling, according to new research. Using interviews with more than 4,000 self-identified gay and bisexual men, the Stop AIDS Project said last week that half as many men reported using the drug compared with two years ago. In the current questionnaire, 10 percent of men interviewed said they had used meth in the past six months. Two years ago, the result was 18 percent, the group said. "For us, this is a very good sentinel of a shift or a change," said Dr. Willi McFarland of the San Francisco Department of Public Health's Office of AIDS. A 2004 study found that the risk of contracting HIV doubles for gay men who use crystal meth.

Barriers falling for HIV-positive people who seek organ transplants

NEW YORK - Buoyed by a legislative victory in California and a court ruling in Arizona, advocacy groups say they are making significant headway in efforts to ensure that HIV-positive people have the same access as other patients to kidney and liver transplants. California recently became the first state to prohibit insurers from denying coverage for organ transplants based solely on a person's HIV status. In Arizona, a judge ruled that the state's Medicaid program can't deny a liver transplant to an HIV-positive woman on the basis of her health status. "There are a lot of optimistic signs," said Jon Givner, who heads the HIV Project at the Lambda Legal Defense & Education Fund, a New York-based gay-rights group. "When presented with the evidence, reasonable people have a hard time coming to the conclusion that an HIV-positive person should be denied a transplant." In the past, health leaders often refused transplants for HIV-positive people, believing that the always-tight supply of donor organs should be directed toward patients whose survival prospects weren't clouded by the complication of HIV. However, the development of effective anti-retroviral therapy extended the longevity of HIV-positive people and changed the thinking of many experts.

Gay Canadian leader: Consult gays to improve health care

HALIFAX (AP) - Gay citizens must be consulted to develop a health care system that is better able to treat them, says Ontario's health minister. George Smitherman, who was in Halifax last week to address the Rainbow Health Coalition's health and wellness conference, said medical workers are often unprepared for the needs of patients with different sexual orientations. Alcohol and drug abuse, depression and HIV/AIDS are more common among people who are not heterosexual. And Smitherman, who was Ontario's first openly gay legislator, said medical workers can neglect sexual orientation when looking for root causes or treatment options. "Much of this is behavioral in nature and it does require a health care system that is responsive to needs, but it also requires community leadership,'' Smitherman said before his speech. Smitherman said Ontario is developing a network of offices to make health care decisions at the community level.

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