One of the more heated HIV-related debates to develop this year relates to a very old issue: whether or not HIV causes AIDS (see the "Special Report on HIV & AIDS"). While supporters of the ill-informed "AIDS is a hoax" concept remain relatively scarce in North America and Europe, this may not be the case in sub-Saharan Africa, where resources to deal with HIV/AIDS are few and where the dissidents' viewpoint may be favorably received for political and financial reasons. Perhaps most notably, South African President Thabo Mbeki, leader of one of the nations hardest hit by the HIV pandemic, called this past February for an official review of the evidence that HIV causes AIDS. In the meantime, provision of some medications such as AZT (Retrovir) to pregnant women and to the armed forces has been suspended.

A request for an intelligent and objective review of available information is one thing, misleading the vulnerable and uneducated another. For most people not medically trained, HIV treatment information is dauntingly complex and trying to evaluate it likely to cause some degree of uncertainty or anxiety. For instance, while current antiretroviral drugs can cause serious, adverse effects, some of which remain incompletely understood, a wealth of data exists to prove that the use of the same drugs has achieved a significant reduction in the rates of opportunistic illnesses and deaths from HIV. Similarly, it may be difficult to reconcile consistent admonitions to adhere completely, i.e., to take all doses faithfully, as prescribed, with new reports on the possibility of "strategic treatment interruptions," in which people quit taking their antiretroviral medications for specific lengths of time. Further complicating the situation are the entrenched problems of institutional mistrust and the exorbitant prices of anti-HIV medications.

For all of the above reasons, it's not hard to see why many people are confused about their treatment options and even more fundamental questions about the origin and pathogenesis of AIDS. Our mission with BETA is to provide a resource that helps people with HIV and their caretakers to sift through the overwhelming amount of complex information that issues almost daily from various news outlets. We believe that the best approach to treatment decision-making involves a willingness to evaluate all available data, rather than selectively suppressing information, and to ask questions as well as develop skills that allow one to distinguish between valid and invalid soures and data. And herein lie the goals of BETA; to provide balanced, comprehensive coverage of the issues and factual information with which readers can make independent, well-informed, vital decisions. (See the "BETA Reader Survey Summary".)

To these ends, this issue of BETA presents feature stories on several major challenges in HIV treatment including residual HIV replication, structured treatment interruption, and access and adherence. This issue also features news from the 7th Conference on Retroviruses and Opportunistic Infections (CROI), held January 30-February 2 in San Francisco. Also in this issue are an overview of side effects associated with anti-HIV therapy and how to manage them, and a look at the new class of entry inhibitor drugs. Finally, we share results from a reader survey conducted late last year, and announce some new and exciting news about BETA itself.

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Copyright © 2000 - San Francisco AIDS Foundation. Reproduced by permission. Reproduction of this article (other than one copy for personal reference) must be cleared through BETA: PO Box 426182, San Francisco, CA 94142-6182. Tel: 415 487 8060 Fax: 415 487 8069 URL: http://www.sfaf.org/beta E-mail: beta@sfaf.org

ÆGiS is made possible through unrestricted grants from Boehringer Ingelheim, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2000. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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