2002

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Journal of the International Association of Physicians in AIDS Care

IAPAC Monthly

December: Volume 8, Number 12

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HIV grudgingly yields some secrets (or, orthography and the retrovirus): Mark Mascolini; Orthographers—people who make a profession of studying spelling— would have been pleased with one HIV-related change at San Diego's 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC, or ICK-ack).
Dangerous liaison: Club drug use and HIV/AIDS: Jan Swanson and Alan Cooper; Club drugs, or recreational drugs, as they are sometimes called, have only recently been associated with increased high-risk sexual behaviors which, in turn, may cause higher incidence of HIV/AIDS. By club drugs, we mean a number of illegal, mostly synthetic drugs that are commonly used in nightclubs, "raves," and circuit parties

November: Volume 8, Number 11

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The science of side effects (or, who's afraid of 3T3-F44A2 cells?): Mark Mascolini; Research into the metabolic disturbances of HIV and antiretrovirals has reached the point where players abound. Some favor the laid-back backstroke, others the gaudy butterfly, and others the relentless Australian crawl. Some stick to established lanes; some swim uncharted waters. A few pace setters have emerged, even snagging some early trophies.

October: Volume 8, Number 10

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One step ahead of us: Carmen Retzlaff; Data presented at the XIV International AIDS Conference called to mind similarities between the disease's effect on the individual and the pandemic's effect on global society. African human rights activist Graça Machel pointed out this similarity in her plenary address to conference participants, assembled this year in Barcelona.

Clinicians debate antiretroviral tactics and toxicities, resistance testing, and hepatitis virus coinfection: Mark Mascolini; First-time visitors to the University of Chicago’s Gleacher Center, Room 200, may get the vague sense that they’ve seen this place before— perhaps in certain circa-1600 oil paintings. More than anything, Room 200 looks like a 21st century reimagining of a 17th century surgery, those steeply banked semicircles where medicine’s initiates, and the merely curious, gathered to watch the day’s deans dissect cadavers—or less fortunate live specimens—for their edification.

June: Volume 8, Number 6

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May, Volume 8, Number 5

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Report from the President - Full Partners in the Struggle: José M. Zuniga; Each month, as I put pen to paper and draft my message to members and allies of the International Association of Physicians in AIDS Care (IAPAC), I am filled with mixed feelings of concern and hope. Needless to say, it is at these moments of quiet reflection that the success of our efforts, as well as general developments in the struggle against the HIV/AIDS pandemic are most fully measured in my mind. Doubtless, these conflicting sentiments are shared by each of us who is seriously committed to and engaged in this struggle.
I-MED Exchange Evaluation: Patrick Connelly; Secure the Future (STF), a US$100 million philanthropic initiative of Bristol-Myers Squibb, was launched in May 1999 with a goal of funding innovative HIV care, prevention, and research programs to benefit women and children living with and affected by HIV disease in five southern Africa countries. Within a year, STF funded a number of institutions, including the International Association of Physicians in AIDS Care (IAPAC) to launch a series of innovative programs, among them I-Med Exchange. This pilot IAPAC program aimed to determine whether information technology could provide a means for bringing HIV/ AIDS health education and information support to remotely located physicians and allied health professionals working in STF-targeted countries.
The GFATM: Which countries owe, and how much?: Tim France, Gorik Ooms, and Bernard Rivers; Nearly one year ago, the majority of the world’s nations resolved at the United Nations General Assembly Special Session on HIV/AIDS [June 25-27, 2001] to increase annual expenditure on the AIDS epidemic to US$7-10 billion by 2005, with much of this money to be raised and disbursed by a new global fund. When the fund was eventually set up, its mandate was extended, and it was named the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM).
Visit with IAPAC in Barcelona: The International Association of Physicians in AIDS Care (IAPAC) will be well represented at the XIV International AIDS Conference. In addition to the participation of IAPAC members and staff in plenary and poster sessions, IAPAC will have a booth presence within the conference’s exhibition area (Hall 2 of the Fira de Barcelona Conference Center).

April, Volume 8, Number 4

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Report from the President - GALEN: Breathing life into healthcare capacity building: José M. Zuniga; Each day the HIV/AIDS pandemic deepens to the toll of an estimated 16,000 new infections. Roughly 95 percent of these infections, as well as AIDS-related deaths, occur in the least developed countries (LDCs) of the world, most notably those of sub-Saharan Africa and the Caribbean. Many of these countries, crippled by the double burden of HIV disease and staggering international financial debt, stand at a critical crossroads: that of potential recovery, health and prosperity down one path, or increased death and debilitation down the other. Not only do individual lives and vibrant cultures hang in the balance but so, too, is our very humanity called into question as this insidious disease continues to be visited upon our brothers and sisters in these resource-limited settings.
How to treat without the need to deliver continuous HIV suppression?: Mike Youle; In his seminal work, A Brief History of Time, Cambridge University theoretical physicist Stephen Hawking examines the relationship between space and time with regard to the universe. At one point, he describes the thermodynamic arrow of time that relates to the Second Law of Thermodynamics. . . .
How does HIV/AIDS affect African businesses?: For African businesses to attract new investors, they must demonstrate a competitive advantage. In much of Africa, businesses already have a competitive advantage because labor is abundant, affordable, and productive. Countries inevitably compete against one another to attract investors. In turn, investors seek to locate their businesses in a country that has the most productive, lowest-cost workforce.

March, Volume 8, Number 3

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Report from the President - No acceptable excuse for inaction: José M. Zuniga; One of the more lamentable paradoxes of our modern world is that while the marvels of technology and medicine yield potential to significantly enhance both the quality and duration of life, those in positions of political import often fail to harness the will and conscience necessary to make the most of these advances. Most of us remain incessantly bewildered by and horrified at the suffering and death that, sadly, is often caused not by want of either knowledge or means, but rather as a direct and indirect consequence of political complacency and bureaucratic rigidity.
New antiretroviral tactics, new antiretrovirals, old side effects: Mark Mascolini; Opinion on the timing—and, by implication, the merits—of antiretroviral therapy could hardly have been more divided than in a crowd of HIV clinicians attending an interactive session at last December’s ICAAC. When Brian Gazzard (Chelsea and Westminster Hospital, London) posed the session’s first case on when to start antiretroviral therapy, the audience split almost straight down the middle.

February, Volume 8, Number 2

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Wanted: African-American leadership: José M. Zuniga; According to public opinion polls, the United States remains plagued by questions of domestic security, national economy, and personal solvency. Yet, although it would seem that there is little room on our collective agenda for competing public priorities, we must find room to take notice of those in our midst who continue to suffer lingering injustices.
The SMART way to fight AIDS: Anne A. Oplinger; A critical long-term study to determine which of two common HIV treatment strategies ultimately is better began in early January 2002 at 21 US and Australian clinical trial sites. SMART, or Strategies for Management of Antiretroviral Therapies, will eventually enroll 6,000 people who will be monitored for up to nine years.
IAPAC celebrates seventh anniversary: Scott Wolfe; It has been said of anniversaries that they are like martinis-after a few you do not bother to count them. Not so, says Jose M. Zuniga, President of the International Association of Physicians in AIDS Care (IAPAC), who commemorated IAPAC's seventh anniversary February 5, 2002, with a Web-facilitated conference linking IAPAC staff in Chicago, Toronto, and Johannesburg. Zuniga's bottom-line message: There is no more urgent time for IAPAC to marshal resources-human and financial-and expand the association's advocacy and medical education initiatives worldwide.
The meaning of early antiretroviral success--and the rescue of late antiretroviral failure: Mark Mascolini; The HIV docs who came to Athens for the 8th European Conference on Clinical Aspects and Treatment of HIV Infection aren't ducking thunderbolts yet. So far, the gods betray no envy of their prowess. Or maybe the Olympians figure they still easily hold the winning hand in the AIDS contest. Although HIV medicine makers and the clinicians who joined those drugs in life-prolonging strategies helped thousands cheat death, millions will die before they get to visit any antiretroviral Asclepions.

January: Volume 8, Number 1

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'Focus on our human bond': José M. Zuniga; We are gathered here this afternoon, during a most turbulent of times for our nation and for much of the world, to pay tribute to a national and global statesman-former President William Jefferson Clinton.
Clinton's war on HIV/AIDS: President William Jefferson Clinton; This speech was delivered December 8, 2001, by former US President William Jefferson Clinton at an International Association of Physicians in AIDS Care (IAPAC) luncheon at which he received the association's 2001 Dag Hammarskjdld Award for his leadership on HIV/AIDS throughout his eight-year presidency.
The latest word on lipodystrophy and mitochondrial toxicity (and old words that still resound): Mark Mascolini; Many of the words that matter most in English started out Greek: genesis, stasis; agony, pathos; paradigm, metaphor; icon, iconoclast; comedy, tragedy. And that very short list doesn't even touch the ample lexicon of Greek-derived medical terms: atrophy, hypertrophy, lipodystrophy, mitochondria, osteopenia, to name just five.

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©1980, 2002. AEGiS.

2002

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