Volume 11 Number 5/6 May/June 2010

This issue of HTB includes over 25 reports from recent conferences including the recent BHIVA /BASHH conference in Manchester, summaries from the PK workshop in Italy (thanks to the Liverpool drug interaction report) and final reports from CROI held earlier in the year.

We also include news that the large international START study is now open and on the reliance on prompt enrollment into the pilot phase of the trial.

START has the potential to inform our understanding of the pathogenisis of HIV as much as it can answer the primary question of whether initiating treatment above a CD4 count of 500 is better than at 350–500 cells/mm3.

A community statement produced in response to the US DHHS guidelines affirms the importance of this study, and of its safety for participants. We encourgage healthcare workers to inform patients who have CD4 counts >500 when not on treatment, of the option to join this exciting research.

Over news coverage connects the global economic problems with the implications for HIV treatment and prevention programmes. Uganda is one of many countries where treatment programmes are reported to be closing to new patients. Over the last ten years the expansion of treatment access programmes have brought hope that treatments will keep them alive and healthy. These programmes provide the drive behind testing and prevention campaigns, and directly reduced transmission through reducing viral load and risk of infection. Sustainability of these programmes is crucial for treatment that is life-long.

The Global Fund are accepting applications for round ten funding, but this was far from certain earlier in the year. Concern over donor nations maintaining their funding commitments is raised in the report on US funding.

In most countries, HIV-positive people are from sections of the population that are already stigmatised or disenfranchised prior to acquiring HIV. An HIV diagnosis usually increases their vulnerability further. As members of some of the world’s poorest and isolated citizens, these people will be most vulnerable to the downturn in the global economy.

Economic restrictions generate pressure that have the potential to inflame and divide societies in other ways.

We include articles about Uganda and Malawi that have both be widely covered in mainstream press, for the discrimination based on sexuality, specifically agsinst gay men, lesbians and transgender people.

Protecting these human rights and refusing to be complicit in this discrimination is inextricably connected with global programmes to provide great equality in access to medical treatment. Where HIV programmes have the opportunity to challenge this, they should use it.

It is timely that, as this issue of HTB went to press, Steven Monjeza and Tiwonge Chimbalanga in Malawi had their 14-year prison sentences overturned. A concerted campaign will need to insist on similar prinicpals in the future if this single act of compassion is to impact on widespread legislation that continues to maintains broader discrimination.

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