Editor’s Note: On this World AIDSDay, Iasked one of the nation’s leading HIVexperts to share his thoughts with us concerning current HIV-related issues. Dr. Michael Sension is a physician and clinical researcher who has devoted his entire career to assisting patients with HIV/AIDS. A graduate of Johns Hopkins Medical School, Dr. Sension completed his residency at New York Hospital and participated in the Infectious Disease Program at the National Institutes of Health (NIH). He currently serves as Director of the North Broward Hospital District’s Comprehensive Care Center, which provides treatment to one of the nation’s largest populations of indigent persons with HIV/AIDS. He resides in Miami Beach, Florida.
What are the most important current movements in AIDS research that we should know about?
Dr. Sension: There is a lot of research currently going on that is focused on vaccines for HIV. These vaccines are being researched as possible preventative measures against contracting HIV. There are also some widely publicized results from pre-exposure prophylaxis studies (PrEP). New drugs are being developed for people with HIV that look promising both in terms of better tolerability and better effectiveness. These drugs will allow people with HIV to have a higher quality of life than they currently have.
I have heard that there will be a drastic cut in federal funding for HIV treatment. If so, what are the consequences that you foresee?
Dr. Sension: There is a particular crisis currently in the level of federal funding specifically for the medication to treat HIV. This federal grant for HIV medication is referred to as ADAP funding (Aids Drug Assistance Program). Our government has not given the amount of money necessary to provide medication to qualified individuals that would ordinarily qualify for such life-saving medications. Under the existing criteria, almost two-thirds of all states in the U.S. have to place individuals on waiting lists for medication and are not able to provide these life-saving drugs. This is happening at a time when we are realizing it is more important to treat HIV early. By starting HIV medication early, most people with HIV who take their medications regularly can have life expectancies similar to people who do not have HIV. The key is treatment and medication that unfortunately our government has cut off the necessary funding for. It is pretty clear that dire implications will occur if HIV-positive people do not have access to medication. This is a tremendous setback for the HIV-affected community in the U.S. We all need to enlist our friends and families to write their senators and representatives. We must implore them to act immediately to fund the federal programs, known as ADAP and Ryan White, to the necessary levels.
In the media there has been a lot of coverage on Truvada as a preventative measure against contracting HIV. Can you explain and elaborate on this? What are your thoughts on this?
Dr. Sension:Truvada is medication that is currently used for patients who are already HIV-positive. More recently, Truvada has been studied as a prevention for contracting HIV. It has been reported to reduce the risk of contracting HIV in certain high-risk individuals. It remains to be seen how Truvada will be used in the future as more studies are reported. Condom use still remains the most important protective measure for sexually active people.
There are many AIDS/HIV research organizations and many people who want to donate to them. Which one would you recommend and why?
Dr. Sension: I would recommend that people look at the organizations within their communities that provide a high level of social and medical services to people who cannot afford HIV care. I can’t single out any one organization, but I would recommend that people take the time to research how and where the money given will be used.
Which demographic of the population is experiencing the largest rate of HIV infection? Why do you think this is the case?
Dr. Sension: People of color in both the heterosexual and gay communities have some of the highest rates of new HIV infection in the U.S. today. While the exact reasons are unknown, it is likely the result of many factors, including cultural issues, access to care, and educational factors.