Posted onOctober 15, 2012byr|Comments Off on HIV related Fertility Treatment and Child Adoption Study UK
Be part of an important HIV research study looking into parenthood.
Are you HIV positive and receiving anti-retroviral treatment?
Are you above the reproductive age of 21 years and above?
Have you considered parenthood and tried to access fertility treatment or child adoption services?
If you answered YES to these questions, you may be eligible to participate in a parenthood research study.
The purpose of this research is to explore the experiences of people living with HIV in accessing fertility treatment services or adoption services. Whilst this study may not provide direct benefits to you, it is hoped that your experiences will help inform and influence future policies in the way services are planned and provided to people living with HIV, trying to have children using non biological means
This study is being conducted in collaboration with Terrence Higgins Trust for Doctorate research at the University of Surrey. The research will take place at Terrence Higgins Trust offices or at a venue suitable for you, telephone interview may also be arrange.
It does not matter about what your background or sexuality is and couples interested may contact Tam Chipawe on firstname.lastname@example.org / 07547 453600 or, Blake Smith at Terrence Higgins Trust on 020 7812 1813 for more information.
Confidentiality will be maintained at all times. This study has received a favourable ethical opinion from the University of Surrey Ethics Committee.
We often talk about prejudice and stigma relating to HIV / AIDS, and in everything we do, attempt to combat this stigma. Not enough people stand out, and sometimes those that do, speak about stigma on a grand scale. Coming up, Rich Juzwiak, an editor at Gawker has posted a wonderful, honest and frank article about understanding the nature of HIV in the context of sex between men from a presumed HIV negative viewpoint.
What is particularly noteworthy is Rich’s unbiased honesty and openness throughout his article. By asking the right questions to people he is meeting for sex (or not) he’s gained a much improved understanding of viral load, and the risk factors involved when meeting people for sex. Sharing his experiences not only provides an education and insight to HIV negative people, but also informs HIV positive people just how little knowledge there is on viral load and transmission.
In addition to the work of organisations like LASS, the Terrence Higgins Trust, the National AIDS Trust and many, many more, the real advocates are the people (regardless of HIV status) who ask questions, understand what’s going on and share their knowledge to the wider public so we can all know our HIV status and enjoy shared companionship whether that intimacy is based on sex, or conversation.
(Would you like to listen to this article instead? Click the play button below…)
The first guy I ever turned down on Grindr for having HIV, my patient zero if you will, is all kinds of hot: hot in the face, hot in the body and hotheaded. In May, he asked me to come over and make out. We chatted a little bit more, he told me about his status and I slipped out of the conversation, just like that. Randomly in July, I noticed him at a movie theater: On Grindr and online, people lie with pictures all the time, choosing ones that distort their appearance in a captured second, but I was able to pick Miguel right out of a crowd. His picture is a symbol of habitual honesty, maybe, but also because he’s so attractive, he has no reason to lie.
“This always happens: someone will feel bad and then they’ll see me out and they’ll be like, ‘Oh my god, you’re so fucking hot,'” Miguel told me while we waited for our table outside of a Chelsea brunch spot one Saturday in early July after I reconnected and asked him to talk to me.
Miguel told me that being turned down for sex because he’s HIV-positive is something that happens “all the time,” and that “almost every time, the minute someone gets to know me, their mind changes.” Exposure to a gay friend often converts homophobes swiftly; the same can be said of an HIV-positive guy meeting others who are fearful. It’s somewhat reassuring that that’s all it takes in many cases, but it also underlines the exponential burden put upon positive guys. They are either in a constant state of proving themselves socially or they are sitting on a secret.
As a gay man in New York with an active, multiple-partner sex life, the chances are that I have hooked up with an HIV-positive guy or five and didn’t know it. Maybe I didn’t know it because he didn’t know it. Maybe I didn’t know it because he was a liar. Maybe I didn’t ask.
Granted, I generally play it safe, keeping fluid exchange at a minimum, using condoms, opting for oral over anal almost every time, and especially with strangers. (Although, as we are coming to realize, oral sex maybe isn’t as safe as we’d like it to be). Even with that in mind, getting tested is never less than horrifying, no matter how regularly I do it. There have been times, especially after suffering from a weird flu-like bug that no one else around me seemed to contract, that I have been sure that I would test positive.
I haven’t yet. I think I’m HIV negative, but since the virus can take three months to show up in blood, I can’t really be sure. In fact, none of us who are sexually active can be sure – except for those who are HIV positive.
Therein lies the hypocrisy in turning down a potential hookup who a) knows his status, and b) is honest about it in favor of one who doesn’t or is lying about it. That kind of discrimination is motivated by fear of the known while taking an agnostic approach to the unknown. It’s especially foolhardy considering that guys who know they are HIV-positive tend to be healthier and with lower viral loads than guys who don’t know they have it and are going untreated. The kind of optimism that assumes someone’s word is as good as a hard copy of a test result is potentially life-altering.
And yet, I’ve turned down guys who are open about their positive status. I watched the onset of AIDS in the ‘80s through the confused eyes of a child. I had it drilled into me that this was a disease to stay far, far away from. I also know better than to sleep with someone who announces himself as HIV positive. Or knew. Now I’m not exactly sure what to think. I feel guilty and scared, but not necessarily in that order.
I forgot to ask Giovanni* his status on Grindr before he came over. I remembered once he was inside of my apartment, discovered that he was HIV positive and asked if he’d like to be interviewed instead of hooking up. He agreed.
One of the first things we talked about was what complicates the situation the most: The widely held idea (at least among the HIV-positive guys I talked to for this story) that antiretroviral medication, which reduces the amount of HIV in a person’s blood to undetectable levels, is a contagion cure-all. That is to say that many people believe that it is virtually impossible for guys who identify as “poz but undetectable” to transmit HIV to a sex partner.
“I feel a little bit discriminated against just because if someone is taking care of themselves, there’s no risk on it, unless you have cuts or you’re bleeding,” Giovanni said. “But even then, you have to have a high viral load. If your status is undetectable, it’s very rare that someone else can catch from sucking.”
Giovanni contracted HIV about three years ago from his boyfriend who lied to him about his status: His partner said he was negative, they repeatedly had bareback sex, it turned out his partner was positive and it destroyed their relationship. “I blame myself,” he told me. His regard of personal responsibility is also present in his current philosophy regarding disclosure. If he’s not asked directly, he doesn’t open up about his HIV status.
“There are people that never ask me about my status, so I just go and assume that they have it,” he told me. “If you don’t ask me, I assume something’s wrong with you.”
I found this point of view disturbing, but most of what else Giovanni said was endearing. He told me that he empathizes with the people who are too scared to hook up with him and who turn him down: “I was there before it happened to me…I know how a person feels. When someone says you’re positive, your world changes.”
And so does the world of the person who has it. “It’s not hard to find somebody that accepts me the way that I am, but I don’t know…” he trailed off.
Before he left, I gave Giovanni a big hug. We were intimate and raw and we never took our clothes off. We talked about staying in touch and getting together again soon but it never ended up happening.
In early June, I lost interest in Chad when he told me he was “poz/undetectable” on Grindr. I didn’t respond to something he said, and 10 minutes later we shared this exchange:
Chad: Haha is that a no? I can take it 🙂 Me: It’s so weird, the situation. I don’t want to seem like a dick or discriminate. You know? Chad: People discriminate all the time. But if u think I would put you at risk, I disagree. And guys think honesty makes things more dangerous. Me: Tell me more about how it wouldn’t put me at risk. Chad: Safe sex with an undetectable guy has no real risk, never been a documented case of transmission. But if you’re feeling spooked it’s no fun for either person ;). Xx. Me: I need to do more research. I didn’t know that. Chad: Take care.
I attempted to engage Chad again and he didn’t respond, not that I blamed him. In July, though, we met face-to-face through a mutual friend. I already knew who he was the second I set eyes on him from afar. From there we resumed communication and I’m glad: he’s attractive with intellect balanced out by an easygoing attitude. He’s exactly the kind of guy I want to be around. He’s also an AIDS activist, and thus particularly informed on the matter at hand.
“Lack of communication and lack of conversation around HIV is a big issue,” he said when I asked him about anti-HIV discrimination. “You have this turning point where the drugs start working well enough so that people won’t be outed by their physical appearance and then talking about HIV becomes a choice. Gay people were very tired of being associated with HIV and AIDS and it just kind of went underground. That’s the birthplace of the stigma. As soon as it became something you could disguise or put away, then it became a question of character.”
Chad’s activism doesn’t turn off when he logs onto Grindr. He says he regularly schools people on the app, as he did with me. He makes education sound like foreplay: he says the type of guys he’d be attracted to anyway are those who are knowledgeable on the subject or willing to learn. He told me that based on the information at hand, he can do “basically everything” in bed, just as long as he’s safe about it.
We talked a little bit about the rejection he’s faced from others like me, which sounds more patience-testing than soul-crushing. He bemoaned guys who “just go totally cold” and make things awkward when he reveals his status in person when he picks them up IRL (he says he always tells people in advance of meeting them if they initially connect online). “If you’re uncomfortable, fine. But communicate. It’s not the end of the world and you’re certainly not going to hurt my feelings. But it’s annoying to go through this beat-around-the-bush rejection process,” he told me.
I wondered about the other extreme: guys unafraid of having unsafe sex with him. He says he’s only experienced a “handful” of these, most of them “dedicated pigs who value raw butt sex.” Whether he would appease them depends on the dude.
Toward the end of our conversation, I apologized to Chad for brushing him off. He told me it was nothing, a blip in his life.
“If the situation presented itself again, you think the guy’s attractive and you’re still not comfortable, what do you say?” he asked, testing my apology.
I stammered and then finally: “It would depend on the level of attraction. But I don’t think I’m a firm no.”
“You’re weak now?” he asked, grinning.
There is an East vs. West Coast divide on attitudes about HIV positive guys, or so I hear from a new friend, Eddie, who I recently met through other friends. A resident of San Francisco, Eddie told me that uptightness or reluctance on this issue is something he’s only experienced on the East Coast.
“People in San Francisco especially, but on the West Coast [generally], as soon as you say you’re undetectable, it becomes like a free pass,” he explained. “‘Oh, you’re undetectable, and the risk is so minimal, and I’m a top and you’re a bottom, and that’s even less of a risk.’ I’m like, ‘I guess?’ I’m not willing to take that risk.”
He told me that when he was in the gay mecca of Provincetown, Mass., last year, he found himself in a group that was ridiculing someone they knew who was recently diagnosed. That pissed him off, and he told them as much. “On the East Coast, [contracting HIV is considered] your fault, on the West Coast, it’s, ‘That could be me, and so I understand where you’re coming from.'”
Eddie says his experiences with HIV hookups have been “80 percent positive, 20 percent negative.” He was diagnosed in 2003 and says it was “probably the hardest thing I’ve ever dealt with.” It may seem unlikely, but sex ended up being therapeutic for him:
“When I started [dating and hooking up], and it wasn’t a big deal for other people, that really helped me. It really helped me realize that I can incorporate it into my identity.”
Eddie’s own journey to comfort exposes the contradictory cultural status HIV has right now: it’s both no big deal and a huge deal. It’s no big deal because the drugs that make HIV undetectable in blood have largely converted the disease into a manageable inconvenience. For many, it is not the death sentence it was. But for others it is: drugs are expensive and the high cost means that every minute, four people die of AIDS-related illness (as related in David France’s upcoming documentary How to Survive a Plague). The drugs can also have debilitating side effects, diminishing the quality of the life they are also saving. A relaxed, non-stigmatizing attitude is a nice thing for the world but complacency with a plague that continues to rage on is not.
Eddie said he understands his risk of transmission to be incredibly low. “I’ve dated people, and we’ve had unprotected sex, and we haven’t transmitted it. But, that’s in a different context than just hooking up with somebody, because you have that conversation and you make those decisions together,” he told me.
Eddie said he feels more discriminated against than stigmatized and pointed to the number of ways gay men can be socially awful to each other. “I think there are plenty of places where the gay community hurts itself—whether it’s through race, or class, or internalized homophobia. And also with HIV status.”
All of this is great and enlightening and galvanizing, but I still wasn’t sure about the information I was receiving. I know that part of taking care of yourself as an HIV positive individual involves educating yourself, and I have faith that these guys know their shit – much more than I did, at least. But the information that all of them hold true – that hooking up with a guy who is positive but undetectable will almost never or actually never result in the infection of a negative individual – it behooves them to hold true. Because they profess to be ethical people, they wouldn’t have casual sex if they didn’t believe this.
I’m not saying they’re wrong, I’m just saying that they could be biased. They are human, after all.
Through a friend, though, I was able to connect with Bryan Kutner, a counselor who was in South Africa working with an HIV-prevention group when I reached out to him. His is a key populations specialist and a consultant with Columbia University and the Harm Reduction Coalition.
Kutner pointed me to a recent study suggesting that just because HIV is undetectable in blood doesn’t mean it is undetectable in semen. It’s one study of a small sampling of HIV-positive men (81), but it does suggest that being undetectable isn’t the “free pass” that some would like it to be, maybe. The paper raises yet another contradiction: as antiretroviral therapy has become more popular, HIV has experienced a resurgence. At the very least, we shouldn’t rest on our antiretrovirals just yet.
But what does that mean?
“You won’t get a hard answer from me on it, simply because there’s not enough science for us to know exactly the state of affairs for men who are gay or have sex with other men,” Kutner wrote me in an email. “Studies have quantified the lessened risk, but I wouldn’t generalize their findings to the lives of gay men. That said, the consensus is that undetectable viral load is a good thing, all evidence on the subject points toward lessened transmission risk, and there may be more we still don’t know but we’re just gonna recommend that low viral load has some beneficial effect on lessening HIV risk even if we can’t exactly quantify it yet among the gays and other [men who have sex with men].”
But the lack of hard facts does not mean that we must abandon reason. It does not mean that it is impossible to make educated decisions based on the scraps of knowledge that we have. Here is how Kutner broke down the choice faced by Grindr users on the poz/neg divide:
[Say] one profile says nothing about status, another says he’s negative, another says he’s positive and undetectable, etc. As a thought experiment, let’s imagine that what people say online about themselves is always true – which is a stretch to begin with, but let’s go with it for now. The guy whose viral load is undetectable might be the better choice for reducing the chance of transmission; he knows his status, he takes his meds, he has no measurable HIV in his blood. The other guys don’t say their status or they say they’re negative. The unknown status guy could have HIV but not want to say anything about it…Then there’s the negative guy. He’s either truly negative or he just thinks he’s negative; if it’s the latter, then in all likelihood his viral load is more of a transmission risk than the guy who knows his status and has undetectable viral load. Based on counseling NYC men testing for HIV, plenty of “negative” guys fuck without a condom and naively think they and the guy they just fucked is negative – so what they say about being negative is true, but it isn’t accurate since a guy’s HIV status is subject to change before he knows it has changed.
So of those three choices, the guy who’s willing to be out about his status might seem like the easier one to trust. Of course, it’s so much more complicated – who wants to think about HIV during sex when it’s hard enough to contemplate it after sex?
So, right. No firm answers to be had here, except that abstinence is the only way to stay truly safe. And abstinence, as we know, is impossible. How terrifying.
Miguel and Me, Redux
“This always happens: someone will feel bad and then they’ll see me out and they’ll be like, ‘Oh my god, you’re so fucking hot…'”
Miguel is 32 and was 21 when he was diagnosed. A former drug abuser, he told me that when he found out he had HIV, it barely fazed him. It wasn’t until he got clean that he realized the true value of himself – now he says he’s healthier than he’s ever been. He has an insanely cut-up torso to prove it.
Though he told me he isn’t angry, his words suggest otherwise. He gets visibly riled when we discuss HIV-related ignorance within the gay community.
“I’ve had people tell me, ‘I’ve ever been with anyone with HIV.'” he said. “Are you fucking kidding me? Do you live under a rock? ‘Well no one’s ever told me.’ That’s exactly it, and you never bothered to ask. So now you’re an idiot. And then they get mad and it’s like why are you getting mad at me? You’re the dumbass who’s probably going to get HIV because of your mindlessness.”
He isn’t exaggerating. Probably. Using CDC figures, I’ve calculated that 1 in 14 men who sleep with men in America has HIV. I’ve heard estimates as high as 1 in 5 in New York. The stats get fuzzy when you take into account how many guys have it but don’t know it (though there are stats for that percentage, too). In general, the hard facts are elusive. HIV is everywhere or not so much and maybe you’ll get it from someone who is undetectable or maybe you won’t and then maybe you’ll be fine after taking some meds. Maybe.
Where having HIV is concerned, you’re damned to a life of uncertainty and anxiety if you don’t, condemned to one of shoddy treatment from your gay brothers if you do. Even if I never contract HIV, it will remain a concern of mine for life. I have contracted an issue.
Miguel informs everyone of his status up front, and told me that those who don’t “are the people who create this stigma with us.” He said he has a “pretty damn active sex life,” hooking up with “a couple of guys a week.”
But “hooking up” means different things to different people. “I mainly just do what happened earlier. That’s about it,” he added.
After Miguel and I set up our brunch date earlier that day via text, he casually mentioned that he was jacking off. I thought that was hot. It inspired me to do the same and I told him. He sent me shots of his hard cock and asked me to, as well. I explained to him why I never do that (I write in public)…and then I caved. Part of it was out of obligation – I had already turned him down enough – but the bigger part of it was that it was sexually exciting, a slight risk (what if the pics leak?) to make a hot situation hotter. He sent me his ass pic as well, and we said nasty things to each other. “Shoot ur load,” he eventually directed me. “I’m going to in a bit,” I said back. He sent me video of himself ejaculating and then said, “Show me.” And so I did.
At brunch we talked about how hot that was, and how lovely our conversation was going. “I feel like this is much more intimate than a hookup,” I told him, verbalizing what I had felt back when Giovanni sat on my couch and spilled his story to me. “Me too. I would much rather do this,” said Miguel.
After we wrapped up our interview and brunch, Miguel and I stepped onto the bright Chelsea sidewalk outside of our restaurant and kissed passionately. We walked down the subway together, our arms spilling all over each other and I felt proud in the presence of this beauty and flattered that Miguel shared his knowledge and story with me.
* Except for Miguel and Bryan Kutner, the names that appear in this piece are pseudonyms.
The fact HIV was first identified in gay men has “indelibly marked the global response” and “stigmatised those living with the virus”, they said.
The researchers’ paper said there was optimism among HIV specialists about the potential to use prevention, such as the drug Truvada, to reduce levels of HIV in men who have sex with men.
Earlier this week, the US Food and Drug Administration approved Truvada for preventative use in those at high risk of infection and who may engage in sexual activity with HIV-infected partners, the first time it has approved a drug to prevent HIV infection.
‘Struggle for equity’
But the international team said the picture was very different in many other countries.
“In too many settings in 2012, MSM still do not have access to the most basic of HIV services and technologies such as affordable and accessible condoms, appropriate lubricants and safe HIV testing and counselling,” they said.
“The struggle for equity in HIV services is likely to be inseparably linked to the struggle for sexual minority rights—and hence to be both a human rights struggle, and in many countries, a civil rights one.”
The paper, published on the eve of the international Aids 2012 conference, adds that by the end of 2011, only 87 countries had reported prevalence of HIV in MSM.
Data is most sparse in the Middle East and Africa, where homosexual activity is a criminal offence.
The researchers call for same-sex relations to be decriminalised in all countries, so that a true picture of the scale of HIV in men who have sex with men can be ascertained.
A spokeswoman for the UK’s Terrence Higgins Trust said: “We’ve got to have community leaders and people with influence speaking out.
“That’s why what Desmond Tutu is saying is so important.”
And she said it was right to focus efforts on men who have sex with men, in all countries.
She added: “In London, one in seven gay men has HIV.”
The regulator conceded, however, its stipulation that such women must not have previously undergone IVF was likely to mean that “quite small” numbers would actually benefit.
“Only a small minority of women aged 40-42 may benefit from the chance to have one cycle of IVF at that age,” said Susan Seenan, deputy director of patient group Infertility Network UK .
“It is good to see that the upper age limit for women has been raised as the evidence shows that we can have success with older women, though that should not take away from the clear message that age is still a major factor in fertility and that the longer one waits the greater the likelihood of problems”, said Professor Chris Barratt of Dundee University‘s school of medicine.
NICE also wants to cut the time women aged up to 39 should have been trying to conceive from three to two years. Seenan said that would reduce the frustration felt by childless couples and enable them to access IVF more quickly and thus increase their chances of starting a family.
The new proposals will also rule that only a single embryo should be transferred where possible.
It will also recommend for the first time that doctors can advise HIV-positive male patients that they can have unprotected sex with their female partner in order to conceive as long as the man meets certain criteria, such as being up to date with his antiretroviral medication, and agrees that they only do so when she is ovulating.
Catherine Murphy, head of policy at the Terrence Higgins Trust, welcomed the proposed change. “HIV medications have improved enormously in the last decade, making mother to baby transmission of HIV preventable and ensuring people can live long and healthy lives. It also means that natural conception is now a possibility for HIV positive men and HIV negative women in the right circumstances.
“An HIV diagnosis should no longer be a barrier to parenthood and we are very encouraged that NICE have recognised this in their consultation”, she added.
HIV and sexual health charity Terrence Higgins Trust has partnered with GaydarRadio to create a series of spoof public transport announcements, encouraging gay and bisexual men in London to ‘mind the gap’ between their HIV tests.
The announcements, which can be found at Terrence Higgins Trust’s YouTube channel, have been launched to promote the charity’s new campaign Mind the Gap and are voiced by GaydarRadio’s breakfast show presenters Neil Sexton and Debbie Ryan.
They contain references to London’s gay scenes in Soho and Vauxhall, with one advising: “You are now approaching Old Compton Street. Alight here for cocktails, Lady Gaga and an altercation with a drag queen in a kebab shop at 3am – and boys, while you’re at it, remember to have an HIV test at least once a year to ensure there’s a good service running on all lines.”
Gay and bisexual men remain the group most at risk of contracting HIV in the UK, with one in seven men on the London gay scene living with the condition. Current guidelines recommend that men test for the virus at least once every twelve months, with more frequent testing recommended for anyone who has had unprotected sex or experiences symptoms of sero-conversion illness.
Have you ever had a HIV test?
If you’re interested in having a HIV test, we offer a completely free and confidential rapid HIV test and you’ll get the results within 60 seconds from a simple finger prick test. We use the Insti HIV test produced by BioLytical laboratories. The test is 99.96% accurate from 90 days post contact for detecting HIV 1 and 2 antibodies. We also have a mobile testing van which is often out in communities providing mobile rapid HIV tests. Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995
If you’re not from Leicester, or prefer to use a different service, the Terrence Higgins Trust operates a clinic finder with details of clinics across the UK, including its own rapid testing services, at www.tht.org.uk/clinics.
Robin Crowley, Programme Controller at Gaydar Radio, said: “Terrence Higgins Trust’s Mind the Gap campaign reinforces the importance of being tested regularly for HIV in a fun and entertaining way. That’s why GaydarRadio’s breakfast team, Neil Sexton and Debbie Ryan, are perfect as the voices for Mind the Gap, delivering a comedy element to this very important message.”
Cary James, Head of Programmes at Terrence Higgins Trust, said: “We want these announcements to make guys laugh, but we also hope they’ll make them think. For gay and bi men, testing has never been easier, yet a quarter of men with HIV don’t know they have it. That’s thousands of men across London who are putting their health at serious risk. We’re hugely grateful to Gaydar Radio for donating their time and talent to support the project, and hope the campaign will encourage more guys to mind the gap between their HIV tests.”
The ‘Mind the Gap’ campaign, funded by the Pan-London HIV Prevention Programme, will provide information via adverts in gay media, posters in gay venues, and through promotional Oyster card wallets to be handed out across the gay scene.
Posted onMarch 12, 2012byr|Comments Off on Scans Show How HIV Attacks Brain
HIV, which attacks the body’s natural defences, also damages the brain, three dimensional medical scans have shown.
The MRI images captured by a US team could show why up to 40% of people with HIV have neurological symptoms. Compared with healthy people without the virus, the brains of the HIV positive patients studied were 15% thinner.
HIV experts said more work was needed to check that neuroprotective drugs would be beneficial to HIV positive patients and that these treatments would not be safe to take alongside the powerful anti-HIV drugs such individuals are already on. As drugs improve, people with HIV are living much longer.
However, at least two in five living with HIV will suffer from cognitive impairments, ranging from minor deficits to dementia, studies suggest. While researchers are aware of this, the pattern of damage the virus causes in the brain has not been well understood.
We’d need more solid evidence on how HIV can affect the brain in different individuals before we looked at offering neuroprotective drugs
Compared with 14 healthy controls, the +ve patients had 10-15% thinner brain regions, including areas called the primary sensory, motor and premotor cortices, regardless of whether they were taking anti-HIV drugs or not.
This tissue loss shown up by the brain mapping correlated with the cognitive and motor deficits that the Aids patients displayed on a battery of brain function tests. The brain tissue loss was the opposite of that seen in common dementias such as Alzheimer’s disease and appeared to be related to the individual’s CD4 count – a marker of how far HIV has progressed and how healthy the person’s immune system is.
The researchers said: “With 40 million patients worldwide now living with HIV, detailed biomarkers of [brain] deficits, such as the cortical maps presented here, are increasingly needed to help gauge the success of neuroprotective therapies.
“Here, they reveal how HIV impacts the brain and may also help identify early changes in neurologically asymptomatic patients with HIV who might benefit most from neuroprotective agents.”
Rod Watson of the Terrence Higgins Trust said: “We do know that some people with HIV could go on to develop Aids-related dementia or other illnesses affecting the brain.
“This study tracking any cognitive decline is interesting but small. We’d need more solid evidence on how HIV can affect the brain in different individuals before we looked at offering neuroprotective drugs.
“In particular, there would have to be detailed research into how useful these drugs would be and how safe in terms of interacting with existing HIV treatments.”
David Simpson, professor of neurology at Mount Sinai Medical Center in New York, told the BBC News website: “This paper is interesting and provocative, and if the value of this technique is validated in other studies, from other centres, this imaging approach may be a valuable surrogate marker of brain function in HIV infection.”
He added: “The increased survival of patients with HIV, due mostly to HAART, has placed greater emphasis on long-term issues affecting quality of life, such as neurological disease.”
Professor Simpson said that, while many neurological complications are more common in advanced Aids, others, including HIV-associated cognitive disorder, may occur in HIV positive people who have relatively high CD4 counts.
Steve Small, deputy chief executive of Mildmay, a HIV charity, specialising in HIV related brain impairment in the UK, said: “This research backs up what most people have known for sometime.
“You have an increased propensity for cognitive decline the more immunosuppressed you are but, whereas before we have thought that this would go away with anti retro virals, this study claims that it will not.”
Every March, Brain Awareness Week (15 – 19 March) unites the efforts of partner organisations worldwide in a celebration of the brain for people of all ages. It is the global campaign to increase public awareness of the progress and benefits of brain research.