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Wednesday, July 30, 2008

HIV News

posted by on July 30 at 10:34 AM

The HIV vaccine is a total bust… but researchers in Houston claim to have found the Achilles’ heel, a part of the fast-mutating virus that doesn’t mutate. Blast away at that, and you can “disable” the virus in infected persons.

The weak spot is hidden in the HIV envelope protein gp120. This protein is essential for HIV attachment to host cells, which initiate infection and eventually lead to Acquired Immunodeficiency Syndrome or AIDS. Normally the body’s immune defenses can ward off viruses by making proteins called antibodies that bind the virus. However, HIV is a constantly changing and mutating virus, and the antibodies produced after infection do not control disease progression to AIDS. For the same reason, no HIV preventative vaccine that stimulates production of protective antibodies is available.

We’ve been down this road before—Achilles’ heels located, targeted, hopes raised, and then… back to the ol’ drawing boards. These researchers say they’re at least five years away from any treatment for people with HIV, so let’s not go out and stick our asses in the air just yet, boys, okay? And remember: Even if we do one day have a vaccine or an effective treatment for HIV, recreating the gay communal-sewer sex culture of the ’70s is a Very Bad Idea. One important lesson—one of the top lessons—of the AIDS epidemic is this: Given the right conditions, new sexually transmitted infections can emerge and kill you and all your friends.

Remember: Straight people should have more sex (and more sex partners) than they do; gay people should have less sex (and fewer sex partners) than we can. Balance, balance, balance—oh, and anal sex is not a first-date activity; use condoms for anal sex with casual partners to protect yourself from HIV and other STIs, known and unknown; and lower your inhibitions the old-fashioned way—therapy and beer—and stay the fuck away from meth and meth users.

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I have to agree though; we have seen this before. The famous "we think we have something" and then it turns out to be false.

Wait a couple of years and see if this "discovery" is really leading somewhere before putting much hope into it.

Posted by Cato the Younger Younger | July 30, 2008 10:40 AM

It's hard dealing with the receptors, since we have less knowledge of them in the lit, actually.

Even today's news about Alzheimers drugs is not as great as it sounds, in that people are hyping what is at best a minor treatment for people who haven't yet developed full blown AD and don't have the AD genes that give you a high chance of getting AD early. So it's a lot less useful than people think ...

Want to avoid HIV? - don't eat bush meat. That's where we got it from.

More promising news on the other vaccine fronts, though, like field reports from TB and Malaria.

Posted by Will in Seattle | July 30, 2008 10:46 AM

@2 Bush meat?

Posted by Hartiepie | July 30, 2008 10:55 AM

total douche chill...

Posted by michael strangeways | July 30, 2008 10:56 AM

@3, I'll have the Barbara ribs, and a side of Jeb gizzards. Yummy tummy!

Posted by Jubilation T. Cornball | July 30, 2008 10:57 AM

Dan, you're totally right. Given the right conditions, MRSA could become the next gay epidemic. Or something even scarier. Creating the right conditions for such a disease to emerge will produce fantastic pressure for such a disease to appear and spread rapidly, and then it's 1980 and GRID all over again. This is scary, scary shit.

Posted by Greg | July 30, 2008 10:59 AM

I put a condom on my meat to avoid HIV etc...

Posted by Hartiepie | July 30, 2008 10:59 AM

Dan, for realz.

@2, shut up.

@5,7, lawl.

Posted by rb | July 30, 2008 11:03 AM

Every little bit of knowledge helps. I doubt we'll find a vaccine, but more effective treatments, those we'll find.

However, I don't foresee gay men (or anyone, really) acting terribly rationally when it comes to sex. Humans are inherently irrational creatures, and anyone who tells you otherwise is trying to sell you something.

Posted by Gitai | July 30, 2008 11:04 AM

golly gee, Will, your knowledge on all subjects imagineable knows no bounds...

STFU. I can only imagine how insufferable of an ass you must be in real (non-internets) life.

Posted by moonface | July 30, 2008 11:18 AM

I'm with Will -- I've avoided bush meat all my life.

Posted by Dan Savage | July 30, 2008 11:22 AM

@2 Nobody outside of the Congo has contracted an HIV infection from bush-meat. Which decade and country are you living in?

Posted by inkweary | July 30, 2008 11:25 AM

Good. For one thing, it smells, Dan.

Posted by Will in Seattle | July 30, 2008 11:26 AM

Damn it, why don't local bushmeat-enthusiast organizations do more to combat the spread of HIV? It's all about "self-esteem" and feeling GOOD about eating bushmeat. Very irresponsible of them.

Posted by tsm | July 30, 2008 11:29 AM

Aw, fuck.

It never occurred to me that there will be more new STDs in the future. Great point Dan, and screw you for freaking me out.

Posted by Carlos | July 30, 2008 11:29 AM

@11 --Yah, eating the little man in the boat would be cannibalism, and that's just wrong...

Posted by Hartiepie | July 30, 2008 11:33 AM

Thanks, Dan, for yet another attempt at voicing reason. Hopefully the message will, er, penetrate the thick skulls out there... despite being told by recent "little prick" adds that if I don't have condoms, all I have to do is "test often, test often, test often" and all will be just fine.

To quote Auden, "we must love one another or die." (And act like it. Respect.)

Posted by Andy Niable | July 30, 2008 11:34 AM

The death of the gay self as a result of blatantly ignoring all medical evidence e.g. having unprotected sex renders no sympathy from me. I mean...seriously what the fuck?

Posted by Non | July 30, 2008 11:41 AM

Because being condescending works so well in getting through to people.

Posted by monkey | July 30, 2008 11:55 AM

Coddling isn't working for some, Monkey, so why not a multi-pronged approach? Coddling, "harm reduction," and excuse-making from the HIV "educators," and shame, derision, and condescension from folks with brains?

Posted by Dan Savage | July 30, 2008 11:58 AM

Or you could hand out dunce caps with "HIV Dumb" on them.

Posted by Will in Seattle | July 30, 2008 12:02 PM

@20, you keep on keepin' on, Dan. Your candid (and, frankly, suffer no fools) approach to HIV education (as well as Eli's past articles) are a breath of fresh air.

I grew up in an atmosphere of HIV terror (early 80s); this mutated to relentless safe sex messages focused on responsibility, which then became safe sex messages imbued with counter-intuitive paens to hedonism. Thank god I locked in on the message when it was still about personal responsibility and the fact that AIDS = death. Because it does = death. The runway may have been extended, but eventually, it gets everyone.

Someday, I hope, a kid who reads The Stranger will decide not to bareback his new Manhunt friend and thereby live to old age...and will say thanks to you.

Posted by Jubilation T. Cornball | July 30, 2008 12:10 PM

And, while we're talking about STDs, let's not forget the major reasons to wear condoms - Gonorrhea and Chlamydia.

Posted by Will in Seattle | July 30, 2008 12:26 PM

@Dan #11:

(hand on eyes)

Posted by Paul Lundgren | July 30, 2008 12:28 PM

"recreating the gay communal-sewer sex culture of the ’70s is a Very Bad Idea"

Characterizing the gay culture of the 70s as a communal-sewer sex culture is Another Very Bad Idea.

Posted by BobN | July 30, 2008 12:31 PM

I was there for the, er, tail end of it, BobN. Came out in 1980. I was there, I saw, and my characterization is accurate.

Posted by Dan Savage | July 30, 2008 12:38 PM

I thought only Lesbians ate bush meet?

Posted by Impeach Bush Meat | July 30, 2008 12:41 PM

No, it's pit bulls that do that, IBM.

Posted by Will in Seattle | July 30, 2008 2:05 PM

I get the sense the communal-sewer sex culture is kind of back....bathhouses seem to be much less stigmatized than they were 8 years ago. Ditto anal sex/group sex for first-time hookups.

Posted by Jason | July 30, 2008 2:14 PM

Oh that's such bullshit Dan. Telling straight people to have more sex and gay people to have less sex is just perpetuating stereotypes.

You should be telling people to have safe sex, and as much of it as they want as long as every experience is enjoyable, wanted, and healthy.

and telling people to lower their inhibitions with beer...yeah that's a great way to make sure people have safe sex...get em drunk.

You are such an armchair piece of shit psychologist Dan.

Posted by Hunter | July 30, 2008 2:26 PM

Dan is completely right. As a health care professional working with HIV research, a few things you guys should know:
1. New treatments and meds for HIV are not coming out anytime soon, maybe 5 years down the road before we see any new meds FDA approved, and those in the pipeline are merely new drugs of the already existing classes of antiretroviral meds we have. So it's really nothing all that new. And quite a ways off.
2. New treatments are not being developed like they were when HIV was a death sentence. Roche pharmaceuticals just announced they won't invest another dime in HIV research. Why? Because there's already 2 dozen meds out on the market. HIV research doesn't pay unfortunately. And since less than 1% of the US population has HIV, and since those in Africa don't have money to pay for meds, research into new HIV therapies is dwindling, and will continue to dwindle, even more so since the WHO recently announced that outside of subsaharan Africa, HIV will NEVER be heterosexual epidemic.
3. A vaccine may likely never be found. And if so, we are talking years... decades... there is NO immediate hope in sight for an HIV vaccine. And if a vaccine were to be discovered--companies would no longer create new HIV medications. Again, not worth the money, especially when knowing (after a vaccine) that the HIV + population to buy your product will die out and nobody will be left to buy their drugs (since everyone will be vaccinated). HIV research as a whole is focused on finding a preventative measure to reduce/eliminate transmission--NOT into treating those that already have it.
4. The future of HIV/AIDS in the US among MSM is only getting worse.

HIV is completely avoidable. Use a condom, dammit! And those of you using crystal... it is just a matter of time before you end up with HIV, HepC/B or any combination thereof. HIV sucks. Gay men need to take responsibility and realize the reality of this nightmare of a disease.

Posted by Mike | July 30, 2008 2:34 PM

As a long time HIV+ man, I think it best to underscore Dan's point-maybe its some good news BUTT (pun intended) keep this tidbit in mind for your next visit to BP, ManHunt/Craigslist/M4M/SexNow/LustLab/Bar/Meth party pick-up:
STIs continue to be the most
commonly reported of all communicable diseases in
Washington State and comprised more than 75% of all
communicable diseases or conditions reported to the
Department of Health in 2007.
HIV sucks even with meds, but dripping sores, dead livers, warty holes, lesions, tumors, sterility, birth defects, and cancer can put a crimp in your day too. Love yourself to care enough to fuck someone else-disclose, use condoms, and live long.

Posted by chk_it | July 30, 2008 2:51 PM

that's right, keep sounding the alarm! it's stories like these that reveal your pathetic internalized homo hatred. yawn.

Posted by bob | July 30, 2008 3:10 PM

My homo hatred is fully externalized, bob.

Posted by Dan Savage | July 30, 2008 3:29 PM

I see from the latest WA HIV quarterly surveillance report that new HIV stats increased slightly in 2007. Check out the info on page 5, in table 1, in this report:

Sad to see that unlike San Francisco, where the HIV stats continue to fall, fall, fall, most likely because of treatment adherence and sero-sorting, infection rates in WA are not declining.

Posted by MPetrelis | July 30, 2008 3:39 PM

For a fuller report on WA HIV and AIDS stats, check out this 41-page report:

I believe all debates about HIV prevention should always include links to the latest infection stats. Whether the stats are up, down or stable, the gay community needs more discussion on infection rates.

And when the stats are clearly falling, as they've been for years in SF, we need to know why the drop is happening and keep the numbers going down.

Posted by MPetrelis | July 30, 2008 3:42 PM

It's mostly due to growth in HIV infection among African-Americans, actually. I don't know if they show you a break down, but in the original source data there you are.

Posted by Will in Seattle | July 30, 2008 3:51 PM

Dan, it might be time to add GHB to the list of drugs most likely to destroy the current crop of kids. Not as bad as meth, but they seem to be using ten times as much of it.

Posted by eclexia | July 30, 2008 4:26 PM

wrong mike, the fda approved TWO new classes of hiv meds last year (a CCR5 antagonist, Maravoric, and an integrase inhibitor, Isentress). as well, the fda approved new drugs in the old classes that show effectiveness in those who have developed resistance. THIS IS GREAT NEWS!!! Also, via joe my god: A new study published in The Lancet says that advances in treatment since the late 90's have added 13 years to the average life expectancies of people with HIV. In high-income countries with the appropriate health care available, a 20-year-old infected with HIV in 2008 can expect to live another 49 years with the disease.

Posted by WHAT! | July 30, 2008 4:29 PM

Um...I'm with #30. Don't tell me when and how much sex to have Dan. As long as I am not a moron and wrap that shit up I think I can have as much ass sex on whichever date I like, thank you very much. What, you think that on the second or third date that someone trying to get in your pants will magically tell the truth about their hiv status or that you can trust them by that point?

My philosophy: Be a slut if you want, but a smart, latex sheathed, and drug free slut.

Posted by thaumaturgistguy | July 30, 2008 4:30 PM

To WHAT: I'm familiar w/ Maravoric and Isentress. I have numerous patients taking them. Each drug represents the 1st new drug of 2 new classes of HIV meds. There were only 3 classes before (with numerous new meds that have come out over the years belonging to them), now we have 5, the latest 2 classes having only 1 drug each. So yes, 2 new classes of drugs out w/in the last 2 yrs is awesome. But the new drugs we'll see out on the market in 5 yrs are merely additional meds belonging to these two new classes. They will function in the same manner, but hopefully have a better side effect profile (i.e. don't have to inject the med). But it's nothing cutting edge or "new." Just additional options that will hopefully be FDA approved for resistant virus. It's wonderful for those that will require it. But my point is that new treatment strategies, or hopes of a cure, are dying off. Most of HIV research today is focusing on finding a vaccine or means to prevent transmission.

Posted by Mike | July 30, 2008 5:01 PM

Dan @20

Harm Reduction is also condoms, syringe exchange, and teaching alternatives to buttsecks. You preach harm reduction in your column all the damned time. You may not like where gay harm reduction advocacy has gone at times, but don't throw the twink out with the bathhouse water.

Posted by NaFun | July 30, 2008 5:23 PM

Mike, you need to quit preaching. HIV IS a heterosexual disease in the Black and Latino community and coming to the White community soon. Have you ever heard of Russia? India? Thailand? HIV is not limited to gays. You need to stop thinking that the only people in the world are gay white American men. As for Dan--yes we should protect ourselves, but I'm going to have all the damn sex I want and won't feel guilty about it. Life is too short to be worrying about what some uptight Queen thinks of my sex habits.

Posted by Quit Preaching | July 30, 2008 5:35 PM

I'll tell you whatever the hell I wanna tell you, @40, and you can make up your own damn mind what you're going to do. And I didn't tell you how much sex to have. I told you to maybe think about having less sex than you could have, as a gay man. Our nearly limitless opportunities for sex is a blessing and a curse. We have to use our power wisely.

And you can wrap it up all you like -- if you're having sex with tons of guys, odds are good that you're having tons of sex with guys who themselves are having tons of sex with guys who are having tons of sex with guys, etc. Your chances of winding up in bed -- or bathhouses or bushes -- with guys who have an STI are higher, and your chances of suffering a life-altering breakage, seepage, or theassholetakesoffcondomage are greater.

But it's your ass, kiddo, knock yourself out.

Posted by Dan Savage | July 30, 2008 5:40 PM

I love that urging a little restraint -- not a lot, a little -- on gay men makes me uptight. Please read my column, books, etc., and then get back to me about uptight. And if you only knew what I was up to last night. Sheesh.

Posted by Dan Savage | July 30, 2008 5:43 PM

Waddayamean, we straigt people need to have more sex! SOMEBODY has to read all of these Slog comments!

Posted by CP | July 30, 2008 6:27 PM

@ #39,

It's not live ANOTHER 49 years, It's live TO 49 years old. As in you get infected at age 20 and without drugs you can live to an average of 16 more years (age 36). But with the miracle of antivirals you'll get to see your 49th birthday...

...looking like this.:

Posted by Y.F. | July 30, 2008 6:38 PM

I agree completely with Dan and #31. I'm an HIV epidemiologist with a state health department, and I cringe when I hear the nonchalance that some people have towards HIV because we now have drugs that allow you to die later rather than sooner. It is true that the epidemic is growing fastest in African-Americans, but men having sex with men of all races continue to be at high risk. It is estimated that approximately 49% of the HIV/AIDS cases in the U.S. are in men who have sex with men (for more information, visit the CDC HIV/AIDS page). If you absolutely refuse to wear a condom, please at least get tested at least twice a year to keep from unknowingly infecting someone else.

Posted by J. | July 30, 2008 8:33 PM

Thanks for getting my back, J. But I doubt that someone who care so little for his own health will suddenly start wearing condoms to avoid "unknowingly infecting someone else" once he gets infected. Scum is scum.

Posted by Dan Savage | July 30, 2008 9:16 PM

@ Dan 44

You're right, you can tell me whatever you want. Doesn't mean I have to agree and that I can't tell you I don't agree. My point is that getting preachy about when to have anal sex and sounding like the nuns at catholic school telling kids to wait till marriage is just as effective at stopping the spread of hiv as it is at stopping teen pregnancy.

Posted by thaumaturgistguy | July 30, 2008 10:36 PM

When did STD's become STI's? Why the change?

Posted by GS | July 30, 2008 10:40 PM

@51 - I think it was around time people started making grilled cheese sandwiches with sage derby instead of American.

Posted by Megan Lynch | July 30, 2008 11:48 PM

If you don't think HIV is a predominantly gay disease (and I'm gay myself), please read what the World Health Organization has to say about it. Remember--MSM make up less than 5% of the population, and that's a generous figure; yet they make up nearly 50% of all US infections. While it can effect straight people, and has disproportionate rates amongst blacks and latinos, per CDC the ONLY group which has seen a consistent RISE in transmission is MSM. In MSM that are black/latino the figures are even higher.

Posted by Mike | July 31, 2008 5:17 AM

@51 Google mofo:

From wikipedia:
A sexually transmitted disease (STD) or venereal disease (VD), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact, including vaginal intercourse, oral sex, and anal sex. Increasingly, the term sexually transmitted infection (STI) is used, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without showing signs of disease.

Posted by NaFun | July 31, 2008 12:06 PM

STD or is it now STI?

Who the hell cares? The fact is a person who's "infected" is still diseased and poses a potential threat to himself and others with whom he engages in unsafe sexual contact.

In splitting hairs between STD or STI, we place far too much value on the appearance of illness. The key aspect about HIV/AIDS is these days you can't tell by looking.

Posted by wileyjon | August 2, 2008 2:13 PM

I just read tody that they are now saying the CDC messed up on the infection rate in the U.S. by 40%. 40%??? That is freaking huge, enormous, inexcusable. I hope you will do some writing on this.

Posted by jb | August 3, 2008 9:40 AM

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