Kicking A Lion

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The Future of AIDS

According to the Centers for Disease Control and Prevention, more than 1.1 million Americans are living with HIV. Three-fourths of patients are male. Roughly 70 percent of HIV positive individuals are 25 to 49. 25 percent are 50 and older.


Robert Gallo, M.D., HIV Director of the Institute of Human Virology, University of Maryland School of Medicine, helped discover the AIDS virus in the 1980s. He also developed the blood test to detect the virus. Gallo says, scientists have come a long way in AIDS treatment. 15 to 20 years ago, patients with HIV/AIDS had few treatment options and most lived only five to ten years after diagnosis. Today, there are six different classes of drugs and more than 30 medications. Although there is still no cure, the current medications can help control reproduction of the HIV virus and slow progression of the disease. And Gallo says many HIV positive patients are living for decades after their diagnosis. He believes a vaccine to protect against AIDS may soon be available.


HIV Treatment Compliance


One of the most important factors in living with HIV is medication adherence. Missing a dose of medication, or not taking it correctly, can give the virus time to reproduce. In addition, the virus may gain strength, and start to resist the effects of the medication. Drug-resistant strains can be transmitted to others through risky behaviors, limiting treatment options for newly infected patients, as well. While doctors may be able to try a different treatment regimen, the virus may eventually become resistant to all therapies.


The JACQUES Initiative


The JACQUES Initiative was started by the Institute of Human Virology, University of Maryland School of Medicine to improve medication compliance among HIV positive patients. The goal of the program is to provide patients with whatever resources they need to stick with their treatment.


Derek Spencer, N.P., HIV Specialist with the Institute of Human Virology, says fear of HIV or the stigma associated with infection can influence treatment compliance, or keep some patients from seeking treatment. The JACQUES Initiative emphasizes HIV/AIDS education to dispel misconceptions, reinforce the serious nature of the disease and teach clients about the importance of taking their medication. Family members, friends and neighbors may be included in the educational program to provide support and assistance for the patient.


The JACQUES Initiative also provides clinical management and intensive treatment support. Patients can drop in at any time to have lab tests and exams to help monitor progression of the disease. In some cases, HIV patients may take their medication in front a clinician to ensure compliance (a program called direct observation therapy). Clients can also get medications for other conditions they may have, like high blood pressure or diabetes.


Spencer says in the first year of the program, roughly 70 percent of clients were experiencing treatment failure. Now, in a complete reversal, he says, 75 percent of patients are sticking to their treatment plans and continue to do well one year later.


The JACQUES Initiative also provides support to help clients succeed and thrive. In addition to advocating for early testing and prompt treatment, patients are given the opportunity to complete a GED, bachelor’s degree or other advanced education and training to improve all aspects of their lives. A few other hospitals around the country are now starting to adopt some of the JACQUES Initiative programs. For information about the JACQUES Initiative:


    For general information about HIV or AIDS:

  • Centers for Disease Control and Prevention
  • U.S. Department of Health and Human Services
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    Written by kickingalion

    December 13, 2008 at 4:35 pm

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