Year in review: The top HIV-related stories of 2010

In 2010, HIV garnered headlines on Michigan Messenger for a variety of reasons, from continued criminalization concerns to activists gathering to create a coalition to drive pubic policy debates to controversies over Michigan Department of Community Health policies related to the virus.

Here are the top five HIV-related stories from Michigan in 2010:

State health officials fail to produce non-occupational post-exposure prophylaxis policy

In December of 2009, Michigan Messenger released the results of an investigation into state policies which found the Michigan Department of Community Health had never developed a policy on non-occupational post-exposure prophylaxis (n-PEP). Such a policy would direct hospitals, physicians, and other health officials on how to administer antiretroviral medications within 72 hours of an exposure to HIV. The 28-day course of the medications has been shown to be extremely effective in preventing HIV from taking hold.

An MDCH leader promised a policy would be in place by “early” 2010, however, a year later the policy had still not materialized. Officials say the policy is in the legal department being reviewed. That revelation led two national LGBT groups to issue statements condemning the MDCH, and Equality Michigan launched a campaign to pressure health officials to install the new policy immediately.

Corrections department rescinds policy that prevented HIV-positive prisoners from working in food service in prisons.

After a Messenger investigation revealed that the Michigan Department of Corrections policy banned HIV-positive prisoners from working in food service posts, the department announced it would create a new policy. That new policy was put in place in July of 2010.

The new policy was put in place after officials from the Michigan Department of Civil Rights said the old policy and its justification may violate state civil rights laws.

Obama administration announces first National HIV/AIDS Strategy

For the first time in the history of the HIV epidemic, the U.S. unveiled a comprehensive strategy designed to address the disease in the state. The new strategy calls for increased testing, but does not provide an increase in funding for prevention and testing. That was criticized by lawmakers and activists alike. The strategy also contained a call for state and local officials to adopt anti-discrimination laws to protect members of the lesbian, gay, bisexual and transgender community. The policy also called for a review, and repeal, of HIV-specific criminal laws.

MDCH policy guidance on recalcitrant persons with HIV raises concerns

A 2006 policy guidance from the Michigan Department of Community Health has raised concerns about due process for persons with HIV accused of failing to disclose their status to sex and intravenous drug using partners. The guidance directs local health departments on how to identify HIV-positives who are failing to disclose their status, and then take action to constrain their behavior. The health department has a variety of interventions in such circumstances including mandated education, further sexually transmitted infection screenings, and other interventions. In some cases, a health department can seek a court order to restrain a person with HIV, and could seek up to six months of detention for persons in such situations.

For those HIV positives identified as recalcitrant, and thus a health threat to others, the MDCH maintains a database of names, addresses, contact information, employer and other information.

While the guidance lays out a series of procedures in dealing with recalcitrant persons, officials from at least two local health departments said the implementation on the ground is very different than what the policy requires.

A year of scientific discoveries

2010 saw a variety of high profile discoveries in relation to HIV. Some came out in reference to prevention, while others pointed the way towards an elusive but desired cure.

Perhaps the highest profile story in the cure column was that of an American in Germany. The man, Timothy Ray Brown, has been declared ‘cured’ of HIV infection after undergoing a bone marrow transplant with cells that created a genetically modified version of immune cells. That mutation prevents the virus from infected the CD4 cells — which the virus takes over in order to replicate — and thus prevents infection. Doctors in Berlin have declared Brown cured.

The big story in prevention news was the release of a study about the use of antiretroviral medications to prevent HIV infection. In this study, called iPrEx, scientists provided participants with Truvada, a once a day HIV medication which combines to drugs. The study found that it was effective in preventing transmission of the virus in 44 percent of the cases overall, and in participants who used the medication daily as prescribed, prophylaxis was achieved in 90 percent of the cases. The study did however notes some serious potential negatives in the process including possible mutation of the virus to be immune to one of the two medications in the combination drug, and health impacts like kidney problems. The study also was unable to identify what role the increased use of condoms played in the prevention effectiveness.