Advances in HIV

Thanks, web-books.com

Big news came out this past week in the fight against the spread of HIV.  For years, initiation of highly active antiretroviral therapy (HAART) has been determined by the sufficiency of a patient's immune system.  HAART initiation occurs after either CD4 counts (which is an indication of how well one's immune system is stocked) reach a low threshold or after an AIDS-related event, such as developing a strange disease that does not typically afflict folks with functioning immune systems.
The development of HAART was a game-changer in the AIDS epidemic, shifting the infection from a sure-fire killer to a chronic, manageable disease.  HAART involves some combination of daily medications, not without cost and side-effects, but its increasing availability has provided hope in the fight against AIDS worldwide.


An international study of HIV transmission has shown that those who are infected with HIV who take HAART before reaching that low threshold are 96% less likely to transmit HIV to their sexual partners.  The study, HPTN052, was a randomized control trial (in the realm of clinical science, that's about as good as they get) of over 1600 heterosexual couples from Brazil, sub-Saharan Africa, Thailand and the US scheduled to run through 2015.  However, results were so convincing that the researchers stopped the trial early on so they could get the information out.

This will likely alter treatment plans for those at risk of spreading HIV, and will almost certainly require an even higher ramping up of medication production and distribution worldwide.  But this brings us to the issue of HIV prevention: we already have effective, proven means of preventing its spread.  Condoms and needle-exchange programs (not to mention sexual abstinence) are actually sufficient to prevent the spread of HIV.  The crux of the matter lies in health behavior.  Why are those infected, as well as those at risk of infection, not partaking in the effective means of preventing disease spread?

Another issue is adherence to medication regimens.  As mentioned above, HAART is not without costs, both in terms of finances and side-effects.  Particularly in the US, even those at greatest risk of death by AIDS can be negligent of their medication regimens.  Even missing a few doses can lead to patients rapidly developing resistant strains of the virus.  What happens when we dramatically expand the treated population, particularly to patients who are taking their medications for ostensibly altruistic purposes?  This strategy will require not only an increased production of current medications, but also a wave of research into new medications capable of battling new resistant strains.

Regardless of the drawbacks, this is good news for the global fight against HIV.  Future research will be needed to determine the efficacy of this treatment for men who have sex with men, which were not targeted in this study, as well as in the realm of interventions to promote medication adherence in this broad population.

A new church

For several years, I have talked a big game about wanting to address issues of race and poverty.  I have read articles and books on racism, sociology, theology and health.  I have engaged people in conversation and watched films on the issues.  But James tells me that my beliefs are manifested by my deeds, not my words.

Rachel and I started looking for churches together when she moved to town last winter.  We visited congregations across the denominational spectrum, looking for a home that prioritized our values of racial reconciliation, social justice and the redeeming gospel of Jesus.  And what we found is that these are really hard things.  Most churches do some things well, but almost every church seemed to fall either to one side or the other.  Some where committed to the importance of the gospel while only including issues of race and greed as an addendum, while others delivered soft-serve Jesus while advocating for social issues.  The struggle is real in my life, and when you multiply it to a church-wide level, things get messy fast.  Through our search, as well as a range of conversations with smart people, we began to recognize that if we wanted to participate in racial reconciliation, we would have to step out of our position of majority and into a place where church was not done the way that best fit our preferences.

A few months ago I came across Community Church Without Walls while researching a class project on West End Community Gardens.  Though we didn't know much about the congregation, we decided to visit.  What we found was certainly out of the realm of our preferences.  Our friends Mikey and Lindsay joined us that first night, and I was thankful they came with us as we looked for a house church on Tuscaloosa Avenue in Birmingham's notoriously poor (and thus, in my mind, dangerous) West End.  The first word that came to my mind that night was chaos.  Aside from the four visitors, the only other white person there was the young, soft-spoken pastor, R.G.  I have always attended churches with rich music; here the songs were a capella versions of "This Little Light of Mine" and "Sanctuary."  The service was regularly interrupted by irrelevant questions.  But in the chaos, there was something good.

We have been attending now for a few months, and for the first time in years I feel settled at a church.  CCWW certainly has its issues, and sometimes the chaos is a bit maddening.  But the people in that community know God in different way than I have known Him.  I think the honesty has been most refreshing. One evening during the message and discussion about "turning the other cheek," a woman provided a real-life example of smacking her daughter.  Teen pregnancies are regular announcements.  Last week, during prayer requests, someone said he had recently learned that there was a hit out on his life.  I don't know how to react in those situations, mostly because I've never seen them in church before.  Who are we kidding?  I've never seen them anywhere before.  I don't know what will come of our experience at our new church, but I know this - I'm seeing God in a whole new way.  So maybe I will remain a big talker when it comes to race and poverty.  But at CCWW, I am hoping to see my words sprout into actions.

Friday Pick of the Week

This Friday heralds Secret Stages, a brand new walking music festival situated in Birmingham's downtown district.  Secret Stages is unique in that its primary focus is providing a venue for new music, with a rangy line-up of over 60 up-and-coming artists, both local and national.  Weekend passes are $25.  I encourage you to check it out.

An act featured in the festival is The Green Seed, a local hip-hop trio.  They had the good fortune to play SXSW this year.  "Crack Kills" is a well produced, an appropriate choice for a Birmingham festival.  Enjoy.


The Green Seed - Crack Kills from sugartooth on Vimeo.

It's Mothers Day

Happy Mothers Day.  This is for all the mothers out there, especially Rita.

Friday Pick of the Week

Happy Friday, friends.  Today's pick is chosen for a little different reason.  Last Friday, I was offered a one year HIVCorps fellowship with the Center for Infectious Disease Research in Zambia (CIDRZ).  CIDRZ is a non-governmental organization based in Lusaka, Zambia that partners with UAB to do cutting-edge research in HIV/AIDS.  After days of prayer, deliberation and seeking advice, Rachel and I accepted the position on Wednesday.  While this throws a kink in some of our short-term plans, we are unanimous in that this is an opportunity that holds tremendous benefits for us.  Rachel will interview next week for a position with CIDRZ, and if she is offered a position, it will be another answer to prayers.


Anyway, enough about that; you are here for the Friday Pick of the Week.  Given the circumstances, I couldn't imagine a better selection than Toto's "Africa."  If you'll take the time to watch the video, you will basically experience the entirety of our next year. Gonna take some time to do the things we never had...

'We come crying into the world and we celebrate when we leave.' - Ms. Ernestine

Redemptive Violence

"Truly, truly, I say to you, unless a grain of wheat falls into the earth and dies, it remains alone; but if it dies, it bears much fruit." - John 12:24


We must be careful to celebrate "redemptive violence."  Murdering an enemy of the state was not the best way to crush Jesus's movement.  I fear the repercussions...