Posts Tagged ‘new york’

NYC Recommends AIDS Drugs For Any Person With HIV

Thursday, December 1st, 2011


City health officials said Thursday they are recommending that any person living with HIV be offered AIDS drugs as soon as they are diagnosed with the virus, an aggressive move that has been shown to prolong life and stem the spread of the disease.

Standard practice has been to have patients put off the expensive pill regimen — which can cost up to $15,000 a year in the United States — until the immune system weakens.

But New York City Health Commissioner Thomas Farley said recent studies have shown that the benefits of early treatment, combined with education and testing, appear to be a promising strategy for countering the epidemic.

“I’m more optimistic now than I’ve ever been about this epidemic that we can drive our new rates down to zero or close to it — eventually. I don’t know how soon. But I’m very optimistic of the direction that it’s going to take the epidemic to,” Farley said in an interview Wednesday.

More than 110,000 people in New York City are infected with HIV, more than in any other U.S. city and about 75 percent of all cases in the state. San Francisco, which had more than 18,000 people living with HIV, is believed to be the only other major city to have made a similar recommendation in 2010.

City health officials said the new recommendation could initially help about 3,000 people get on medications. About 66,000 New Yorkers living with HIV that the Health Department tracks are being effectively treated with AIDS drugs, they said. But they said it was difficult to estimate how many people would eventually need the medications.

Some doctors agree with the Department of Health that it is time to update the guidelines for initiating AIDS drug treatment.

“The New York City health department is a little bit ahead of the curve. In my opinion, the rest of the country will follow and I think it will be pretty quick,” said Dr. Michael Saag of the University of Alabama at Birmingham and past chairman of the HIV Medicine Association.

The standard measure of the CD4 count — a way to measure the strength of the immune system — is an outdated trigger for therapy, a relic from research on early antiretroviral drugs, Saag said.

“It’s an anachronism. It’s old school. It’s yesterday,” Saag said. “I agree completely with the New York City health department.”

Dr. Joel Gallant of Johns Hopkins University School of Medicine and vice chair of the HIV Medicine Association also agrees with the New York recommendation for offering early treatment. He recommends early treatment for his own patients.

“Nobody I know who is an HIV expert feels that it’s a bad idea to treat HIV at high CD4 counts from a medical or scientific standpoint,” Gallant said. “If there are objections, they’d usually be based on cost or feasibility.”

Saag said the cost questions are very important because brand-name drugs can retail for $1,200 to $1,600 per month.

“For sure, they’re very expensive drugs and we should be careful about that,” he said, though he added that the medications are going generic so costs should come down.

City health officials said they anticipated that the cost for expanding the use of AIDS drugs would be covered by private insurance or by the AIDS Drug Assistance Program, a $270 million program for the uninsured or underinsured that is partially funded through federal dollars. The health officials said they expect the benefits over the long term would far outweigh the initial costs because there would be fewer hospitalizations and new HIV cases.

“There will be some increasing costs over the short term,” said Farley. “But over the long term, it’s absolutely the right thing for the epidemic.”

HIV experts are split about whether early therapy should be recommended or optional. Besides the high costs, the pills have side effects from nausea to liver damage. Patients unwilling to take them religiously for life could develop drug resistance.

A panel that recently updated U.S. guidelines was divided evenly, with half favoring starting therapy early for everyone and half regarding an early start as elective.

But there’s growing evidence that untreated HIV can lead to cancers and heart disease. What’s more, antiretroviral drugs are safer, have fewer side effects and work better than they did in the past. New research also indicates that people live better, healthier lives and their sex partners are less likely to get infected.

The new research cited by the city’s Health Department in making its recommendations includes a nine-nation study whose preliminary results were announced earlier this year and showed that earlier treatment meant patients were 96 percent less likely to spread the virus to their uninfected partners.

Dr. Moupali Das, the director of research at the San Francisco Department of Health HIV Prevention Section, said its surveillance data indicated that physicians were treating their HIV patients early even before the city recommended doing so. She said the average amount of time from diagnosis to having no virus in the blood went from 32 months in 2004 to eight months in 2008.

“That reflects that the newer medications are more potent and efficacious, and the doctors were likely initiating them earlier,” she said.

She said they are currently analyzing what has happened since the recommendations went into effect. But, anecdotally, she said that there has been a change among patients seeking treatment. “It’s changed the dialogue and empowered our patient population,” she said.

Public health experts predict the guidelines for starting AIDS drugs treatment will shift toward a clear recommendation for early treatment.

But New York City’s health commissioner said officials there could not wait to respond.

“What we’re doing here is we’re making a really clear and unequivocal statement that we think this is good for the health of the patient, good for the health of the entire population, good for the response to the epidemic,” Farley said.

À New York, les mariages gays sont tirés au sort !

Wednesday, July 20th, 2011


À partir de dimanche, l’état de New York pourra célébrer les mariages gays en toute légalité ! Le maire, Michael Bloomberg, permet ainsi à des milliers d’Américains homosexuels de vivre leur amour en étant mariés. Seul bémol, l’affluence des demandes oblige la ville à organiser une loterie pour désigner les heureux gagnants.

Le 24 juin dernier, l’état de New York devenait le 6e état américain à légaliser le mariage homosexuel. En adoptant le « Marriage Equality Act », qui prendra acte le 24 juillet, un mois après sa signature, l’état de New York devient le plus gros état à légaliser le mariage gay.
Pour fêter l’événement, un tirage au sort a été mis en place pour désigner les couples pouvant se marier cette fin de semaine. La ville a déjà reçu 2 661 demandes de mariages depuis le 5 juillet. Mais dimanche, « seulement » 764 couples auront la chance de célébrer leur union dans un des cinq quartiers de la ville : Manhattan ( qui prévoit 400 cérémonies), le Bronx (98), Brooklyn (112), le Queens (112) et Staten Island (42). La ville a tout prévu pour que l’attente entre les cérémonies ne soit pas trop longue. Pour les autres, il faudra patienter jusqu’à la semaine prochaine.
Cette évolution de la loi fait de New York un lieu phare pour les couples homosexuels, comme le décrit l’office du tourisme new-yorkais NYC & Co. qui y voit une opportunité pour booster un peu plus l’enthousiasme des étrangers, notamment homosexuels, pour les États-Unis. Ce sera l’occasion « de positionner la ville en tant que destination de mariage idéale pour les couples gays ». On espère cependant que cette décision sera pérenne. En Californie en 2008, le mariage gay a été légal pendant 6 mois avant d’être interdit à nouveau.

New York mayor to preside at same sex wedding on July 24

Friday, July 8th, 2011


New York Mayor Michael Bloomberg will officiate at the wedding of two city officials on July 24, the first day same sex couples can legally marry in the state.

It will only be the third time that Bloomberg, who has been a staunch supporter of changing the law to allow same-sex couples to wed, has officiated at a wedding since taking office in 2002.

Jonathan Mintz, the city’s consumer affairs commissioner, and John Feinblatt, a chief adviser to the mayor, will marry at Gracie Mansion in Manhattan.

“John and Jonathan have each done so much to make the City a better place, and together, they helped me see the issue of marriage equality in very clear terms,” Bloomberg said in a statement provided through a spokesman. “This will be one of the biggest days of their lives, a day they’ve waited a long time to see, and I’m just honored to be a part of it.”

New York Governor Andrew Cuomo last month signed the state’s Marriage Equality Act into law, making New York the sixth U.S. state to allow gay marriage, and by far the most populous one to do so.

Bloomberg has also announced that clerk’s offices in New York City will be opened on Sunday, July 24, saying that same-sex couples should not “wait one day longer than they have to” to take advantage of the change in the law.

Bloomberg previously officiated at the weddings of his predecessor, former Mayor Rudy Giuliani, and of his daughter.