HIV Drug-Resistance Model
Thanks to the reporting by longtime science and medical reporter Liz Highleyman, writing at the HIVandHepatitis site recently, I've been made aware of a study from Canada that seriously contradicts the latest alarmist math model created by Sally Blower of UCLA. Highleyman reports:
SUMMARY: Is HIV drug resistance becoming more common? Two recent studies suggest opposite answers. A mathematical model by University of California at Los Angeles (UCLA) researchers found that resistant HIV strains are common in San Francisco, and 60% of them could potentially cause self-sustaining epidemics. [...] And a study looking at actual trends in drug resistance among participants in the British Columbia Drug Treatment Program found that the incidence of new resistance fell more than 12-fold between 1997 and 2008.
It's complicated, but in a nutshell the stigmatizing UCLA math model created by Blower is at serious odds with the reality-based findings from Canada.
According the British Columbia study published in the Clinical Infectious Diseases journal in early January, the researchers methods involved thousands of persons with AIDS on drug cocktails, over a period of more than a decade:
Longitudinal plasma viral load and genotypic resistance data were obtained from patients receiving antiretroviral therapy from the British Columbia Drug Treatment Program from July 1996 through December 2008. A total of 24,652 resistance tests were available from 5422 individuals. The incidence of successful plasma viral load suppression and of resistance to each of 3 antiretroviral categories [...] was calculated for the population receiving therapy.
So what were the reality-based results uncovered by the Canadians, and what conclusions did they draw? Quite surprising, really, emphases mine:
There has been a drastic decrease in the incidence of new cases of HIV‐1 drug resistance in individuals followed during 1996–2008. [...] Our results suggest an increasing effectiveness of highly active antiretroviral therapy at the populational level.
Now does that sound like the sky is falling to you? It sure doesn't to me. And bear in mind that the area where the study was conducted, British Columbia, includes the city of Vancouver.
That city, unlike San Francisco, has bathhouses and even with such gay sex establishments, it doesn't appear as though the Vancouver baths led to the drug-resistance Sally 'Chicken Little' Blower was so sure would happen here, if the baths reopened.
IMHO, the study from Canada calls into serious question the math models developed by Blower, her continual and cavalier stigmatizing words heaped upon PWAs in San Francisco. We must also ask if her models have any bearing on treating PWAs.
Blower and her colleagues at UCLA owe the entire PWA community here, along with officials at SF DPH and front-line physicians caring for us, an open discussion about her research and how it may have absolutely no bearing on the real live and concerns of individuals living with AIDS.
For too many years, Blower has dumped her models on the PWA community, resisted calls for communication, and the media departments at the University of California have dismissed serious criticism with pass-the-buck one-sentence replies. She should no longer be allowed to present her models without comprehensive scrutiny and better engagement with the PWAs she stigmatizes.