Friday, March 05, 2010

Another ULCA Gays =
HIV Drug Resistance Model?

In February 2008, at the time when San Francisco gays and people with AIDS were reeling from a questionable UCSF study about drug resistant staph infections alleging an epidemic of MRSA in the gay community about to spread out to the so-called general population, another questionable gay-related study, this time from UCLA, was being sensationalized and peddled by the UCLA media office.

You don't need a crystal ball to learn that Sally Blower, UCLA mathematician behind the January 2010 math model alleging drug resistant strain of HIV among gay PWAs in San Francisco was "a great and immediate threat to global public health," was also responsible for the February 2008 study out of UCLA.

From the opening sentence of the sensationalistic 2008 UCLA press release, written by Enrique Rivero, gay men in San Francisco are presented as creators of another public health problem, one that only Blower and her team have noticed:

A mathematical model shows that a new wave of drug-resistant HIV is rising among among men in San Francisco who have sex with men and that this trend will continue over the next few years, according to a new study from the UCLA AIDS Institute.

If this alleged new wave was not only happening but also rising, I would think AIDS Inc in this town -- SF DPH, HIV prevention and Ryan White councils, SF AIDS Foundation, Stop AIDS Project, et al. -- not just one ivory tower-based mathematician, would have noticed. Yet, nowhere in the release does UCLA mention how Blower has reached out to AIDS Inc here and is working with them to address the problem.

That 2008 opening sentence isn't all that different from the 2010 UCLA news release, also penned by Rivero:

New research based on a novel mathematical model predicts that a wave of drug-resistant HIV strains will emerge in San Francisco within the next five years.

There goes UCLA again with the wave of drug resistance fears. With so many waves, we all ought to get out our surfboards. The endless math models and alarming press releases from UCLA about alleged HIV drug resistant strains among gay men in San Francisco, spew from Blower and the press office, with slight variations over the years. There is a cookie-cutter method at work here, framing the "novel" model bringing "new waves" and research that is "surprising."

So where did UCLA present its 2008 research and findings, and can we call have a look at the model? The release said:

The model and its results were unveiled today by UCLA biomathematics professor Sally Blower, director of the Biomedical Modeling Center at the David Geffen School of Medicine at UCLA, during a session on drug-resistant diseases at the annual American Association for the Advancement of Science conference in Boston.

The study was not published in any peer-reviewed scientific journal, nor did Blower present her findings at an HIV or retrovirus conference. Nope, she presented her model at a generic science meeting, and nowhere in the UCLA release does the university link to the study or tell readers how to locate it. We're all supposed to just take the hollow words of Blower and Rivero at face-value.

The release explains that Blower and colleagues proved their own hypothesis. No need to get independent experts to give UCLA's model a stamp of approval:

"Our amplification cascade model has been validated by our reconstructions and can now be used to design novel and effective health policies for controlling single-, dual- and triple-class resistant strains of HIV in both resource-rich and resource-constrained countries," said Blower, who is also a member of the UCLA AIDS Institute.

If indeed their 2008 model can be used to create novel and effective health policies related to HIV drug resistance, I'd like to know who in San Francisco, or anywhere in the world, was able to take the UCLA press release, and do what Blower claimed was possible. Where's the proof a single HIV expert took Blower's model and used it to help PWAs?

But all was not gloomy in 2008. UCLA said:

At the same time, the evolution of drug-resistant HIV may have actually reduced the severity of the city's epidemic, saving many men from becoming infected. [...]

The model predicts that resistance to NRTIs will decline substantially and PI resistance will fall slightly through 2012, and that resistance to NNRTIs will rise over the next five years and then begin falling. [...]

Most surprising of all, the evolution of drug-resistant HIV strains has substantially reduced the severity of the San Francisco AIDS epidemic because the strains that have emerged have become less infectious than the wild-type strains.

Okay, now I'm really confused by Blower's convoluted research. She's sounding her usual alarm about rising new waves of drug resistance, while also claiming the positive aspect is that resistance is helping drive down new transmissions.

Which is it? Is HIV drug resistance in San Francisco good or bad? How can it be that in 2008 Blower alleges drug resistance is bringing down the transmission rate, and two years later that same resistance is a direct threat to worldwide public health?

And who is footing the bill for this questionable, and unverified, HIV modeling from UCLA? The American public:

The National Institute of Allergy and Infectious Diseases funded this research.

In closing, I must say that if all this drug resistance is happening in San Francisco, I can't locate proof from SF DPH about it, nor are the SF DPH and AIDS Inc validating Blower's claims or doing anything about what she alleges is going on.

Who in San Francisco is standing up and saying Blower's research is serious? Where are Blower's collaborators up here, working with her to address the crises she says exist? Heck, even her co-author on her 2010 model, Dr. James Kahn of UCSF, is unwilling to defend their research on KPIX TV.

By the way, for anyone thinking this matter pertains only to gays in San Francisco, check this out:

"This isn't just about San Francisco," said senior author Sally Blower [...]

What is to be done about this UCLA math modeler and the UCLA press office pathologizing gay men _everywhere_ , and not a shred of independent validation proving their allegations? At the very least, continue to bring UCLA's stigmatizing efforts out into the open and raise questions. One day, we may actually put a stop to this nonsense.

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