American Dermatological Association September 16, 2011 Silverado Resort, Napa, California

1. Pitfalls, Perils & Pearls • American Dermatological Association • September 16, 2011 • Silverado Resort, Napa, California

2. HIV/AIDS • Marcus A. Conant M.D. • Conant Foundation • www.conantfoundation.org

3. Pearl • 27% of all new HIV cases are women. • These women have been infected by HIV positive men and by the use of IV drugs. • These women are infecting their heterosexual male partners. • 16% of all of the new cases of HIV infection are in heterosexual males.

4. Pitfall • Everyone knows that HIV is a gay disease • If you see a young woman with a persistent yeast infection. You may not think to order an HIV test. • If you see a college athlete with shingles will you order an HIV test? • You may not want to order an HIV test. If you don’t know how to tell the patient he/she is HIV-positive go to www.conantfoundation.org.

5. Peril • If you do not make the correct diagnosis, you may face litigation for failure to diagnose. • If this individual infects another you may face litigation from a second injured party.

6. Pearl • 94% of patients treated with HAART with an undetectable viral load will not in infect their sexual partners. • Treatment of everyone in the United States who is HIV-positive would stop the transmission of this disease.

7. Pitfall • We have 1.1 million US citizens infected with HIV. • One third of those are taking HAART. • One third know they are positive but are not on HAART. • One third do not know they are positive. • It will cost too much to identify and treat all of these patients.

8. Peril • Only 19% of individuals who are taking HAART have an undetectable viral load. • 81% of individuals taking HAART are developing resistance to their drugs. • Resistance is class not drug specific. • Individuals infected by these HIV-positive partners will have partially or completely resistant virus. • It will take years but we will eventually see the failure of all current HIV drugs. • Pharmaceutical companies have abandoned the HIV market.

9. Pearl • Only 13% of teenagers have been tested for HIV. • Teenagers begin having sex at age 14. • Teenage girls often have sex with older men. • There is only one program designed to destigmatize HIV/AIDS so that teenagers are comfortable being tested.

10. Pitfall • Teenagers will live with the possibility of contracting HIV for the rest of their lives. • Parents are not comfortable with teaching their children about the risks of HIV. • School teachers, physicians, and ministers are not teaching children about the risks of HIV

11. Perils • Teenagers account for 40% of all of the new HIV infections. • 77% of HIV-positive teenagers in New York did not think they had a risk factor for contracting the disease. • Teenagers are unknowingly transmitting the disease to their sexual partners.

12. Pearl • The Centers for Disease Control is not addressing controversial public health issues. • The reason the CDC is hogtied are the political/social/ethical/religious divisions in this country. • If the CDC were to address these issues. It would be at risk for losing federal funding.

13. Pitfall • Issues not addressed by the Centers for Disease Control include: • Reproductive health, The obesity epidemic • Condom distribution, Needle distribution • Anal warts in young girls, Anal Pap smears • Global warming, Location of biological warfare labs, hepatitis C

14. Peril • The American people are being denied essential health information for political reasons. • If an alternative to the CDC is not forthcoming, the cost of these unaddressed social issues will be enormous.

15. Solutions • For suggestions on how to address each of these concerns go to our website: www.conantfoundation.org