Archive for February, 2010

New study!! Many patients diagnosed with HIV today will have normal life expectancies

Posted in The Fierceness on February 26, 2010 by jackmax2

Two studies presented at the 17th Conference on Retroviruses and Opportunistic Infections (CROI) show that some groups of patients – those diagnosed recently, or some of those with high CD4 counts when they begin treatment – will have normal or near-normal life expectancies.

These are not the first studies to calculate normal life expectancies for some groups of patients, but they are based on larger cohorts and extend the expectation of a normal lifespan to a broader group of patients.

Dutch patients not diagnosed late should live near-normal lifespans
The first study, from the Dutch ATHENA Cohort, took a sample of 4612 patients, newly diagnosed between 1998 and 2007, and measured their death rate for, on average, the next 3.3 years. The only patients excluded from the cohort were those who had to start antiretroviral therapy (ART) less than six months after diagnosis or who had an AIDS-defining illness in the first six months. Patents in the study could start ART after six months.

This study, therefore, includes a large proportion of the newly diagnosed patients in the Netherlands over a nine-year period, except the sickest, which makes its findings even more surprising.

The average CD4 count 24 weeks after diagnosis was 480 cells/mm3, with 75% of patients having a CD4 count over 350 cells/mm3.

During the study 118 patients died, indicating an annual mortality rate of 0.67% a year (one death in 150 patients a year). The only predictors, at 24 weeks, of death in the next few years were HIV-related but not AIDS-defining symptoms, coming from somewhere other than developed countries or sub-Saharan Africa, and age – there was a doubling in the risk of death for every 14 years older at diagnosis.

This mortality rate enabled the researchers to compute life expectancies. For a patient diagnosed at the age of 25 the life expectancy came out at 52.7 years – in other words they would die, on average, at the age of 77.7. This was scarcely different to the life expectancy for 25 year olds in the general Dutch population – 53.1 years.

Men and women diagnosed aged 25 could expect to live just five months less than HIV-negative people and men diagnosed at age 55 would live 1.3 years less (women 1.5 years less). For patients diagnosed with HIV (but not AIDS) symptoms the figure was two years shorter for men and women diagnosed at 25, and six and 7.5 years shorter for men and women respectively diagnosed at 55.

The researchers comment: “The life expectancy of asymptomatic HIV-infected patients who are still treatment-naive and have not experienced [an HIV or AIDS-defining symptom] at 24 weeks after diagnosis approaches that of age and gender-matched uninfected individuals.”

They note that the follow-up time was short and that the predictions depend on ARV treatment continuing to work, and it is again worth emphasising that this study excludes the large proportion of patients who are late-diagnosed.

…and so will European men achieving CD4 counts over 500 and not using drugs
The second study involved a much bigger group of 80,642 patients from 30 European countries and was a study, not of the newly diagnosed, but of all patients in the group initiating ART after 1998. It found that men who were not injecting drug users and who had a current CD4 count over 500 were no more likely to die during the follow-up period than their HIV-negative equivalents.

A study of the French Aquitaine Cohort reported a similar finding in 2005, but in this study Aquitaine is only one of 25 patient cohorts that combined to make a new European ‘super-cohort’ called COHERE. It’s important to note that the geographical spread was very uneven, ranging from only 19 patients in Ireland to 30,000 in France (and 11,000 in the UK).

The median age at ART initiation was 37, at which point the average CD4 count was 225 cells/mm3. During a median follow-up time of 3.5 years, 3813 patients died.

The study computed the annual mortality rate for patients with CD4 counts under 200 cells/mm3; between 200 and 350; between 350 and 500; and over 500.

These were 3.9%, 0.8%, 0.5% and 0.4% respectively.

The researchers then computed the Standard Mortality Ratio (SMR). This measures how much higher the mortality rate in each group is compared with HIV-negative people of the same sex and age.

The SMR for all patients with a CD4 count under 200 was 13.0, and for the other CD4 strata it was 3,0, 1.8 and 1.5.

So for the patient group as a whole, being HIV positive raised the risk of death by 50%, even in those who had CD4 counts over 500 cells/mm3.

However, for men, in those who maintained a CD4 count over 500 cells/mm3 for at least three years, the SMR was 1.0 and it was also 1.0 if current or ex-injecting drug users (IDUs) were excluded. These groups had the same life expectancy as their HIV-negative peers.

In IDUs the SMR for those with high CD4 counts was 4.5, within a wide margin of uncertainty, but this declined to 3.0 after five years maintaining high counts.

The absolute annual death rate for women was actually lower than for men. For instance it was 4.2% in men with CD4 counts under 300 cells/mm3 and 3.0% in women, and 0.4% and 0.2% respectively in men and women with counts over 500 cells/mm3.

But because the death rate in HIV-negative women is lower than in men, the SMRs for HIV-positive women were higher: it was 2.2 for women with CD4 counts over 500 cells/mm3 (1.5 excluding IDUs). This excess 50% SMR rate in women probably reflects that women with HIV have relatively lower socioeconomic status than HIV-negative women, whereas in positive men the wealth gap is not so large.

New York Fashion Week: What to Expect for Fall 2010

Posted in The Fierceness on February 18, 2010 by jackmax2
New York |  February 18, 2010

By Sarah Fones for the JC Report

The process of identifying trends six months in the future has become both a blogger’s sport and a buyer’s necessity. Luxe fabrics predominated this season with the majority of designers incorporating fur, leather and velvet into their collections. Be they controversial, questionable or tried-and-true, we’re guaranteed to glimpse any or all of the above come September. Another love-it-or-leave-it trend to look out for is cutouts, which, truth be told, aren’t for everyone. They nevertheless managed to look fresh and sexy this go-round. With these upcoming staples in mind, here’s our low-down on the season ahead.

While animal-friendly faux fur alternatives have increasingly appeared in more collections, the real deal was all over the recent runways. Derek Lam knit fox into a black and white cardigan, Halston’s Marios Schwab embellished the sleeves of a sweater dress and Marc Jacobs used it on the lapels of a see-thru trench. Fresh off his Swiss Textiles Award win, Alexander Wang experimented with a number of different fabrics, backing a zip-away leather jacket and criss-crossing lapels with mink. Many of these looks will show up at H&M and Forever 21 too, albeit in decidedly less expensive manifestations. The heretofore fur-free designer’s unfortunate use of pelts in his show makes sense given recent supported from Saga, but thankfully some of it won’t be produced for stores.

Leather was the most common go-to fabric for fitted, asymmetrical jackets. It was also used in more novel ways, as in the case of men’s leggings at both Maria Cornejo and Rad Hourani. To wit, Joseph Altuzarra held high-slit pencil skirts together with straps of leather, lending the pieces a vaguely S&M vibe. Threeasfour, meanwhile, paired it with wool to create a collared, almost hood-like coat and Ohne Titel’s Flora Gill and Alexa Adams coupled it with silk to fashion a chic, patchwork drawstring skirt. In addition to singular pieces, expect to see leather—both real and faux—used as embellishment or in conjunction with fabrics like wool, cashmere and twill.

Velvet’s sartorial connotations ran the gamut—little girl party dress, “festive” formal wear, hippie-chic topper—but there’s little doubt we can escape it for fall. Elise Øverland showed a velvet menswear-inspired suit and tuxedo wrap dress, while Carly Cushnie and Michelle Ochs fashioned a lace and velvet cap-sleeved dress for their semi-eponymous label. In keeping with his naughty schoolgirl vibe, Peter Jensen’s take was admittedly cheekier (tartan bloomers), while Zac Posen’s conjured thoughts of chi-chi late ’70s holiday parties.

Cutouts continue as a reining trend. When strategically placed they imbue basic black with some much-needed sex appeal, but not-so-gym-toned flesh might be better kept under wraps in any of the season’s other trends. Max Azria’s designs for Hervé Léger have never been a go-to for the faint of heart, so it’s little surprise that his sheer-paneled cutouts came courtesy of some killer mini-dresses. Speaking of itty bitty, Halston incorporated the technique into Grecian-style party gowns, featuring artfully exposed flesh and miles of leg. Preen offered what was perhaps the most wearable take in bandeau bra topped silk and cashmere dresses that revealed the areas above and below the décolletage—and leaving just enough to the imagination.

Article I did for Queeried.com.uk

Posted in The Fierceness on February 7, 2010 by jackmax2

Find Out What Happened Next With Project Runway’s Jack Mackenroth

Whilst many cast members from Project Runaway soon get forgotten one who has remained firmly in the spotlight is the HIV-positive gay designer Jack Mackenroth.

Forced to leave the series early due to a MRSA infection on his face, Mackenroth definitely had the potential to win if he’d remained, but unlike some who would have dwelled on it Jack has instead put all his energy into doing what he loves most – making the most of his life.

And he’s doing it in many ways, ranging from competitive swimming to creating a brand new reality show, Queens of Drag and giving speeches about his HIV-positive status as part of the HIV education initiative, Living Positive By Design.

You have become one of the most celebrated cast members of the TV series, Project Runway. What do you feel it is about you that makes people drawn to you, and do you feel that what they saw of you on TV is the true you?

I do feel that the way I was portrayed on TV was a very accurate part of my personality. I think I am a little bit wackier than they made me out to be but you have to remember that we are surrounded by cameras all the time so it’s hard to let yourself go completely. Plus, we are so focused on sewing that we really don’t have time to be doing high kicks in the workroom. Though, I did a few.

I think people responded well to me on the show for a variety of reasons. First of all I was kind and helpful to the other designers which is a bit atypical in a competition. But I went into the whole experience just wanting to get the most out of it and enjoy the process. I truly believe in sharing the spotlight. I still rope many of my friends from the show into different projects that I do.

I also think many people appreciated my openness about my HIV status and I’m sure the unfortunate way in which I left the show was very memorable to a lot of people.

You had to leave close to the end of the fourth season of the show due to a MRSA infection on your face. Did you at all think about ignoring it and continuing on to finish the show, and was there a sadness when you realized you had it and would have to leave the show prematurely?

It wasn’t really a choice. MRSA is very serious and very contagious. What the viewers don’t really understand is that we filmed a challenge every other day. There were no days off. So the infection in my face may have looked like it advanced over a period of weeks but really is swelled up in a matter of days. There was no way for me to get the medical attention I needed and stay on the show. By the time I was better I had already missed 2 challenges. Plus I was also concerned about the other designers and the crew. We were all so exhausted and sleep deprived I didn’t want to put anybody else at risk.

However, that does not mean that it was not excruciatingly upsetting to have to leave. When I came to the realization that I had to go, I sat down with Tim Gunn and the producers and I was crying uncontrollably for hours. Good times. Tim was very supportive and always has been ever since.

How do you think the season would have ended if that had not happened? Do you think there would have been much difference from how it turned out for you and the show? Do you think you would have been the winner?

I am not so arrogant to say, “I would have won.” However I do think I would have had a decent chance at being a finalist. You also have to remember that the show is heavily produced and not completely “real”. The best designs don’t always win and the worst designs aren’t Auf’d so it’s impossible to say what might have happened. I really just wish I could have stayed longer because I was having so much fun. Our season’s cast was a blast. Honestly I think the best person won. Christian Siriano is a genius and obviously the most successful winner of Project Runway in history. I adore him.

Twenty years ago, on the day of your initial diagnosis of being HIV-positive, what was your feeling? Did you feel at that time that your life was forever changed?

Yes. I was diagnosed 20 years ago and I honestly thought I would be dead within a few years. It was not unrealistic at the time to believe that to be true. People were dying all around me. There were very few treatments back then so I just assumed I would have no future. I was wrong. The best is yet to come.

What advice would you give other HIV-positive men when they go on dates? What has been the best way to disclose your status?

That’s a difficult question and I am asked that all the time. There is really no right answer. I am an extremely open and honest person, so as soon as I became comfortable with it I started talking about it. Before I went on Project Runway, I always disclosed on the first date. As cliche as it sounds–honesty is the best policy. I truly believe that. For some people HIV is a deal breaker. I understand that. But why waste time on someone who is ultimately going to reject you anyway? I also try to remind HIV-positive people that when they disclose their status, even to one person, they are helping to fight the stigma for the entire HIV community. More than likely they will also find a lot of support through disclosure. I recommend telling the world on a a popular television show. It saves a lot of time.

I also found online dating very helpful and you can out your HIV status in your profile or use a site for men looking for other HIV-positive men like Sinmen or Poziam.

In terms of outreach regarding AIDS awareness to the younger generations, what do you think is the best method of breaking through the message of safe sex to youth?

We need to remind them that there is no cure for HIV and though the medications may be more effective now there can still be side effects. There are also a host of other STDs besides HIV. Everyone should be responsible for protecting themselves. I also advise people that just because someone says they are HIV-negative doesn’t mean it’s true. 1 out of 4 HIV-positive individuals in the US do not know their status and people lie. It’s unfortunate but it’s true.

Is there one accomplishment in your life, so far, that you feel the most proud of?

I think being open about my HIV-positive status on Project Runway helped a lot of people. I’m very proud of that. I have received emails from a number of people that were going to kill themselves because they found out they were HIV-positive and then they either saw me on TV or found me online and they didn’t go through with it. That’s amazing and incredibly humbling.

In the past couple of years, you have started to work on the other side of television. You have finished filming a pilot for a design-inspired TV show with your co-star of Project Runway, Kevin Christiana, in addition to helping to produce Queens of Drag: NYC. Now working on the opposite side, how has that changed your perception of the television world?

God yes! It’s kind of a bummer because I loved Reality TV but I can never watch it in the same way again. I know how staged and manipulated some of it can be. I have also learned even more about the power of editing. It’s a magical tool. I’ve come to understand how difficult it is to get a show on the air. With the advent of Reality TV, basically every talented person I know is “working on a show idea.” I have yet to see any of them on the air.

Can you tell us about the new show you’re working on, Queens of Drag: NYC?

It’s amazing. We just finished editing the pilot and now we are in the process of pitching it to networks. You can check out our Queens of Drag website and become a fan on the Queens of Drag Facebook fan page and see all the info on our fabulous cast. Basically we follow the lives of the top working drag queens in New York, both in and out of drag. It’s sort of a Real Housewives type show but with famous drag queens and less make up. We film the glamorous side of the art form and the struggles the “girls” face as they try to “make it” as a performer in New York. It’s dazzling, touching, heartfelt, inspiring and really fascinating. They are all unique and incredibly talented and intriguing. We are really proud of it.

You have done so many things in your life. What made you want to transition from one into another? Do you feel that many of these industries are interrelated, or is there some kind of motivation behind your professional turns?

I have always been interested in so many things–fashion design, illustration, painting, modeling, acting, TV production, HIV advocacy, writing, public speaking–the list is really endless. So I am open to any opportunity that come my way. If it seems like a good idea at the time then I go for it. I work best when I have about 10 different projects going on in my life at once.

Living Positive By Design seems to have been an opportunity for you to discuss with people one of the more personal aspects to your professional career. What is your comfort in discussing your HIV-positive status with complete strangers?

I have absolutely no discomfort talking about my HIV status. I am well educated about the disease and I know that my health is amazing and I can do anything I want as long as I take care of myself. I think the more a person talks about it, the more comfortable they become with it. With my Merck partnership, Living Positive by Design, I have given speeches in front of thousands of people where I discuss my HIV status. If someone has a problem with it then that’s their issue. I have enough to think about. I’m not worried if someone is going to judge me. Life is too short.

In all of your travels, both professional and personal, what would you say would be your favorite, and why?

I swim competitively, so I love traveling internationally for big swimming competitions. My favorite is the Gay Games. I have been to every Gay Games since 1990. They’ve been held in Amsterdam, Sydney, and Vancouver, just to name a few. This summer they will be in Cologne. I just started training again two weeks ago with Team New York Aquatics (TNYA.org). It will be a blast. Although right now me body is hating me.

Do you have limitations to maintaining your physical fitness routine, or are you able to swim and workout at your leisure and pace?

If you are asking if I have physical limitations–then no. I work out harder than most people I know. The only limitations I have on training is my schedule. Sometimes its hard to fit everything into my day. I often swim at 6 in the morning, because it’s the only time I can do it.

You have lived in New York for so long. What has been the appeal of staying there than anywhere else in the States?

I wanted to live in New York City ever since I was a teenager. I’ve lived here for almost twenty years and I will never move until I retire to a gay assisted living facility in Palm Springs and gain 300 pounds. I just love the diversity and the energy and the pace of the city. Some people find it overwhelming but I thrive on it. I have made amazing friendships and created my life here. Plus, if you want to be taken seriously as a fashion designer in the US, you really have to be in New York. Just ask Tim Gunn.

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