Photo credit: Michael Thompson

By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

Christina Aguilera sells millions of CDs combining her astounding vocal talent with provocative fashion and music. As a spokesperson for the MAC AIDS Fund, Aguilera hopes she commands even more attention with her message of awareness.

"I think this whole topic of AIDS is something that can be taken very lightly in the world today, especially in the younger generation," says the Grammy-winning Aguilera. "They think it can't happen to them or that it only happens to a certain stereotype or gender but it's affecting everyone's lives."

Many lives.

The UN and the World Health Organization (WHO) estimate that nearly 42 million people were living with HIV at the end of 2003, including 5 million new infections.

Despite the staggering numbers, MAC, the innovative cosmetics company, is making a difference.

Since its creation 10 years ago, the MAC AIDS Fund has raised more than $32 million for men, women and children living with HIV and AIDS. MAC will be donating 100% of the selling price of its new Viva Glam V lipstick to the fund. As part of their Viva Glam V campaign, MAC has also teamed up with Chloe Sevigny, Linda Evangelista, Missy Elliott and Boy George to help raise HIV/AIDS awareness.

"AIDS became a reality in my life two years ago when my cousin passed of AIDS," says the multi-platinum hip-hop star Elliott. "My family and I all got a chance to see him before he passed and see the different stages that people go through. It made me more knowledgeable about AIDS because a lot of times we think it's happening to other people or happening in another country but this was very close to home."

Supermodel Linda Evangelista has also experienced Elliott's grief.

"I have experienced the loss of colleagues and friends to AIDS," Evangelista says. "There is nothing beautiful about AIDS. We still live in a world where the stigma surrounding HIV/AIDS is truly ugly. Millions of people living with this disease don't seek help because they fear rejection and humiliation."

And that fear and that stigma cost lives -- all kinds of lives - men, women, children and all races and sexual preferences.

HIV/AIDS makeover

"Over the past ten years the face of AIDS has undergone a dramatic change in terms of who is affected," states John Dempsey, president of MAC and chairman of the MAC AIDS Fund. "We're seeing HIV/AIDS transferring itself into the inner cities of the US, affecting men, women and children -- primarily Hispanics and Blacks. We're also seeing more and more women being affected."

Particularly alarming are the increases of young people now at risk for HIV infection. According to the MAC AIDS Fund, five people under the age of 25 get HIV every minute.

"About half of the new infections in 2001 occurred in individuals between the ages of 13 and 24," reports Pat Flynn, director of Clinical HIV services at St. Jude Children's research Hospital in Memphis, Tennessee. "If you limit that to 13-18 age group, it represents 25% of new infections."

Dempsey says the five celebrity spokespeople were chosen specifically for the targeted outreach they could achieve.

"I think it's very important to speak to the different age groups about AIDS because they need to know that it's not just one particular age group or one particular color," says Elliott. "No one is immune to HIV. Everybody can get it so it's very important."

It is also extremely important to know if you're at risk and if you are, to get tested.

Flynn says that anyone who is sexually active but who is not with a long term partner - meaning together for many years - and not practicing safe sex is at risk.

"Our experience with the teenage population is that condom use is not 100%," says Flynn, who is also board certified in pediatric infectious diseases. "Because of these unprotected episodes, it is worthwhile for those people to get tested."

Many people are afraid of testing, fearing stigma or lack of insurance. For those untested at-risk individuals, some possible symptoms that might be warning signs include:

• Acute HIV syndrome characterized by fever, lymph node involvement in the head and neck area typically. It can be confused with flu or mononucleosis.
• Thrush
• Weight loss
• Shingles

Treatment strategies

Once diagnosed by one of the many available HIV tests, early treatment often translates into better long-term outcomes and a higher quality of life.

"If you meet the currently recommended criteria, most of us are prescribing three drugs in combination," Flynn explains. "Two are nucleoside reverse transcriptase inhibitor - these are drugs like zidovudine (AZT) and didanosine (DDI) -- and to this combination we usually add a non-nucleoside reverse transcriptase inhibitor (NNRTI) like efavirenz."

According to Flynn it is optimal if patients can be treated during the acute infection. But denial and fear and lack of testing prevent frequently gaining this advantage over the disease.

For a patient who has chronic infection who has already seroconverted (has a positive blood test), the indications are therapy for viral loads over 55,000, a CD4 count below 350, or if the patient exhibits significant symptoms.

Partial exposure of the drug - not properly taking the medication -- does not suppress the viral reproduction and as a result patients develop drug-resistant mutations

"The biggest problem is in resistance to the class of drugs called NNRTIs," Flynn notes. "Right now the three drugs that are available in this class can be rendered ineffective by one mutation."

'Genie' in a bottle

While researchers look for new treatment options, a new class of anti-retroviral drugs - called fusion inhibitors -- has emerged. Flynn calls this new treatment option "critically important" and is hopeful more medications will arrive soon.

"We also have identified other steps in the pathway of the HIV invasion of the cell and multiplication so we are looking for new ways to exploit these points," Flynn says. "Having multiple points of action is very helpful. We need both more drugs in the existing classes and completely new classes of drugs like the fusion inhibitors."

While fusion inhibitors are proving to be very effective, the only commercially available drug is only in injectable form and is very expensive.

Flynn stresses that until a preventive vaccine is developed the best defenses will remain abstinence, awareness and education.

But Aguilera knows that young people are under intense pressure to become sexually active and hopes her message, along with her fellow MAC spokespersons', can make a difference.

"There's nothing wrong with sexuality, expressing your sexuality being comfortable with your sexuality or sex in general," Aguilera says. "It's just a matter of being sure you protect yourself, that you are safe. You have to respect yourself and your body."

Actress Chloe Sevigny agrees and urges young women to be especially vigilant.

"I think it's really important to teach young girls and all girls across the world about the disease and make them aware how fast it's spreading and that they should take precautions and protect themselves," Sevigny says. 

For Aguilera, making the right choices starts getting the right information.

"I want today's youth to know that you have to take control over your own destiny," Aguilera says. "If you don't take action, the future you have planned will be at risk. I feel fortunate to be part of the Viva Glam V campaign. I know that together we can save future generations by increasing awareness of this epidemic."

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 3/7/2004  -  John Morgan & Stephen A. Shoop, M.D.
Reviewed: 3/7/2004  -  Donnica Moore, M.D.