January / December #19 : DOT's the Limit - by Walter Armstrong and Faye Penn

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Table of Contents

Cheese and Crackers

Blood from a Stone

A World Drenched in Blood

The Bride Wore White

Life After Ryan

Dream Team

Unmasked Avenger

S.O.S.

Mailbox

Special Delivery

Tattoo Hullabaloo

Dirty Sticks, Dirty Tricks

Best Little U.S. AIDS Hospital

Blow It Dry

Desert Flora Has Anti-HIV Aura

DOT's the Limit

Murder by Member

Milk and Money

Stoned in a Park

By Any Peer Necessary

Obituaries

Dubin's List

Blood Money

Taxi-cum-Pro

If the Birds Come

POZ Picks-December 1996/January 1997

Home of the Brave

POZ Biz-December 1996/January 1997

Tribute-December 1996/January 1997

Patrick Webb's Adventures With Punchinello

Cremation Sensation

Sexual Healing

A Holistic Holiday How-To

Wisdom Out of Africa

And Nary a Drop to Drink

Adding in the Health Factor

Hitting Herpes Hard

Q Tip

Managed Care Joins Death and Taxes

Play Your Cards Right

Raising Hormones

Deadly Cocktails

In the Den

The Dating Game



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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January / December 1997

DOT's the Limit

by Walter Armstrong and Faye Penn

Health head's forced-compliance blunder infuriates activists

Activists in San Francisco are up in arms over statements made by San Francisco City Health Director Sandra Hernandez in a recent issue of The San Francisco Bay Times, a gay weekly. When asked what public health policies she would implement if protease inhibitors are found to completely suppress or even eradicate HIV in the blood for good, Hernandez said she would consider replicating the "Directly Observed Therapy" (DOT) model currently used with TV. In this scheme, people who are unlikely to follow a medication schedule-by virtue of mental illness, drug problems, homelessness or other factors-are enrolled at local clinics and observed taking drugs as prescribed. To be effective, Hernandez said, DOT would require the tracking of all people who are positive.

In an interview with POZ, Hernandez called OT "the best TB-control program in the country" and reiterated that with regard to AIDS, it is merely an idea she has no plans to implement at this point. But ACT UP/Golden Gate spokesperson Edward Zold called the idea "way out of line. The way to ensure compliance is to give people access to food, shelter and therapy," said Zold. "That's what public health officials should be advocating, not a sandwich at the emergency room and supervision."

With combination therapy becoming the standard in AIDS treatment, researchers worry that inconsistent dosing will cause multidrug resistance, as with TB. But according to Dr. Iris Long of ACT UP/New York, DOT has no relevance to anti-HIV combo-therapy. "This approach is wildly impractical because each drug has to be taken around the clock but at different times," said Long. "The observer would have to live with the patient."



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