Parting Glances
Welcome to a new issue of HIV Plus - it teems with radical ideas. This month we decided to explore a new frontier of HIV: the immune system. HIV treatment and prevention has entered a new era. Now that we have antiretroviral drugs powerful enough to bring the virus under control, our attention has refocused on the immune system's potential to control HIV over the course of a lifetime. The implications are far-reaching and stand to profoundly change the quality of life and daily management of HIV for many people. They also offer new hope to millions around the world who can't afford the cost of combination HIV therapy.

Think of it as a paradigm shift: away from the virus, onto the body's natural defenses; away from a "hit hard, hit early" chemotherapy approach, onto "drug holidays" and new immune-based therapies and experimental vaccines-all coming your way now.

As for prevention, the future looms as positively revolutionary. Microbicides, after languishing on research shelves for more than a decade, have gotten scientists excited again. These new products block sexual transmission of HIV and other sexually transmitted diseases in the vagina and rectum. Although having sex without a condom seems like science fiction, microbicide researchers dream about it. We recently sent Vicki Burkitt to the first Microbicides 2000 Conference to report back from the trenches, and as you'll see, there are a number of exciting products that block HIV, according to early laboratory and animal studies. Some are cheap to make and appear nontoxic. Several antiretroviral drugs could also double as microbicides. Further ahead appear new mucosal vaccines, designed to boost natural defenses against STDs.

The biggest obstacles to getting these types of products into humans remain the familiar trio of lack of money, political will, and the interest of big drug companies. All three are needed - urgently - along with community advocacy, to push promising approaches through the pipeline.

Which takes us back to our mission in this issue. With so much going on in HIV research it's hard to keep up. We asked treatment whiz kid Richard Jefferys to give us a layperson's review of what we've recently learned about the immune system and its relationship to HIV. If you've never heard of a dendritic cell, now's the time to learn. Gregg Gonsalves, another longtime activist, kicks in with an experts' roundtable on the various strategies being tried to achieve immune control of HIV.

Since we're examining the frontiers of AIDS research, not every idea or theory has been proved. But we're hoping these articles will provide a perspective to better evaluate the changing face of AIDS treatment. We're also dedicated to the old ACT UP slogan: Knowledge = Power. And in this new arena, we need a lot of people to be part of the debate. So sit back, put on your geek hat and dive in.

Beyond the science, there's still the thorny issue of access to lifesaving therapies for the vast majority of people with HIV. With the world's spotlight on Durban, South Africa, site of the XIII International AIDS Conference in July, this issue takes center stage. For our global report, we've looked at how the battle for essential medicines is shaping up in South Africa and Latin America, and how a new generation of activists is braving the fight.

On a personal note, I am sad to report that this will be the last issue of HIV Plus that I and my staff will produce. Our magazine and our parent company, OUT magazine, were recently sold to Liberation Publications, the publisher of the Advocate, and they will both be edited by new teams based in Los Angeles. When we launched HIV Plus two years ago, we made it our mission to fill what we saw as a critical need for informed, balanced reporting on trends in AIDS research and treatment. We wanted the magazine to be useful to a broad consumer audience of people living with HIV, care providers, policy makers, and educators, as well as physicians and scientists. We were especially concerned about covering and reaching out to groups at the highest risk for HIV who have often been left behind: women, infants, gay and bisexual men of color, teenagers, prisoners, sex workers, and the poor. Judging from the many letters we received from so many of you, I believe we fulfilled our mandate beyond our expectations. I hope the magazine continues to do so.

On behalf of my staff and myself, thank you for your support.
See you in Durban,

ANNE-CHRISTINE D'ADESKY
EDITOR IN CHIEF