157-528: AIDS Healthcare Foundation ( AHF ) is a Los Angeles -based 501(c)(3) nonprofit organization that provides HIV/AIDS prevention, treatment, and advocacy services. As of 2024, AHF operates about 400 clinics, 69 outpatient healthcare centers, 62 pharmacies, and 22 Out of the Closet thrift stores across 15 U.S. states, Washington, D.C., Puerto Rico, and 46 countries, with over 5,000 employees, and provides care to more than two million patients. The organization's aim
314-462: A PI / NNRTI / INSTI ("base"). Initial regimens use "first-line" drugs with a high efficacy and low side-effect profile. The US DHHS preferred initial regimens for adults and adolescents in the United States, as of April 2015, are: Both efavirenz and nevirapine showed similar benefits when combined with NRTI respectively. In the case of the protease inhibitor based regimens, ritonavir
471-567: A 69% increase in the risk of death. In 2015 the START and TEMPRANO studies both showed that patients lived longer if they started antiretrovirals at the time of their diagnosis, rather than waiting for their CD4 counts to drop to a specified level. Other arguments for starting therapy earlier are that people who start therapy later have been shown to have less recovery of their immune systems, and higher CD4 counts are associated with less cancer. The European Medicines Agency (EMA) has recommended
628-465: A business exodus from Downtown Los Angeles since the COVID-19 pandemic , the city's urban core is evolving as a cultural center with the world's largest showcase of architecture designed by Frank Gehry . On September 4, 1781, a group of 44 settlers known as " Los Pobladores " founded the pueblo (town) they called El Pueblo de Nuestra Señora la Reina de los Ángeles , 'The Town of Our Lady
785-543: A chronic disease that in the absence of a cure will persist for many decades." The United States Department of Health and Human Services and the World Health Organization (WHO) recommend offering antiretroviral treatment to all patients with HIV . Because of the complexity of selecting and following a regimen, the potential for side effects, and the importance of taking medications regularly to prevent viral resistance , such organizations emphasize
942-659: A de León spokesman, his meetings with city officials on AHF's behalf were only intended as briefings. In 2023, AHF organized a "We The People" national rally in response to bills introduced in state legislatures that the organization claims discriminate against women, immigrants, LGBTQ individuals, and others. More than 4,000 people marched in Fort Lauderdale, Florida in July 2023, including activist organizations and individuals like David Hogg and Debbie Allen . Labor leader and civil rights activist Dolores Huerta also joined
1099-419: A drug that greatly reduces the risk of contracting H.I.V. AHF does, however, prescribe PrEP, and as of 2022 is the largest provider of PrEP in the U.S. According to AHF's founder and president, Michael Weinstein in 2019, "It's a mischaracterization to say that we were opposed to PrEP." He stated that "PrEP would help individuals who were certain not to use condoms," and "We said that we did not believe it would be
1256-525: A high rate of baseline resistance, resistance testing is recommended before starting treatment; or, if the initiation of treatment is urgent, then a "best guess" treatment regimen should be started, which is then modified on the basis of resistance testing. In the UK, there is 11.8% medium to high-level resistance at baseline to the combination of efavirenz + zidovudine + lamivudine, and 6.4% medium to high level resistance to stavudine + lamivudine + nevirapine . In
1413-534: A lasting effect. As a result, the standard of care is to use combinations of antiretroviral drugs. Combinations usually consist of three drugs from at least two different classes. This three drug combination is commonly known as a triple cocktail. Combinations of antiretrovirals are subject to positive and negative synergies , which limits the number of useful combinations. Because of HIV's tendency to mutate, when patients who have started an antiretrovial regimen fail to take it regularly, resistance can develop. On
1570-741: A lawsuit against the City of Los Angeles over the mismanagement of AIDS Housing Funds. Following a state legislator's audit, the Los Angeles City Controller revealed that more than $ 17 million in federal funds for people with AIDS went unspent as an AIDS homeless crisis raged in Los Angeles. In 2004, Darren James and three other adult film actors tested positive for HIV. In response to the outbreak, AHF began lobbying in favor of laws requiring condom use by male actors during sex scenes in adult films. In 2010, AHF unsuccessfully sued
1727-477: A mutation in the CCR5 delta gene which results in a nonfunctional CCR5 co-receptor and in turn, a means of resistance or slow progression of the disease. However, as mentioned previously, this can be overcome if an HIV variant that targets CXCR4 becomes dominant. To prevent fusion of the virus with the host membrane, enfuvirtide can be used. Enfuvirtide is a peptide drug that must be injected and acts by interacting with
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#17327651697481884-461: A period of many years," under the 340B Drug Pricing Program , a federal drug discount program designed to stretch scarce federal resources as far as possible for community healthcare providers such as AHF. The organization is a participant in the 340B Program, claiming it improves the "clinical outcomes of vulnerable Americans" while "cost[ing] the American taxpayer nothing." In May 1999, AHF filed
2041-425: A profit; the other, according to an analysis of contemporary newspaper reports, was the 1932 Summer Olympics , also held in Los Angeles. Racial tensions erupted on April 29, 1992, with the acquittal by a Simi Valley jury of four Los Angeles Police Department (LAPD) officers captured on videotape beating Rodney King , culminating in large-scale riots . In 1994, the magnitude 6.7 Northridge earthquake shook
2198-608: A program called Global Immunity, whose goal is to change the course of the HIV/AIDS epidemic by expanding access to treatment for those living with HIV across the globe. As of 2023, the organization operates clinics in 45 countries. In 2001, AHF became the first international organization to sponsor an HIV/AIDS clinic in South Africa. The clinic, Ithembalabantu (Zulu for "People's Hope"), was opened in Umlazi, Durban where 10% of
2355-412: A range of views on this subject and the decision of whether to commence treatment ultimately rests with the patient and his or her doctor. The US DHHS guidelines (published April 8, 2015) state: The newest WHO guidelines (dated September 30, 2015) now agree and state: Baseline resistance is the presence of resistance mutations in patients who have never been treated before for HIV. In countries with
2512-555: A retail store. In 2014, the AIDS Healthcare Foundation filed suit against the County of Dallas. AHF claimed that the County did not give the agency a fair chance to bid for federal AIDS funding. Los Angeles Los Angeles , often referred to by its initials L.A. , is the most populous city in the U.S. state of California . With an estimated 3,820,914 residents within the city limits as of 2023 , it
2669-507: A single type, where industrial uses were prohibited. The proscriptions included barns, lumber yards, and any industrial land use employing machine-powered equipment. These laws were enforced against industrial properties after the fact. These prohibitions were in addition to existing activities that were already regulated as nuisances. These included explosives warehousing, gas works, oil drilling, slaughterhouses, and tanneries . Los Angeles City Council also designated seven industrial zones within
2826-400: A successful Los Angeles County initiative to require condoms in adult films ( 2012 Los Angeles Measure B ), and then a similar statewide initiative which failed ( 2016 California Proposition 60 ). They also ran two measures seeking to cap prescription drug prices ( California Proposition 61 (2016) and Ohio Issue 2 (2017) ), both of which failed. In 2017, AHF created a new organization named
2983-433: A successful public health strategy." Weinstein's opposition to PrEP and his calling it a "party drug" made him disliked by many within the anti-AIDS space. He believes that usage of PrEP will reduce the use of condoms (what he calls "condom culture") and thereby increase new AIDS cases. The global clinical trial for PrEP found that usage did not lead to riskier sex, which was explained by the fact that condom use among gay men
3140-494: A total investment of $ 110,000 per unit) as a much more cost-effective way to provide housing than the City of Los Angeles, which pays about $ 500,000 per unit for constructing new affordable housing. In 2020, tenants in one of the AHF's apartment buildings (an almost century-old hotel named The Madison) sued the AHF over slum-like conditions. The tenants had reached a settlement with the previous owner for similar problems, and allege that
3297-707: A year's worth of Viraday cost Rs 54,000 when sold in India, but only Rs 21,000 when exported to Africa. Some NGOs declined to join AHF in criticizing Cipla's drug prices, citing a potential conflict of interest: Cipla's opposition to the patent application for Viread , a component of Viraday, filed by AHF contributor Gilead Sciences . Gilead denied involvement in AHF's complaint, and an AHF regional chief stated that AHF also opposed Gilead's patent application for Viread. In March 2008, AHF petitioned drug manufacturers including Abbott , Boehringer Ingelheim , Bristol-Myers Squibb , Gilead, GSK, Merck, Pfizer, Roche and Tibotec to freeze
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#17327651697483454-438: Is Mount San Antonio , locally known as Mount Baldy, which reaches 10,064 feet (3,068 m). Further afield, the highest point in southern California is San Gorgonio Mountain , 81 miles (130 km) east of downtown Los Angeles, with a height of 11,503 feet (3,506 m). The Los Angeles River , which is largely seasonal, is the primary drainage channel . It was straightened and lined in 51 miles (82 km) of concrete by
3611-722: Is a common problem in this population. Although Serieys et al. 2014 find selection of immune genetics at several loci they do not demonstrate that this produces a real difference which helps the bobcats to survive future mange outbreaks . Los Angeles is subject to earthquakes because of its location on the Pacific Ring of Fire . The geologic instability has produced numerous faults , which cause approximately 10,000 earthquakes annually in Southern California, though most of them are too small to be felt. The strike-slip San Andreas Fault system, which sits at
3768-517: Is a proponent of increasing the housing supply for low-income and homeless individuals, and also advocates for rent control. The organization states that their housing platform is based on what they call the "3 Ps": Protect, preserve, and produce. They explain this as addressing gentrification and homelessness by promoting rent control and discouraging evictions; supporting sustainable land-use policies without disrupting neighborhoods; and creating affordable housing through cost-effective new construction and
3925-719: Is a sprawling metropolis of over 18.3 million residents. The majority of the city proper lies in a basin in Southern California adjacent to the Pacific Ocean in the west and extending partly through the Santa Monica Mountains and north into the San Fernando Valley , with the city bordering the San Gabriel Valley to its east. It covers about 469 square miles (1,210 km ), and is the county seat of Los Angeles County , which
4082-492: Is also important, with a planned Caesarian section having a lower risk than vaginal delivery or emergency Caesarian section. HIV can also be detected in breast milk of infected mothers and transmitted through breast feeding. The WHO balances the low risk of transmission through breast feeding from women who are on ART with the benefits of breastfeeding against diarrhea, pneumonia and malnutrition. It also strongly recommends that breastfeeding infants receive prophylactic ART. In
4239-439: Is an AHF holiday celebrated on February 13. It was created to promote safer sex and provide access to condoms and free Rapid Testing. AHF uses World AIDS Day and International Condom Day as fun ways to engage with people, get them tested for HIV, and get them connected to care if they need it. In 2014, the organization was noted as being unique amongst H.I.V.-prevention groups in advocating against pre-exposure prophylaxis (PrEP),
4396-452: Is complicated by rugged terrain, which has necessitated having different grids for each of the valleys that Los Angeles covers. Major streets are designed to move large volumes of traffic through many parts of the city, many of which are extremely long; Sepulveda Boulevard is 43 miles (69 km) long, while Foothill Boulevard is over 60 miles (97 km) long, reaching as far east as San Bernardino. Drivers in Los Angeles suffer from one of
4553-455: Is complicated by the fact that many children who are born to mothers with HIV are given a single dose of nevirapine (an NNRTI) at the time of birth to prevent transmission. If this fails it can lead to NNRTI resistance. Also, a large study in Africa and India found that a PI based regimen was superior to an NNRTI based regimen in children less than 3 years who had never been exposed to NNRTIs in
4710-437: Is divided into many different districts and neighborhoods, some of which had been separately incorporated cities that eventually merged with Los Angeles. These neighborhoods were developed piecemeal, and are well-defined enough that the city has signage which marks nearly all of them. The city's street patterns generally follow a grid plan , with uniform block lengths and occasional roads that cut across blocks. However, this
4867-502: Is expected to continue to drop in the coming years because of aggressive steps to reduce it, which include electric and hybrid cars, improvements in mass transit , and other measures. The number of Stage 1 smog alerts in Los Angeles has declined from over 100 per year in the 1970s to almost zero in the new millennium. Despite improvement, the 2006 and 2007 annual reports of the American Lung Association ranked
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5024-539: Is generally low. AHF engages in public advocacy for government programs to address the HIV/AIDS epidemic, including efforts to reduce drug costs. The organization has filed lawsuits against pharmaceutical companies regarding the pricing of HIV treatments, such as tenofovir . In November 2006, AHF asked Indian anti-HIV drug manufacturer Cipla to reduce the price of its combination drug Viraday from its launch price of about Rs 62,000 per year. Cipla CEO Y. K. Hamied cited taxes and custom duties on raw materials as reasons for
5181-454: Is intended for maintenance treatment of adults who have undetectable HIV levels in the blood (viral load less than 50 copies/ml) with their current ARV treatment, and when the virus has not developed resistance to certain class of anti-HIV medicines called non-nucleoside reverse transcriptase inhibitors (NNRTIs) and integrase strand transfer inhibitors (INIs). A separate argument for starting antiretroviral therapy that has gained more prominence
5338-590: Is intrinsically resistant to NNRTIs. Integrase inhibitors (also known as integrase nuclear strand transfer inhibitors or INSTIs) inhibit the viral enzyme integrase , which is responsible for integration of viral DNA into the DNA of the infected cell. There are several integrase inhibitors under clinical trial, and raltegravir became the first to receive FDA approval in October 2007. Raltegravir has two metal binding groups that compete for substrate with two Mg ions at
5495-555: Is its effect on HIV transmission. ART reduces the amount of virus in the blood and genital secretions. This has been shown to lead to dramatically reduced transmission of HIV when one partner with a suppressed viral load (<50 copies/ml) has sex with a partner who is HIV negative. In clinical trial HPTN 052 , 1763 serodiscordant heterosexual couples in nine countries were planned to be followed for at least 10 years, with both groups receiving education on preventing HIV transmission and condoms, but only one group getting ART. The study
5652-465: Is its network of pharmacies and clinics that provide primary care to patients, most of whom have their insurance claims paid by government insurance programs like Medicaid . The excess income from these patients has helped AHF provide free care to millions of patients—the greatest reach of any HIV/AIDS organization. AHF acquired the MOMS Pharmacy chain of pharmacies in 2012, and in 2013, rebranded
5809-519: Is known as highly active antiretroviral therapy ( HAART ). HAART decreases the patient's total burden of HIV, maintains function of the immune system , and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same-sex and opposite-sex partners so long as the HIV-positive partner maintains an undetectable viral load. Treatment has been so successful that in many parts of
5966-429: Is no meaningful difference between abacavir-containing regimens and other NRTI-containing regimens. The evidence is of low to moderate quality and therefore it is likely that future research may change these findings. The goals of treatment for pregnant women include the same benefits to the mother as in other infected adults as well as prevention of transmission to her child. The risk of transmission from mother to child
6123-399: Is proportional to the plasma viral load of the mother. Untreated mothers with a viral load >100,000 copies/ml have a transmission risk of over 50%. The risk when viral loads are < 1000 copies/ml are less than 1%. ART for mothers both before and during delivery and to mothers and infants after delivery are recommended to substantially reduce the risk of transmission. The mode of delivery
6280-488: Is rich in native plant species partly because of its diversity of habitats, including beaches, wetlands , and mountains. The most prevalent plant communities are coastal sage scrub , chaparral shrubland, and riparian woodland . Native plants include: the California poppy , matilija poppy , toyon , Ceanothus , Chamise , Coast Live Oak , sycamore , willow and Giant Wildrye . Many of these native species, such as
6437-448: Is the most populous county in the United States with an estimated 9.86 million residents as of 2022 . It is the third-most visited city in the U.S. with over 2.7 million visitors as of 2023. The area that became Los Angeles was originally inhabited by the indigenous Tongva people and later claimed by Juan Rodríguez Cabrillo for Spain in 1542. The city was founded on September 4, 1781, under Spanish governor Felipe de Neve , on
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6594-426: Is the second-most populous city in the United States, behind only New York City ; it is also the commercial, financial and cultural center of Southern California . Los Angeles has an ethnically and culturally diverse population, and is the principal city of a metropolitan area of 12.8 million people (2023). Greater Los Angeles , which includes the Los Angeles and Riverside–San Bernardino metropolitan areas,
6751-569: Is to end the AIDS epidemic by ensuring access to quality healthcare, including HIV and STD testing, prescription of medications like Pre-exposure Prophylaxis (PrEP), and referrals to specialty pharmacies. AHF is the largest provider of PrEP in the United States, though its founder Michael Weinstein has received criticism for his past opposition to the drug. Since 2012, AHF has become highly active in sponsoring and exclusively financing multiple high-profile ballot initiatives in two states, starting with
6908-446: Is used at low doses to inhibit cytochrome p450 enzymes and "boost" the levels of other protease inhibitors, rather than for its direct antiviral effect. This boosting effect allows them to be taken less frequently throughout the day. Cobicistat is used with elvitegravir for a similar effect but does not have any direct antiviral effect itself. The WHO preferred initial regimen for adults and adolescents as of June 30, 2013, is: In
7065-413: The 1916 New York City Zoning Ordinance did. Second, the residential zones did not distinguish types of housing; they treated apartments, hotels, and detached-single-family housing equally. In 1910, Hollywood merged into Los Angeles, with 10 movie companies already operating in the city at the time. By 1921, more than 80 percent of the world's film industry was concentrated in L.A. The money generated by
7222-805: The Army Corps of Engineers to act as a flood control channel. The river begins in the Canoga Park district of the city, flows east from the San Fernando Valley along the north edge of the Santa Monica Mountains, and turns south through the city center, flowing to its mouth in the Port of Long Beach at the Pacific Ocean. The smaller Ballona Creek flows into the Santa Monica Bay at Playa del Rey . Los Angeles
7379-547: The Hillside Stranglers murder cases in 1977–1978. In early 1984, the city surpassed Chicago in population, thus becoming the second largest city in the United States. In 1984, the city hosted the Summer Olympic Games for the second time . Despite being boycotted by 14 Communist countries , the 1984 Olympics became more financially successful than any previous, and the second Olympics to turn
7536-476: The Los Angeles County government to compel its health department to mandate condom use in adult film productions. In 2012, AHF supported a Los Angeles city ordinance requiring condoms in certain adult films. Later the same year, the organization spent US$ 1,654,681 funding the successful campaign to pass Measure B , a ballot initiative that expanded the condom requirement countywide. AHF again sued
7693-495: The Los Angeles sunflower , have become so rare as to be considered endangered. Mexican Fan Palms , Canary Island Palms , Queen Palms , Date Palms , and California Fan Palms are common in the Los Angeles area, although only the last is native to California, though still not native to the City of Los Angeles. Los Angeles has a number of official flora: The city has an urban population of bobcats ( Lynx rufus ). Mange
7850-593: The Mission San Gabriel Arcángel , the first mission in the area. On September 4, 1781, a group of 44 settlers known as " Los Pobladores " founded the pueblo (town) they called El Pueblo de Nuestra Señora la Reina de los Ángeles , 'The Town of Our Lady the Queen of the Angels';. The present-day city has the largest Roman Catholic archdiocese in the United States. Two-thirds of
8007-577: The Spanish Empire in 1542, while on an official military exploring expedition, as he was moving northward along the Pacific coast from earlier colonizing bases of New Spain in Central and South America. Gaspar de Portolà and Franciscan missionary Juan Crespí reached the present site of Los Angeles on August 2, 1769. In 1771, Franciscan friar Junípero Serra directed the building of
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#17327651697488164-703: The World AIDS Day to mobilize communities and promote a greater understanding of the impact of HIV/AIDS worldwide. AHF hosted its 2022 World AIDS Day Concert on Wednesday, November 30, at the concert hall of The Kennedy Center in Washington, D.C., where multi-Grammy Award-winning vocalists Patti LaBelle and Gladys Knight delivered performances. In December 2023, AHF hosted its World AIDS Day Concert at NRG Arena in Houston, Texas, featuring Janet Jackson , Debbie Allen , and Blair Underwood . Underwood received
8321-625: The XIX International AIDS Conference, 2012 . The film premiered on March 29, 2013 at the Vail Film Festival . In August 2024, AHF opened a new all-in-one facility in Austin, Texas , including an HIV healthcare center, pharmacy services, STI testing and treatment, and an Out of the Closet thrift store, where 96 cents of every dollar earned goes back into local patient care. In the early 2000s, AHF developed
8478-577: The siege of Los Angeles where 150 Mexican militias fought the occupiers which eventually surrendered. Mexican rule ended during following the American Conquest of California , part of the larger Mexican-American War . Americans took control from the Californios after a series of battles, culminating with the signing of the Treaty of Cahuenga on January 13, 1847. The Mexican Cession
8635-487: The 1890s brought rapid growth to the city. The city was further expanded with the completion of the Los Angeles Aqueduct in 1913, which delivers water from Eastern California . Los Angeles has a diverse economy with a broad range of industries. Despite a steep exodus of film and television production since the COVID-19 pandemic , Los Angeles is still one of the largest hubs of American film production ,
8792-671: The 1930s, / l ɔː s ˈ æ n dʒ əl ə s / has been most common. In 1934, the United States Board on Geographic Names decreed that this pronunciation be used by the federal government. This was also endorsed in 1952 by a "jury" appointed by Mayor Fletcher Bowron to devise an official pronunciation. Common pronunciations in the United Kingdom include / l ɒ s ˈ æ n dʒ ɪ l iː z , - l ɪ z , - l ɪ s / loss AN -jil-eez, -iz, -iss . Phonetician Jack Windsor Lewis described
8949-507: The 20th century, Los Angeles substantially reduced the amount of housing that could be built by drastically downzoning the city. In 1960, the city had a total zoned capacity for approximately 10 million people. By 1990, that capacity had fallen to 4.5 million as a result of policy decisions to ban housing through zoning. Racial tensions led to the Watts riots in 1965, resulting in 34 deaths and over 1,000 injuries. In 1969, California became
9106-749: The Carl Bean House and Linn House, which opened in 1992 and 1995, respectively—provided 24-hour medical and palliative care to people living through the final stages of AIDS. The Carl Bean House was named after then-Reverend Carl Bean , a singer and activist who founded the Minority AIDS Project. Located in South Central Los Angeles, it specifically focused on care for predominantly Black and Latino community members, accepting all terminal AIDS patients regardless if they had health insurance or not. Brownlie died at
9263-792: The Centre of Excellence ART clinic was opened by AHF India Cares in New Delhi , with AHF becoming the first provider to offer free anti-retroviral therapy (ART) in the area. In May 2023, AHF began a collaboration with the Pan American Health Organization (PAHO) to eliminate HIV/AIDS, tuberculosis, viral hepatitis, monkeypox, and other STIs in Latin America. The partnership set out to implement WHO recommendations through advocacy, including improvement of prevention programs, quality of care, and treatment outcomes. AHF
9420-579: The Chris Brownlie Hospice. In 1997, Out of the Closet thrift stores began offering free and anonymous HIV testing. In 1991, AHF opened the Richard Polanco HIV Clinic as a place where people in the early stages of AIDS could receive treatment even without private health insurance. In 2000, AHF opened its first pharmacy, a move that proved crucial to its underlying business model. The organization's main business
9577-507: The City of Los Angeles from selling or providing water from the aqueduct to any area outside its borders, many adjacent cities and communities felt compelled to join Los Angeles. Los Angeles created the first municipal zoning ordinance in the United States. On September 14, 1908, the Los Angeles City Council promulgated residential and industrial land use zones. The new ordinance established three residential zones of
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#17327651697489734-426: The City of Los Angeles to develop health services independent from the county. Health officials in affected departments filed responsive suits, arguing massive wastes would result in a transition or duplication of services. In 2014, the AIDS Healthcare Foundation filed suit against the City of San Francisco. AHF claimed that city restrictions on chain stores targeted them unfairly when the organization attempted to open
9891-512: The Healthy Housing Foundation (HHF). HHF is responsible for finding or building affordable housing units in several places across the country, including Los Angeles and Miami-Dade County , where the organization has made a multi-million dollar commitment to house people in need. In 2017, AHF created a new organization named the Healthy Housing Foundation (HHF) which started acquiring hotels (often single-room occupancy ) in
10048-631: The Healthy Housing Foundation, which has been creating housing for homeless and low-income individuals, primarily in Los Angeles. AHF also shifted its political focus to attempting to block housing construction through lawsuits against several new projects, as well as an initiative seeking to block local development in Los Angeles ( 2017 Los Angeles Measure S ), and three seeking to allow for the expansion of rent control in California ( 2018 California Proposition 10 , 2020 California Proposition 21 , and 2024 California Proposition 33 ); all of these failed at
10205-593: The L.A. Times showed that De León told a staff member that angry messages are "coming from the top" about a staff member's visit to one of the foundation's properties. Ethics experts expressed concerns about conflicts of interests in the relationship between the two and the failure to disclose the payment. De León's consulting contract with AHF ended before taking office as a council member. He maintains he showed no favoritism to AHF in addressing tenant complaints, showing that his staff monitored concerns and referred tenants to city enforcement officials. According to Pete Brown,
10362-479: The Los Angeles County government, alleging that an August 2012 audit conducted by the county was an illegal retaliation for AHF's support for Measure B. In 2013, AHF began collecting signatures for a ballot measure to create a Los Angeles city health department that would take over part of the county health department's jurisdiction. The City of Los Angeles and County of Los Angeles oppose the measure, and
10519-454: The Los Angeles area for conversion to affordable housing units, renting them for about $ 400–600 per month. By 2020, it owned seven such properties totaling 800 units. As of 2022, it owns over a dozen in Los Angeles, Hollywood, and Skid Row neighborhoods, and by 2023 has spend more than $ 180 million on the purchase and renovation of these properties. AHF has specialized in buying old (and sometimes vacant) hotels and converting them to housing (for
10676-629: The Los Angeles area include the 1933 Long Beach , 1971 San Fernando , 1987 Whittier Narrows , and the 1994 Northridge events. All but a few are of low intensity and are not felt. The USGS has released the UCERF California earthquake forecast , which models earthquake occurrence in California. Parts of the city are also vulnerable to tsunamis ; harbor areas were damaged by waves from Aleutian Islands earthquake in 1946, Valdivia earthquake in 1960, Alaska earthquake in 1964, Chile earthquake in 2010 and Japan earthquake in 2011. The city
10833-502: The Los Angeles area was the headquarters of six of the country's major aircraft manufacturers ( Douglas Aircraft Company , Hughes Aircraft , Lockheed , North American Aviation , Northrop Corporation , and Vultee ). During the war, more aircraft were produced in one year than in all the pre-war years since the Wright brothers flew the first airplane in 1903, combined. Manufacturing in Los Angeles skyrocketed, and as William S. Knudsen , of
10990-685: The Los Angeles/Long Beach port complex, Los Angeles suffers from air pollution in the form of smog. The Los Angeles Basin and the San Fernando Valley are susceptible to atmospheric inversion , which holds in the exhausts from road vehicles, airplanes, locomotives, shipping, manufacturing, and other sources. The smog season lasts from approximately May to October. While other large cities rely on rain to clear smog, Los Angeles gets only 15 inches (380 mm) of rain each year: pollution accumulates over many consecutive days. Issues of air quality in Los Angeles and other major cities led to
11147-489: The Mexican or ( New Spain ) settlers were mestizo or mulatto , a mixture of African, indigenous and European ancestry. The settlement remained a small ranch town for decades, but by 1820, the population had increased to about 650 residents. Today, the pueblo is commemorated in the historic district of Los Angeles Pueblo Plaza and Olvera Street , the oldest part of Los Angeles. New Spain achieved its independence from
11304-477: The Morrison Hotel, made famous by The Doors ' 1970 album cover, with plans to convert the building into 111 units of affordable housing. The Doors drummer John Densmore and rock photographer Henry Diltz helped HHF make the announcement, with the hotel becoming the 15th affordable housing property owned and managed by the organization in Los Angeles. AIDS Healthcare Foundation actively participates in
11461-468: The N-terminal heptad repeat of gp41 of HIV to form an inactive hetero six-helix bundle, therefore preventing infection of host cells. Nucleoside reverse-transcriptase inhibitors (NRTI) and nucleotide reverse-transcriptase inhibitors (NtRTI) are nucleoside and nucleotide analogues which inhibit reverse transcription. HIV is an RNA virus, so it can not be integrated into the DNA in the nucleus of
11618-523: The National Defense Advisory Commission put it, "We won because we smothered the enemy in an avalanche of production, the like of which he had never seen, nor dreamed possible." After the end of World War II Los Angeles grew more rapidly than ever, sprawling into the San Fernando Valley . The expansion of the state owned Interstate Highway System during the 1950s and 1960s helped propel suburban growth and signaled
11775-569: The National Institute of Allergy and Infectious Diseases began recruiting patients for a trial examining the effects of a three drug combination of the protease inhibitor indinavir and two nucleoside analogs, illustrating the substantial benefit of combining two NRTIs with a new class of antiretrovirals, protease inhibitors , namely indinavir . Later that year David Ho became an advocate of this "hit hard, hit early" approach with aggressive treatment with multiple antiretrovirals early in
11932-537: The PARTNER study, which ran from 2010 to 2014, enrolled 1166 serodiscordant couples (where one partner is HIV positive and the other is negative) in a study that found that the estimated rate of transmission through any condomless sex with the HIV-positive partner taking ART with an HIV load less than 200 copies/ml was zero. In summary, as the WHO HIV treatment guidelines state, "The ARV regimens now available, even in
12089-571: The Queen of the Angels'. The original name of the settlement is disputed; the Guinness Book of World Records rendered it as "El Pueblo de Nuestra Señora la Reina de los Ángeles del Río Porciúncula "; other sources have shortened or alternate versions of the longer name. The local English pronunciation of the name of the city has varied over time. A 1953 article in the journal of the American Name Society asserts that
12246-696: The San Fernando Valley. Other hilly parts of Los Angeles include the Mt. Washington area north of Downtown, eastern parts such as Boyle Heights , the Crenshaw district around the Baldwin Hills , and the San Pedro district. Surrounding the city are much higher mountains. Immediately to the north lie the San Gabriel Mountains , which is a popular recreation area for Angelenos. Its high point
12403-527: The Southern Californian coast, is subject to a late spring/early summer weather phenomenon called " June Gloom ". This involves overcast or foggy skies in the morning that yield to sun by early afternoon. More recently, statewide droughts in California have further strained the city's water security . Downtown Los Angeles averages 14.67 in (373 mm) of precipitation annually, mainly occurring between November and March, generally in
12560-475: The Spanish Empire in 1821, and the pueblo now existed within the new Mexican Republic . During Mexican rule, Governor Pío Pico made Los Angeles the regional capital of Alta California . By this time, the new republic introduced more secularization acts within the Los Angeles region. In 1846, during the wider Mexican-American war , marines from the United States occupied the pueblo. This resulted in
12717-535: The US, 10.8% of one cohort of patients who had never been on ART before had at least one resistance mutation in 2005. Various surveys in different parts of the world have shown increasing or stable rates of baseline resistance as the era of effective HIV therapy continues. With baseline resistance testing, a combination of antiretrovirals that are likely to be effective can be customized for each patient. Most HAART regimens consist of three drugs: Two NRTIs ("backbone")+
12874-731: The United States there are both the International AIDS Society-USA (IAS-USA) (a 501(c)(3) not-for-profit organization in the US) as well as the US government's Department of Health and Human Services guidelines. In Europe there are the European AIDS Clinical Society guidelines. For resource limited countries, most national guidelines closely follow the World Health Organization (WHO) guidelines. The guidelines use new criteria to consider starting HAART, as described below. However, there remain
13031-507: The adaptive reuse of existing buildings. Weinstein likens the homelessness and housing affordability crises to the "moral outrage of AIDS in the [1980s]," with many homeless youth identifying as LGBTQ. Under his leadership, AHF has sued to prevent the destruction of available housing units by developers who favor luxury housing. In recognition of the interconnectedness between housing stability and overall health outcomes for individuals living with HIV/AIDS, AIDS Healthcare Foundation established
13188-410: The age of 39, on November 26, 1989 because of AIDS-related complications, less than a year after the hospice named in his honor first opened, survived by his father, sister, brothers, his longtime partner, Phill Wilson and countless friends and fellow AIDS activists. In addition to Brownlie, over 1,000 people had been given dignified, specialized, compassionate final care at the Chris Brownlie Hospice by
13345-769: The birthplace of the Internet, as the first ARPANET transmission was sent from the University of California, Los Angeles (UCLA) to the Stanford Research Institute in Menlo Park . In 1973, Tom Bradley was elected as the city's first African American mayor, serving for five terms until retiring in 1993. Other events in the city during the 1970s included the Symbionese Liberation Army 's South Central standoff in 1974 and
13502-632: The boundary between the Pacific Plate and the North American Plate , passes through the Los Angeles metropolitan area. The segment of the fault passing through Southern California experiences a major earthquake roughly every 110 to 140 years, and seismologists have warned about the next "big one", as the last major earthquake was the 1857 Fort Tejon earthquake . The Los Angeles basin and metropolitan area are also at risk from blind thrust earthquakes . Major earthquakes that have hit
13659-485: The boundary of a Mediterranean climate ( Köppen : Csb on the coast, Csa otherwise). Daytime temperatures are generally temperate all year round. In winter, they average around 68 °F (20 °C). Autumn months tend to be hot, with major heat waves a common occurrence in September and October, while the spring months tend to be cooler and experience more precipitation. Los Angeles has plenty of sunshine throughout
13816-490: The chain as AHF Pharmacy. AHF sponsored HIV awareness-themed Rose Parade floats in 2012 and 2013, each winning the Queen's Trophy for best use of roses. The organization fashioned a tribute to actress Elizabeth Taylor , who championed HIV and AIDS programs in the 1980s. In 2014, AHF made history during the Rose Parade by hosting a same-sex wedding on its float for the first time in the parade's history. The float, with
13973-404: The city as the most polluted in the country with short-term particle pollution and year-round particle pollution. In 2008, the city was ranked the second most polluted and again had the highest year-round particulate pollution. The city met its goal of providing 20 percent of the city's power from renewable sources in 2010. The American Lung Association's 2013 survey ranks the metro area as having
14130-549: The city has filed a lawsuit seeking to invalidate the measure. In August 2014, the AIDS Healthcare Foundation filed a formal complaint with Nevada OSHA, against Cybernet Entertainment LLC, which does business as Kink.com and related spin-offs. The complaint alleges the California porn company did not require its actors to use condoms during an adult film shoot in Las Vegas . In 2013, AHF found itself entangled in dual lawsuits when AHF allegedly attempted to use its clout to force
14287-537: The city is 342 miles (550 km). Los Angeles is both flat and hilly. The highest point in the city proper is Mount Lukens at 5,074 ft (1,547 m), located in the foothills of the San Gabriel Mountains at the north extent of the Crescenta Valley . The eastern end of the Santa Monica Mountains stretches from Downtown to the Pacific Ocean and separates the Los Angeles Basin from
14444-504: The city, causing $ 12.5 billion in damage and 72 deaths. The century ended with the Rampart scandal , one of the most extensive documented cases of police misconduct in American history. In 2002, Mayor James Hahn led the campaign against secession, resulting in voters defeating efforts by the San Fernando Valley and Hollywood to secede from the city. In 2022 , Karen Bass became the city's first female mayor , making Los Angeles
14601-497: The city. However, between 1908 and 1915, the Los Angeles City Council created various exceptions to the broad proscriptions that applied to these three residential zones, and as a consequence, some industrial uses emerged within them. There are two differences between the 1908 Residence District Ordinance and later zoning laws in the United States. First, the 1908 laws did not establish a comprehensive zoning map as
14758-409: The country's largest oil producer, accounting for about one-quarter of the world's petroleum output. By 1900, the population had grown to more than 102,000, putting pressure on the city's water supply . The completion of the Los Angeles Aqueduct in 1913, under the supervision of William Mulholland , ensured the continued growth of the city. Because of clauses in the city's charter that prevented
14915-412: The course of the infection. Later reviews in the late 90s and early 2000s noted that this approach of "hit hard, hit early" ran significant risks of increasing side effects and development of multidrug resistance, and this approach was largely abandoned. The only consensus was on treating patients with advanced immunosuppression (CD4 counts less than 350/μL). Treatment with antiretrovirals was expensive at
15072-477: The demise of the city's privately owned electrified rail system , once the world's largest. As a consequence of World War II, suburban growth, and population density, many amusement parks were built and operated in this area. An example is Beverly Park , which was located at the corner of Beverly Boulevard and La Cienega before being closed and substituted by the Beverly Center . In the second half of
15229-585: The development of multi-drug resistant mutations. In contrast, antiretroviral combination therapy defends against resistance by creating multiple obstacles to HIV replication. This keeps the number of viral copies low and reduces the possibility of a superior mutation. If a mutation that conveys resistance to one of the drugs arises, the other drugs continue to suppress reproduction of that mutation. With rare exceptions, no individual antiretroviral drug has been demonstrated to suppress an HIV infection for long; these agents must be taken in combinations in order to have
15386-566: The difference between the average daily low and the average daily high is over 30 °F (17 °C). The average annual temperature of the sea is 63 °F (17 °C), from 58 °F (14 °C) in January to 68 °F (20 °C) in August. Hours of sunshine total more than 3,000 per year, from an average of 7 hours of sunshine per day in December to an average of 12 in July. Due to
15543-595: The disease through advanced medical care. This shift was marked with the change of the Foundation's name to AIDS Healthcare Foundation in July 1990. AHF operates the Out of the Closet thrift store chain. 96 cents of every dollar earned at the thrift stores goes to AHF's HIV/AIDS programs and housing services, on-site pharmacies, and free HIV testing. The first Out of the Closet thrift store opened in 1990 in Los Angeles' Atwater Village to benefit residents living with AIDS at
15700-470: The drug resistant strains to become dominant. This in turn makes it harder to treat the infected individual as well as anyone else they infect. One trial showed higher rates of opportunistic infections, cancers, heart attacks and death in patients who periodically interrupted their ART. There are several treatment guidelines for HIV-1 infected adults in the developed world (that is, those countries with access to all or most therapies and laboratory tests). In
15857-410: The ease with which they can be taken, which in turn increases the consistency with which medication is taken ( adherence ), and thus their effectiveness over the long-term. Although antiretroviral therapy has helped to improve the quality of life of people living with HIV, there is still a need to explore other ways to further address the disease burden. One such potential strategy that was investigated
16014-400: The enzyme; NNRTIs act as non-competitive inhibitors of reverse transcriptase . NNRTIs affect the handling of substrate (nucleotides) by reverse transcriptase by binding near the active site. NNRTIs can be further classified into 1st generation and 2nd generation NNRTIs. 1st generation NNRTIs include nevirapine and efavirenz . 2nd generation NNRTIs are etravirine and rilpivirine . HIV-2
16171-524: The era of Spanish colonization). The historic center of Tongva power in the region was the settlement of Yaanga ( Tongva : Iyáangẚ ), meaning "place of the poison oak ", which would one day be the site where the Spanish founded the Pueblo de Los Ángeles . Iyáangẚ has also been translated as "the valley of smoke". Maritime explorer Juan Rodríguez Cabrillo claimed the area of southern California for
16328-580: The first six months after infection HIV viral loads tend to be elevated and people are more often symptomatic than in later latent phases of HIV disease. There may be special benefits to starting antiretroviral therapy early during this acute phase, including lowering the viral "set-point" or baseline viral load, reduce the mutation rate of the virus, and reduce the size of the viral reservoir (See section below on viral reservoirs ). The SPARTAC trial compared 48 weeks of ART vs 12 weeks vs no treatment in acute HIV infection and found that 48 weeks of treatment delayed
16485-407: The form of moderate rain showers, but sometimes as heavy rainfall during winter storms. Rainfall is usually higher in the hills and coastal slopes of the mountains because of orographic uplift. Summer days are usually rainless. Rarely, an incursion of moist air from the south or east can bring brief thunderstorms in late summer, especially to the mountains. The coast gets slightly less rainfall, while
16642-501: The granting of marketing authorizations for two new antiretroviral (ARV) medicines, rilpivirine (Rekambys) and cabotegravir (Vocabria), to be used together for the treatment of people with human immunodeficiency virus type 1 (HIV-1) infection. The two medicines are the first ARVs that come in a long-acting injectable formulation. This means that instead of daily pills, people receive intramuscular injections monthly or every two months. The combination of Rekambys and Vocabria injection
16799-586: The high price, but agreed to a price cut. In January 2007, AHF filed suit in Los Angeles over Pfizer 's direct-to-consumer marketing of Viagra , accusing Pfizer of promoting off-label, recreational use of Viagra, and suggesting a link between Viagra, methamphetamine , and unsafe sex. Pfizer denied AHF's claims, and mentioned that AHF had recently asked Pfizer to fund an educational program about meth. In August 2007, AHF began purchasing full-page ads in Indian newspapers accusing Cipla of overpricing. According to AHF,
16956-495: The host cell by blocking one of several targets. Maraviroc , enfuvirtide and Ibalizumab are available agents in this class. Maraviroc works by targeting CCR5 , a co-receptor located on human helper T-cells. Caution should be used when administering this drug, however, due to a possible shift in tropism which allows HIV to target an alternative co-receptor such as CXCR4 . Ibalizumab is effective against both CCR5 and CXCR4 tropic HIV viruses. In rare cases, individuals may have
17113-742: The human cell unless it is first "reverse" transcribed into DNA. Since the conversion of RNA to DNA is not naturally done in the mammalian cell, it is performed by a viral protein, reverse transcriptase , which makes it a selective target for inhibition. NRTIs are chain terminators. Once NRTIs are incorporated into the DNA chain, their lack of a 3' OH group prevents the subsequent incorporation of other nucleosides. Both NRTIs and NtRTIs act as competitive substrate inhibitors . Examples of NRTIs include zidovudine , abacavir , lamivudine , emtricitabine , and of NtRTIs – tenofovir and adefovir . Non-nucleoside reverse-transcriptase inhibitors (NNRTI) inhibit reverse transcriptase by binding to an allosteric site of
17270-566: The importance of involving patients in therapy choices and recommend analyzing the risks and the potential benefits. The WHO has defined health as more than the absence of disease. For this reason, many researchers have dedicated their work to better understanding the effects of HIV-related stigma, the barriers it creates for treatment interventions, and the ways in which those barriers can be circumvented. There are six classes of drugs, which are usually used in combination, to treat HIV infection. Antiretroviral (ARV) drugs are broadly classified by
17427-565: The industry kept the city insulated from much of the economic loss suffered by the rest of the country during the Great Depression . By 1930, the population surpassed one million. In 1932, the city hosted the Summer Olympics . During World War II Los Angeles was a major center of wartime manufacturing, such as shipbuilding and aircraft. Calship built hundreds of Liberty Ships and Victory Ships on Terminal Island, and
17584-521: The inland and mountain areas get considerably more. Years of average rainfall are rare. The usual pattern is a year-to-year variability, with a short string of dry years of 5–10 in (130–250 mm) rainfall, followed by one or two wet years with more than 20 in (510 mm). Wet years are usually associated with warm water El Niño conditions in the Pacific, dry years with cooler water La Niña episodes. A series of rainy days can bring floods to
17741-575: The largest U.S. city to have ever had a woman as mayor. Los Angeles will host the 2028 Summer Olympics and Paralympic Games , making Los Angeles the third city to host the Olympics three times. The city of Los Angeles covers a total area of 502.7 square miles (1,302 km ), comprising 468.7 square miles (1,214 km ) of land and 34.0 square miles (88 km ) of water. The city extends for 44 miles (71 km) from north to south and for 29 miles (47 km) from east to west. The perimeter of
17898-490: The lowest is 28 °F (−2 °C), on January 4, 1949. Within the City of Los Angeles, the highest temperature ever officially recorded is 121 °F (49 °C), on September 6, 2020, at the weather station at Pierce College in the San Fernando Valley neighborhood of Woodland Hills . During autumn and winter, Santa Ana winds sometimes bring much warmer and drier conditions to Los Angeles, and raise wildfire risk. Owing to geography, heavy reliance on automobiles, and
18055-505: The lowlands and mudslides to the hills, especially after wildfires have denuded the slopes. Both freezing temperatures and snowfall are extremely rare in the city basin and along the coast, with the last occurrence of a 32 °F (0 °C) reading at the downtown station being January 29, 1979; freezing temperatures occur nearly every year in valley locations while the mountains within city limits typically receive snowfall every winter. The greatest snowfall recorded in downtown Los Angeles
18212-422: The metal binding site of integrase. As of early 2022, four other clinically approved integrase inhibitors are elvitegravir , dolutegravir , bictegravir , and cabotegravir . Protease inhibitors block the viral protease enzyme necessary to produce mature virions upon budding from the host membrane. Particularly, these drugs prevent the cleavage of gag and gag/pol precursor proteins. Virus particles produced in
18369-530: The most common one, / l ɒ s ˈ æ n dʒ ɪ l iː z / , as a spelling pronunciation based on analogy to Greek words ending in -es , "reflecting a time when the classics were familiar if Spanish was not". The settlement of Indigenous Californians in the modern Los Angeles Basin and the San Fernando Valley was dominated by the Tongva (now also known as the Gabrieleño since
18526-546: The mountainous terrain of the surrounding region, the Los Angeles area contains a large number of distinct microclimates , causing extreme variations in temperature in close physical proximity to each other. For example, the average July maximum temperature at the Santa Monica Pier is 70 °F (21 °C) whereas it is 95 °F (35 °C) in Canoga Park, 15 miles (24 km) away. The city, like much of
18683-483: The name's pronunciation with a hard g ( / ɡ / ), reported that there were at least 12 pronunciation variants. In the early 1900s, the Los Angeles Times advocated for pronouncing it Loce AHNG-hayl-ais ( / l oʊ s ˈ ɑː ŋ h eɪ l eɪ s / ), approximating Spanish [los ˈaŋxeles] , by printing the respelling under its masthead for several years. This did not find favor. Since
18840-470: The nation's worst smog, and fourth in both short-term and year-round pollution amounts. Anti-retroviral drugs The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection . There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets
18997-583: The opening of Chris Brownlie Hospice by protesting and picketing of then-Supervisor Mike Antonovich 's home. Following an emotional plea for hospice care to Los Angeles County Commission on AIDS, which included the Los Angeles County Board of Supervisors, they secured a $ 2 million commitment to AIDS care on the grounds of the Barlow Respiratory Hospital. The 25-bed hospice—the first of three operated by AHF, including
19154-488: The organization's Lifetime Achievement Award at the event. The organization paid $ 110,000 to Kevin de León for consultancy work in the period after he won election to the Los Angeles City Council, but before he took office. Once in office, De León allegedly pressured his staff not to investigate various health and code violations at properties owned by the foundation in De León's district. Internal communications revealed by
19311-453: The other hand, patients who take their medications regularly can stay on one regimen without developing resistance. This greatly increases life expectancy and leaves more drugs available to the individual should the need arise. In 2000 drug companies have worked together to combine these complex regimens into single-pill fixed-dose combinations . More than 20 antiretroviral fixed-dose combinations have been developed. This greatly increases
19468-514: The passage of early national environmental legislation, including the Clean Air Act . When the act was passed, California was unable to create a State Implementation Plan that would enable it to meet the new air quality standards, largely because of the level of pollution in Los Angeles generated by older vehicles. More recently, the state of California has led the nation in working to limit pollution by mandating low-emission vehicles . Smog
19625-783: The past. Thus the WHO recommends PI based regimens for children less than 3. The WHO recommends for children less than 3 years: and for children 3 years to less than 10 years and adolescents <35 kilograms: US DHHS guidelines are similar but include PI based options for children > 3 years old. A systematic review assessed the effects and safety of abacavir-containing regimens as first-line therapy for children between 1 month and 18 years of age when compared to regimens with other NRTIs. This review included two trials and two observational studies with almost eleven thousand HIV infected children and adolescents. They measured virologic suppression, death and adverse events. The authors found that there
19782-465: The phase of the retrovirus life-cycle that the drug inhibits. Typical combinations include two nucleoside reverse-transcriptase inhibitors (NRTI) as a "backbone" along with one non-nucleoside reverse-transcriptase inhibitor (NNRTI), protease inhibitor (PI) or integrase inhibitors (also known as integrase nuclear strand transfer inhibitors or INSTIs) as a "base". Entry inhibitors (or fusion inhibitors) interfere with binding, fusion and entry of HIV-1 to
19939-440: The polls. Regarding the housing initiatives, critics have questioned whether the group is misusing foundation and taxpayer money by sponsoring ballot initiatives they consider unrelated to the stated mission of the organization. Weinstein argues, however, that housing is linked to a "sustainable public health structure." During the late 1980s and early 1990s, AHF emerged as an advocate for gay and bisexual men who were hit hardest at
20096-402: The poorest countries, are safer, simpler, more effective and more affordable than ever before." There is a consensus among experts that, once initiated, antiretroviral therapy should never be stopped. This is because the selection pressure of incomplete suppression of viral replication in the presence of drug therapy causes the more drug sensitive strains to be selectively inhibited. This allows
20253-648: The population was infected with HIV at the time. In 2002, AHF opened an HIV/AIDS clinic in Masaka, Uganda under the program Uganda Cares. In 2004, the organization developed an "HIV Medic Program" in Masaka, a task-shifting training program that was awarded a "Best Practice" designation by the World Health Organization (WHO). By 2022, Uganda Cares had tested over seven million Ugandans, started treatment for more than 112,000 Ugandans, and distributed over 45 million condoms. In 2004, AHF began working in India. Two years later,
20410-412: The presence of protease inhibitors are defective and mostly non-infectious. Examples of HIV protease inhibitors are lopinavir , indinavir , nelfinavir , amprenavir and ritonavir . Darunavir and atazanavir are recommended as first line therapy choices. Maturation inhibitors have a similar effect by binding to gag, but development of two experimental drugs in this class, bevirimat and vivecon ,
20567-502: The previous owner defrauded AHF by not disclosing that settlement, though others say that AHF should have known from due diligence . AHF has argued against accusations about lingering maintenance problems in the organization's Skid Row residential buildings, blaming city officials for failing to permit planned upgrades. In 2022, the city and public utility paid AHF $ 100,000 to settle claims that they had delayed needed improvements to an elevator at The Madison. In December 2023, AHF purchased
20724-463: The price of their HIV drugs in the U.S, stating that as a result of regular drug price increases "HIV/AIDS assistance programs will essentially be flat funded and unable to provide access to additional people in need of lifesaving drugs." In September 2013, AHF filed a lawsuit in California against GSK alleging that the company "... failed to fully satisfy its obligations with respect to discounts for drugs it sold to AIDS Healthcare Foundation over
20881-423: The pronunciation / l ɔː s ˈ æ n dʒ əl ə s / lawss AN -jəl-əs was established following the 1850 incorporation of the city and that since the 1880s the pronunciation / l oʊ s ˈ æ ŋ ɡ əl ə s / lohss ANG -gəl-əs emerged from a trend in California to give places Spanish, or Spanish-sounding, names and pronunciations. In 1908, librarian Charles Fletcher Lummis , who argued for
21038-404: The rally. AHF hosts global events to both commemorate those lost to HIV/AIDS and educate the public about the importance of safer sex with condom use. Each year on December 1, AHF marks World AIDS Day with a series of international events throughout many of the countries where AHF operates. It is an opportunity to reflect on the progress made in battling HIV/AIDS over the years and be a reminder of
21195-563: The rest of the surrounding landscape. Most construction is done in separate units, rather than wall-to-wall . However, Downtown Los Angeles itself has many buildings over 30 stories, with fourteen over 50 stories, and two over 70 stories, the tallest of which is the Wilshire Grand Center . Los Angeles has a two-season semi-arid climate ( Köppen : BSh ) with dry summers and very mild winters, but it receives more annual precipitation than most semi-arid climates, narrowly missing
21352-599: The risk of HIV transmission from a person living with HIV who has been undetectable for a minimum of six months is negligible to non-existent, with negligible being defined as "so small or unimportant to be not worth considering". The Chair of the British HIV Association (BHIVA), Chloe Orkin , stated in July 2017 that 'there should be no doubt about the clear and simple message that a person with sustained, undetectable levels of HIV virus in their blood cannot transmit HIV to their sexual partners.' Furthermore,
21509-761: The risks of HIV treatment. Therapy during acute infection carries a grade BII recommendation from the US DHHS. HIV can be especially harmful to infants and children, with one study in Africa showing that 52% of untreated children born with HIV had died by age 2. By five years old, the risk of disease and death from HIV starts to approach that of young adults. The WHO recommends treating all children less than 5 years old, and starting all children older than 5 with stage 3 or 4 disease or CD4 <500 cells/ml. DHHS guidelines are more complicated but recommend starting all children less than 12 months old and children of any age who have symptoms. As for which antiretrovirals to use, this
21666-719: The start of the HIV/AIDS epidemic. In 1987, activists Chris Brownlie, Michael Weinstein, Sharon Raphael, PhD, Mina Meyer, MA, and other advocates were among the earliest champions of the AIDS hospice movement. They co-founded the Los Angeles AIDS Hospice Committee, which was the catalyst for the AIDS Hospice Foundation that we know today as the AIDS Healthcare Foundation. Members of the inaugural AIDS Hospice Committee—Brownlie, Weinstein, Myer, Raphael, Paul Coleman, and others—negotiated for
21823-611: The theme "Love is the Best Protection," won best presentation of color and color harmony through floral use. A longtime float participant, the organization has earned a reputation for thought-provoking messages surrounding healthcare, homelessness, gay rights, anti-violence, and other issues. AHF produced the documentary film Keep The Promise: The Global Fight Against AIDS , depicting the AHF-sponsored protest of government anti-HIV funding levels and anti-HIV drug prices at
21980-618: The time it ended hospice operations in September 1996. The building that housed the Brownlie Hospice went through its own rebirths, housing various departments of AHF, including the headquarters for AHF's Public Health Division, before the organization officially turned the property back over to the City of Los Angeles with a sunset memorial ceremony on January 26, 2013. As medical opportunities for managing HIV including anti-retroviral drugs became more available, AHF changed its mission to helping individuals with HIV/AIDS live well with
22137-659: The time to decline in CD4 count below 350 cells per ml by 65 weeks and kept viral loads significantly lower even after treatment was stopped. Since viral loads are usually very high during acute infection, this period carries an estimated 26 times higher risk of transmission. By treating acutely infected patients, it is presumed that it could have a significant impact on decreasing overall HIV transmission rates since lower viral loads are associated with lower risk of transmission (See section on treatment as prevention ). However an overall benefit has not been proven and has to be balanced with
22294-405: The time, ranging from $ 10,000 to $ 15,000 a year. The timing of when to start therapy has continued to be a core controversy within the medical community, though recent studies have led to more clarity. The NA-ACCORD study observed patients who started antiretroviral therapy either at a CD4 count of less than 500 versus less than 350 and showed that patients who started ART at lower CD4 counts had
22451-557: The use of interleukin 2 as an add-on treatment to antiretroviral therapy for adults with HIV. Antiretroviral drug treatment guidelines have changed over time. Before 1987, no antiretroviral drugs were available and treatment consisted of treating complications from opportunistic infections and malignancies. After antiretroviral medications were introduced, most clinicians agreed that HIV positive patients with low CD4 counts should be treated, but no consensus formed as to whether to treat patients with high CD4 counts. In April 1995, Merck and
22608-650: The village of Yaanga . It became a part of the First Mexican Empire in 1821 following the Mexican War of Independence . In 1848, at the end of the Mexican–American War , Los Angeles and the rest of California were purchased as part of the Treaty of Guadalupe Hidalgo and became part of the United States. Los Angeles was incorporated as a municipality on April 4, 1850, five months before California achieved statehood . The discovery of oil in
22765-410: The virus to mutate very rapidly, resulting in a high genetic variability. Most of the mutations either are inferior to the parent virus (often lacking the ability to reproduce at all) or convey no advantage, but some of them have a natural selection superiority to their parent and can enable them to slip past defenses such as the human immune system and antiretroviral drugs. The more active copies of
22922-449: The virus, the greater the possibility that one resistant to antiretroviral drugs will be made. When antiretroviral drugs are used improperly, multi-drug resistant strains can become the dominant genotypes very rapidly. In the era before multiple drug classes were available (pre-1997), the reverse-transcriptase inhibitors zidovudine , didanosine , zalcitabine , stavudine , and lamivudine were used serially or in combination leading to
23079-442: The work left to be done amid the 1.7 million new HIV infections every year. International Condom Day, which is celebrated on February 13, was established by the AIDS Healthcare Foundation. As a part of their advocacy efforts, AIDS Healthcare Foundation offers free condoms to the public at their International Condom Day (ICD) events and year around at their pharmacies, healthcare centers, and wellness centers. International Condom Day
23236-512: The world's largest by revenue; the city is an important site in the history of film . It also has one of the busiest container ports in the Americas. In 2018, the Los Angeles metropolitan area had a gross metropolitan product of over $ 1.0 trillion, making it the city with the third-largest GDP in the world, after New York and Tokyo . Los Angeles hosted the Summer Olympics in 1932 and 1984 , and will also host in 2028 . Despite
23393-708: The world, HIV has become a chronic condition in which progression to AIDS is increasingly rare. Anthony Fauci , former head of the United States National Institute of Allergy and Infectious Diseases , has written, "With collective and resolute action now and a steadfast commitment for years to come, an AIDS-free generation is indeed within reach." In the same paper, he noted that an estimated 700,000 lives were saved in 2010 alone by antiretroviral therapy. As another commentary noted, "Rather than dealing with acute and potentially life-threatening complications, clinicians are now confronted with managing
23550-635: The worst rush hour periods in the world, according to an annual traffic index by navigation system maker, TomTom . LA drivers spend an additional 92 hours in traffic each year. During the peak rush hour, there is 80% congestion, according to the index. Los Angeles is often characterized by the presence of low-rise buildings, in contrast to New York City. Outside of a few centers such as Downtown , Warner Center , Century City , Koreatown , Miracle Mile , Hollywood, and Westwood , skyscrapers and high-rise buildings are not common in Los Angeles. The few skyscrapers built outside of those areas often stand out above
23707-582: The year, with an average of only 35 days with measurable precipitation annually. Temperatures in the coastal basin exceed 90 °F (32 °C) on a dozen or so days in the year, from one day a month in April, May, June and November to three days a month in July, August, October and to five days in September. Temperatures in the San Fernando and San Gabriel Valleys are considerably warmer. Temperatures are subject to substantial daily swings; in inland areas
23864-502: Was 2.0 inches (5 cm) on January 15, 1932. While the most recent snowfall occurred in February 2019, the first snowfall since 1962, with snow falling in areas adjacent to Los Angeles as recently as January 2021. Brief, localized instances of hail can occur on rare occasions, but are more common than snowfall. At the official downtown station, the highest recorded temperature is 113 °F (45 °C) on September 27, 2010, while
24021-502: Was formalized in the Treaty of Guadalupe Hidalgo in 1848, which ceded Los Angeles and the rest of Alta California to the United States. Railroads arrived with the completion of the transcontinental Southern Pacific line from New Orleans to Los Angeles in 1876 and the Santa Fe Railroad in 1885. Petroleum was discovered in the city and surrounding area in 1892, and by 1923, the discoveries had helped California become
24178-532: Was halted in 2010. Resistance to some protease inhibitors is high. Second generation drugs have been developed that are effective against otherwise resistant HIV variants. The life cycle of HIV can be as short as about 1.5 days from viral entry into a cell, through replication, assembly, and release of additional viruses, to infection of other cells. HIV lacks proofreading enzymes to correct errors made when it converts its RNA into DNA via reverse transcription . Its short life-cycle and high error rate cause
24335-710: Was likely to be suppressed. Pre-exposure prophylaxis (PrEP) provides HIV-negative individuals with medication—in conjunction with safer-sex education and regular HIV/STI screenings—in order to reduce the risk of acquiring HIV. In 2011, the journal Science gave the Breakthrough of the Year award to treatment as prevention. In July 2016 a consensus document was created by the Prevention Access Campaign which has been endorsed by over 400 organisations in 58 countries. The consensus document states that
24492-412: Was stopped early (after 1.7 years) for ethical reasons when it became clear that antiviral treatment provided significant protection. Of the 28 couples where cross-infection had occurred, all but one had taken place in the control group , consistent with a 96% reduction in risk of transmission while on ART. The single transmission in the experimental group occurred early after starting ART before viral load
24649-520: Was to add interleukin 2 as an adjunct to antiretroviral therapy for adults with HIV. A Cochrane review included 25 randomized controlled trials that were conducted across six countries. The researchers found that interleukin 2 increases the CD4 immune cells, but does not make a difference in terms of death and incidence of other infections. Furthermore, there is probably an increase in side-effects with interleukin 2. The findings of this review do not support
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