From the New York Times…
The medical school at the University of California, San Francisco, has opened a free telephone consulting service for doctors who are not H.I.V. specialists and want help prescribing the right AIDS drugs for preventing infection in healthy patients.The service, known as PrEPline for pre-exposure prophylaxis line, was announced last week.
In pre-exposure prophylaxis, patients at high risk for H.I.V., such as gay men who frequently have unprotected sex with strangers, ward off infection by taking Truvada, a pill containing two antiretroviral drugs. Uninfected men, if they have doctors at all, usually see general practitioners, who rarely prescribe antiretrovirals. By contrast, doctors at U.C.S.F. have decades of experience in treating H.I.V. because San Francisco was an early center of the outbreak.
The new hotline is aimed at American doctors, but if PrEP is rolled out around the world, it could be a model for other countries, said Dr. Ronald H. Goldschmidt, the director of the school’s clinical consultation center. Since 1993, he said, the center has fielded phone calls from doctors seeking help. Typically, they are obstetricians treating pregnant women infected with H.I.V.; emergency-room doctors treating nurses who have had a needle injury; or patients who had sex with someone they suspect is infected.
South Africa and Ethiopia have sent doctors for training to offer similar services at home, he said; prophylaxis is still rare in poor countries because they are struggling to pay for medicine even for those with advanced AIDS.
The treatment cascade in the United States – good in Ryan White programmes, but overall picture for gay men is poorPosted October 3, 2014 by administrator
Categories: Features, Health Alerts, HIV care, Research
People living with HIV in the United States who receive their care through the Ryan White HIV/AIDS Program have good rates of retention and virological suppression, investigators report in the online edition of Clinical Infectious Diseases. Of the patients seen at least once in 2011, some 82% were retained in care and 73% achieved virological suppression.
These outcomes dwarf those seen for most people living with HIV in the US – previous reports have estimated that as few as 40% were retained in care and 19% had achieved virological suppression.
A second new report focuses on gay, bisexual and other men who have sex with men, demonstrating that outcomes continue to be unacceptably poor in this group. Of those who have ever been diagnosed with HIV, 51% were retained in care and 42% achieved virological suppression.
However, both new studies found that outcomes were poorer in younger people, African American people and some other ethnic groups.
Continue reading on aidsmap.com
Posted on Reuters...
Bustling transport networks, migrant labor and changes to the sex trade in early 20th-century Congo created a “perfect storm” that gave rise to an HIV pandemic that has now infected 75 million people worldwide, researchers said on Thursday. In an analysis of the genetic history of the human immunodeficiency virus (HIV) that causes AIDS, the scientists said the global pandemic almost certainly began its global spread in the 1920s in Kinshasa in Democratic Republic of Congo (DRC).
Here, a confluence of factors including urban growth, extensive railway links during Belgian colonial rule and changes in sexual behavior combined to see HIV emerge in Congo’s capital and spread across the globe. Oliver Pybus, a professor at Oxford University’s zoology department who co-led the research, said that until now most studies have taken a piecemeal approach to HIV’s genetic history and looked only at certain HIV genomes in particular locations. “For the first time, we have analyzed all the available evidence using the latest phylogeographic techniques, which enable us to statistically estimate where a virus comes from,” he said. “This means we can say with a high degree of certainty where and when the HIV pandemic originated.”
United Nations AIDS agency (UNAIDS) data show that more than 35 million people worldwide are currently infected with HIV, and some 1.5 million people died of AIDS-related illness in 2013. Since the HIV/AIDS pandemic began, it has killed up to 40 million people worldwide. The disease is spread in blood, semen and breast milk. No cure exists, but AIDS can be kept at bay for many years in people with HIV who take cocktails of antiretroviral drugs.Various strains of HIV are known to have been transmitted from primates and apes to humans at least 13 times in history, but only one of those transmissions – of a strain known as HIV-1 Group M – led to the current human pandemic.
Pybus said the key questions centered on how this happened.”Why did most of (the HIV strains) die out, and why did some of them — like HIV-2 — go on to generate local epidemics in Africa, and why did only one go to become a global pandemic?” he said in a telephone interview. “To answer that, we needed to try to reconstruct the spread through space and time of the global pandemic strain.”
Continue reading on Reuters.
Categories: Features, HIV care, Research, Stigma
Even though gay and bisexual men make up the majority of Americans infected with HIV, half aren’t receiving ongoing care or getting the virus-suppressing drugs they need to stay healthy, a new report finds.The study, from the U.S. Centers for Disease Control and Prevention (CDC), looked at 2010 data on more than 400,000 male gay and bisexual Americans who were infected with HIV, the virus that causes AIDS.
The research shows that while 77.5 percent did initially get HIV medical care within three months of their diagnosis, only about 51 percent continued getting care on an ongoing basis. Experts note that HIV infection can be manageable if powerful antiviral drugs are taken on a regular basis. But the CDC report finds that less than half of HIV-positive gay or bisexual men were prescribed such drugs, and only 42 percent achieved healthy “viral suppression.”
Why are so many infected men not getting proper treatment? The CDC researchers said many factors could be at play. “Lack of health insurance, stigma and discrimination might influence whether [gay and bisexual men] access medical care,” they wrote. Gaining access to care soon after diagnosis is crucial to whether or not a patient continues to get virus-suppressing medications, the team added.
Continue reading on MedlinePlus.
Kaiser Family Foundation releases new alarming report reflecting gay and bisexual men’s attitudes, knowledge, and experiences with HIV/AIDSPosted September 29, 2014 by administrator
Categories: Community, Features, Health Alerts, HIV care
From Gay Men’s Health Crisis…
On Thursday, September 25, 2014, the Kaiser Family Foundation released a new alarming report reflecting gay and bisexual men’s attitudes, knowledge, and experiences with HIV/AIDS and new HIV therapies in the United States. Their survey on HIV/AIDS in the lives of gay and bisexual men in the United States reports that 56% of gay and bisexual men are not personally concerned about HIV or AIDS affecting them and 30% have never been tested for HIV.
“HIV/AIDS might not be a death sentence anymore, but there are still 50,000 new infections in the United States every year-and gay and bisexual men are still among those most at risk,” said GMHC CEO Kelsey Louie. ” The Kaiser Family Foundation study is a needed wake-up call that communicating the correct information about HIV and AIDS to the public has never been more critical. We must do more to educate our gay and bisexual men about how HIV and AIDS can affect them, and how life-saving medications like PrEP and PEP can help them prevent HIV infections and stay healthy.”
Eight out ten gay and bisexual men surveyed also said that they have heard a little or nothing about PrEP, a life-saving medication that can prevent HIV-infections. Additional findings from the survey can be found here. The Foundation’s survey comes on the heels of a new CDC report showing that 58% of gay and bisexual men diagnosed with HIV are not virally suppressed.
Categories: Features, Stigma
From the Human Rights Campaign Blog…
When the first case of what would become known as HIV/AIDS was diagnosed more than 30 years ago, it was branded a “gay disease.” Homophobia and fear were rampant. Although gay and bisexual men were not the only community affected by HIV, they were among those who felt the greatest burden of the disease. Then, as today, gay and bisexual men, along with transgender women, have the highest rates of HIV infection in the United States.
HIV brought together the gay community in another, more affirming, way as well. LGBT leaders took to the frontlines to advocate for HIV education, prevention and treatment. And that mobilization contributed to the dramatic decreases in new infections—and deaths—in those early years and spurred a new level of political and social activism in the community.
The introduction of antiretroviral (ARV) treatments in the mid-1990s gave hope to those who were infected, improving health and extending life. It also resulted in HIV being less visibly prominent, and thus perceived by some as less serious. Yet, gay and bisexual men, while only about 2 percent of the U.S. population, still account for two thirds of new infections. Transgender women are at high risk for HIV, though there is more limited data regarding representation in the national overview.
One study by the U.S. Centers for Disease Control and Prevention (CDC) estimates that one in five gay and bisexual men in 20 major cities today is HIV positive—with one in three not knowing they are infected. Nationally, the projection is that more than one in 10 gay men is HIV positive. These are rates that compare with some of the hardest hit parts of the world. Especially worrying is that new infections are increasing among gay men in this country – 12 percent between 2008-2010 – and they are the only group for which this is the case.
In focus groups conducted by the Kaiser Family Foundation with gay and bisexual men, many of the same men who proclaimed there was “no stigma” in the gay community today told of having rejected partners who disclosed they were positive. Men who revealed their own positive status in the groups confirmed these as all too common experiences. Many opened up about their fears of what they envisioned a life with HIV to be like if they were to find out they were positive, in particular, the rejection they anticipated.
It doesn’t have to be this way. Recent research now shows that ARV treatment, which already is helping to improve the health and extend the life for so many people with HIV, also has the potential to play a powerful role the prevention of HIV. People who are on ongoing ARV treatment are now known to increase the chances of reducing transmission of infection to others by as much as 96 percent. And, for those who are HIV negative, new pre-exposure prophylaxis (referred to as PrEP) offer another tool, along with condoms, to maintain that status. PrEP is a once a day, prescription medication that reduces the risk of contracting HIV.
Greater Than AIDS is proud to join with HRC to confront the silence and stigma that is fueling this epidemic. Leveraging the support of HRC’s visibility and network of volunteers, we are working together to distribute tens of thousands of informational brochures and other giveaways at LGBT Prides across the country this summer and fall to help bring HIV out to the fore, including producing a new HIV/AIDS guide designed just for this purpose.
Read the full article on the Human Rights Campaign Blog.