HIV-infected men at increased risk for heart disease, MACS-related study finds

Posted April 1, 2014 by administrator
Categories: Features, HIV care, Research

From the National Institutes of Health

NIAID and NHLBI funded the study with additional support from the National Center for Advancing Translational Sciences, part of NIH. Past studies of the association between heart disease and HIV infection have reached

Plaque buildup in the arteries that nourish the heart, a condition called coronary atherosclerosis, narrows the arteries and increases the risk for heart attack.

Plaque buildup in the arteries that nourish the heart, a condition called coronary atherosclerosis, narrows the arteries and increases the risk for heart attack.

inconsistent conclusions. To help clarify whether an association exists, the current investigation drew participants from the Multicenter AIDS Cohort Study (MACS), a study of HIV/AIDS in gay and bisexual men established by NIAID nearly 30 years ago. “One advantage of the MACS is that it includes HIV-uninfected men who are similar to the HIV-infected men in the study in their sexual orientation, lifestyle, socioeconomic status and risk behavior, which makes for a good comparison group,” said Wendy S. Post, M.D., who led the study. Dr. Post is a professor of medicine and epidemiology at the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health in Baltimore.The buildup of soft plaque in arteries that nourish the heart is more common and extensive in HIV-infected men than HIV-uninfected men, independent of established cardiovascular disease risk factors, according to a new study by National

Institutes of Health grantees. The findings suggest that HIV-infected men are at greater risk for a heart attack than their HIV-uninfected peers, the researchers write in Annals of Internal Medicine. In addition, blockage in a coronary artery was most common among HIV-infected men whose immune health had declined the most over the course of their infection and who had taken anti-HIV drugs the longest, the scientists found, placing these men at even higher risk for a heart attack. “These findings from the largest study of its kind tell us that men with HIV infection are at increased risk for the development of coronary artery disease and should discuss with a care provider the potential need for cardiovascular risk factor screening and appropriate risk reduction strategies,” said Gary H. Gibbons, M.D., director of the National Heart, Lung, and Blood Institute (NHLBI), part of NIH. “Thanks to effective treatments, many people with HIV infection are living into their 50s and well beyond and are dying of non-AIDS-related causes¬—frequently, heart disease,” said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), also part of NIH. “Consequently, the prevention and treatment of non-infectious chronic diseases in people with HIV infection has become an increasingly important focus of our research.”

Another advantage was the MACS’ size, with nearly 7,000 men cumulatively enrolled, 1,001 of whom participated in the new study. The participants included 618 men who were HIV-infected and 383 who were not. All were 40 to 70 years of age, weighed less than 200 pounds, and had had no prior surgery to restore blood flow to the coronary arteries. Dr. Post and colleagues investigated whether the prevalence and extent of plaque buildup in coronary arteries, a condition called coronary atherosclerosis, is greater in HIV-infected men than HIV-uninfected men and whether that plaque is soft or hard. Coronary atherosclerosis, especially soft plaque, is more likely to be a precursor of heart attack than hard plaque.

The scientists found coronary atherosclerosis due to soft plaque in 63 percent of the HIV-infected men and 53 percent of the HIV-uninfected men. After adjusting for cardiovascular disease risk factors, including high blood pressure, diabetes, high cholesterol, high body mass index and smoking, the presence of soft plaque and the cumulative size of individual soft plaques were significantly greater in men with HIV infection.

In addition, by examining a subgroup of HIV-infected men, the scientists discovered two predictors of advanced atherosclerosis in this population. The first predictor deals with white blood cells called CD4+ T cells, which are the primary target of HIV and whose level, or count, is a measure of immune health. The researchers found that for every 100 cells per cubic millimeter decrease in a man’s lowest CD4+ T cell count, his risk of coronary artery blockage rose by 20 percent. The scientists also found that for every year a man had taken anti-HIV drugs, his risk of coronary artery blockage rose by 9 percent.

Because the investigators examined coronary artery plaque at a single point in time, further research is needed to determine whether coronary artery plaque in HIV-infected men is less likely to harden over time, or whether these men simply develop greater amounts of soft plaque, according to Dr. Post. In addition, she said, studies on therapies and behavioral changes to reduce risk for cardiovascular disease in men and women infected with HIV are needed to determine how best to prevent progression of atherosclerosis in this population.

Find out more at the National Institutes of Health.

Pitt Men’s Study HIV educational forum April 16th

Posted April 1, 2014 by Nathaniel
Categories: Events

The Pitt Men’s Study will be hosting its annual HIV Educational Forum on Wednesday, April 16th. The forum is an opportunity for Pitt Men’s Study participants to hear talks from researchers and ask questions about important HIV and research matters.

The event starts at 6:30pm and is held at the Hilton Garden Inn, 3454 Forbes Ave, in Oakland. It is a free event and includes a dinner served at 7pm, but you must register by April 7.

To register, email Jessica McGuinness at pitteventrsvp@gmail.com (or call 412-383-1674). When registering, specify your meal choice: Stuffed Chicken Breast, Cheese Tortellini, or Vegetable Napoleon (Cheese Tortellini and Vegetable Napoleon can be served as vegan on request).

Take a look at the flyer here

How Yoga helped me choose to live with HIV, instead of dying of AIDS

Posted March 28, 2014 by administrator
Categories: Commentary, Community, HIV care

Alexander Smith explains his own viral mindfulness and how doing yoga’s corpse pose helped him appreciate his own life (from HIVplusmag.com) …

Alexander Smith

Alexander Smith

Difficult poses (asana) are expected in life and on the yoga mat. Hatha yoga is a style of yoga common in the West that focuses on poses and breathing. As we pose, we learn to sit with the pain and discomfort that arises in our bodies, and we become aware of the suffering in our minds that is attached to our thoughts and story. In a place of discomfort, we often let go of the breath (pranayama), which is there to strengthen and sustain us.

It is taught that shavasana — best known as the corpse pose or dead man’s pose — is the most difficult of all the poses. To assume the posture, lie down on your back, allow your feet to fall outward, rest your arms at your sides with palms facing upward, and let your breath follow its inherent inhaling and exhaling pattern. At the end of our practice we traditionally assume this pose. In the giant metaphor of sitting like a corpse, we have an empty space to release all effort in mind and body. Do nothing. Completely surrender. And experience the sweet spot of shavasana.

Yoga, meditation, and mindfulness drive us toward a strength that rises when we surrender everything. It reminds us that the happiness we seek is already here.

At the end of summer a couple of years ago I posed in my own version of a dead man. Facing the fact that my strain of HIV had mutated and developed a resistance to my current cocktail of antiretrovirals, I stood at a crossroads. After a decade I could stop taking pills and lean toward my own corpse pose. Set down the worry and frustration and struggle I experience in posing with this virus. Develop AIDS, catch an opportunistic infection or two, and be dead within a year.

As I surrendered in this pose I noticed that by focusing so much on my death I had distracted myself from stories of life. In a place of complete honesty and reproach, I made a decision to build me a life. I recommitted myself to regular practice of meditation and yoga — with compassion — and I started by cleaning my entire house, doing the laundry and dishes, feeding my body, and taking my medications.

When I checked the online schedule of yoga classes I saw a picture of a beautiful man and yogi. Posing. I recognized him from years earlier. We had shared a neutral greeting when I attended a class at his studio in Laguna Beach, Calif. I was super excited to think he would be teaching class that day. Perhaps he is my future husband, I thought hopefully. When I looked deeper for class details I realized the picture was in honor and memory of his life. My future husband was dead, but somehow I found comfort in the eerie coincidence — and I marveled at the beauty and strength in his pose.

Continue reading on HIVplusmag.com

Web admin’s note: A beginner’s Hatha Yoga class is held at the Shepherd Wellness Community in Bloomfield every Thursday from 5:30 p.m. – 7:00 p.m. The class is not sponsored by Shepherd Wellness but it is in a confidential and safe environment.  Class participants are asked to contribute as they are able. Suggested donation is $10 per week. Participants are asked to wear loose fitting clothing, bring a mat and pillows for comfort and to come on an empty stomach. We practice mindful meditation and gentle stretching to strengthen our inner core and well being.  Accommodations are made for everyone regardless of abilities, including chair options.

 

 

 

Obama appoints HIV/AIDS activist as new AIDS czar

Posted March 25, 2014 by administrator
Categories: Features

From the Washington Times

President Obama on Monday appointed as his new AIDS czar Douglas Brooks, an activist on health care policy who has been living with the HIV virus for more than 20 years. Mr. Brooks has served most recently as senior vice president at the Justice Resource Institute in Boston, a nonprofit which provides outreach mental health treatment and services people with HIV/AIDS. He also has served on the National Black Gay Men’s Advocacy Coalition in Washington, and was appointed by Mr. Obama in 2010 to the Presidential Advisory Council on HIV/AIDS. “Douglas’s policy expertise combined with his extensive experience working in the community makes him uniquely suited to the task of helping to achieve the goal of an AIDS-free generation, which is within our reach,” Mr. Obama said in a statement. “I look forward to having him lead our efforts from the White House.”

As director of the White House Office on National AIDS Policy, Mr. Brooks will lead the administration’s work to reduce new HIV infections, improve health outcomes for people living with HIV, and eliminate HIV health disparities in the United States, the White House said. A licensed social worker, Mr. Brooks replaces Dr. Grant Colfax, who served in the post for two years.

Read more: http://www.washingtontimes.com

 

The fight against HIV/AIDS is vital to a future without tuberculosis

Posted March 25, 2014 by administrator
Categories: Community, Features

From AIDS.gov

Today, Monday, March 24, 2014, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) joins the international community in commemorating World TB Day and those who have lost their lives to this terrible disease; TB is second only to HIV/AIDS in global deaths due to infectious diseases. Moreover, the World Health Organization estimates that at least one-third of the nearly 36 million people living with HIV/AIDS are also infected with TB. TB is the leading cause of death among people living with HIV in sub-Saharan Africa. With these two diseases so closely linked, the 2015 Millennium Development Goal of a 50 percent reduction of TB-related deaths is integral to achieving an AIDS-free generation.

Despite the staggering cost of lives due to co-infection between TB and HIV, we at PEPFAR, in conjunction with our partners implementing TB programs around the world, are encouraged to see progress over the past few years in combatting co-infection. In 2012:

  • Rates of ART coverage among TB/HIV patients globally rose from 49 percent in 2011 to 57 percent.
  • 4.1 million people enrolled in HIV care were screened for TB in 2012, up from 3.5 million in 2011.
  • The percentage of TB patients who knew their HIV status rose from 69 percent in 2011 to 74 percent in sub-Saharan Africa.

The effects of co-infection between HIV and TB cannot be understated which is why PEPFAR addresses the deadly links between these two diseases as a top policy and programmatic priority. Our efforts are focused on prevention, care, and treatment programs as outlined in the 2012 PEPFAR Blueprint [PDF 2.83KB].

Continue reading on AIDS.gov.

Black voices: leveraging digital tools to reach and engage Black gay men

Posted March 21, 2014 by administrator
Categories: Features, Media

From AIDS.gov

More Americans than ever before have access to Internet-enabled technologies and are participating in online social networking platforms. This trend is particularly notable among women, African-Americans, and Latinos and provides hope that effective use of new social technologies could reshape how we reach, engage, and mobilize vulnerable populations such as Black gay men (BGM) and other men who have sex with men (MSM) who are disproportionately impacted by the domestic HIV epidemic. For example, recent data from the The Pew Research Center’s Internet & American Life Project indicate that while the digital divide persists as it relates to Internet access, African-Americans use mobile devices at the same rate as their peers and lead the way in participation in social media such as Twitter.

There is little data available about how BGM/MSM are using social technologies. So, last year, as part of ongoing efforts to improve the health and wellbeing of BGM/MSM, The National Black Gay Men’s Advocacy Coalition (NBGMAC) launched a national survey to learn about the online communication habits of Black gay men. The survey’s goals are to better understand how BGM/MSM use the Internet to communicate and receive national health policy and advocacy information. The data gathered from this survey will contribute to our understanding of how to effectively leverage the Internet for outreach and engagement around health information and national policy issues of importance to BGM/MSM across the nation.

Preliminary survey data highlight the importance of social networking platforms like Facebook in connecting with communities of Black gay men and sharing health policy and advocacy information. The data also reflect a notable level of interest in biomedical HIV prevention tools like Pre-Exposure Prophylaxis (PrEP). Findings like these point to the growing importance of making information available about HIV prevention in a way that meets the needs of the populations most impacted the epidemic. If you are a Black gay, bisexual or same-gender loving man, please take a moment to complete the brief survey and share with your networks. If not, please also consider sharing with any colleagues, friends or loved ones who may be willing to participate and help us to shed light on the communication, health information, and policy and advocacy needs of this underserved community.

To complete the survey, click here or copy and paste the survey’s URL into your Internet browser: http://svy.mk/15KFMwc .

Being out to your doctor is important for your overall health

Posted March 20, 2014 by administrator
Categories: Commentary, Health Alerts

Why you should consider coming out to your doctor…

There are lots of reasons why men who have sex with men (MSM) don’t tell their doctors about their sexual preferences. But whatever the reason, it is important to keep in mind that who you have sex with can have a serious impact on your health. MSM need to be aware of the unique medical issues that their heterosexual counterparts may not have to worry so much about. For example, MSM have higher rates of HIV, Syphilis, HPV, anal cancer, and hepatitis (just to name a few). In short, your doctor can help you stay on top of the added health issues if he or she knows your sexual preference.

Finding an LGBT-friendly doctor…

The Gay and Lesbian Medical Association (GLMA) keeps an online list of gay-friendly medical providers. It’s especially helpful if you live in or near a large city. You can go to their Website, www.glma.org, and search under their resources link by zip code. If the GLMA database doesn’t have any options near you, and you’re not willing to make a road trip, you’ll have to go about finding a doctor the traditional way: Meet potential providers and interview them. Ask questions, be honest. Doctors work for their patients, not the other way around. Keep shopping until you find one that you can be honest with. It may take some detective work but maintaining your health is worth it.

To subscribe to Pitt Men’s Study Health Alerts, send a message to PMS@stophiv.pitt.edu with the word “subscribe” in the subject line.


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