Why the HIV battle continues for gay men

Posted October 7, 2016 by administrator
Categories: Commentary, Features, Prevention

From the Huffington Post

Ace Robinson
Global Health Policy Analyst

September 27th was National Gay Men’s HIV/AIDS Awareness Day. It’s the day that approximately 80 gay and bisexual men will become infected with HIV. Thirty (30) of those men will be Black. Twenty-five (25) will be White and twenty-one (21) will be Latino. Some of those men will find out about their status very early, will be engaged in competent healthcare, and will live a full productive life while managing this chronic illness. But to this day, that will be the exception and not the rule.

Ace Robinson Global Health Advocate

Like just about all viral illnesses life the flu, treating HIV right away and staying on treatment will not only stop you from getting sicker, but stop you from being able to transmit that virus to others. The same is true for HIV. Last month, Dr. Carl Dieffenbach, Director of the Division of AIDS at the National Institutes of Health confirmed what global experts had been saying for years: “Once you begin therapy and you stay on therapy…you are NOT capable of transmitting HIV to a sexual partner.” It is called Treatment as Prevention (TasP). That is excellent news. But that is only true for 30% of Americans. The vast majority of People Living with HIV (PLWH) are not benefitting from the advances in treatment due to not knowing their HIV status, lacking access to care and treatment, lacking social support, or a mix of all the above.

Of those infected each day in the United States, two-thirds are gay and bisexual men. In vast parts of the USA, gay and bisexual men do not receive the type of needed support to access and stay on treatment which puts them at risk for HIV progression and potentially transmitting the virus to another person. Due to homophobia, some men do not have support from their families, have reduced access to jobs and housing, and have had poor experiences in healthcare settings. That creates the perfect storm for the continued epidemic that has gripped this globe for over 35 years.

Today, we live in an age that PLWH can live nearly their entire expected life span IF they receive sustained treatment. We also live in an age that people can take a daily pill (PrEP) that can prevent HIV infection before exposure. And if that is not enough, we also live in an age that people can take a course of treatment that can prevent HIV infection after exposure(PEP).

But what good does TasP, PrEP, and PEP do if people most at-risk for infection are not aware of it. They are really just a jumble of letters. In my circles, it seems that everyone know about these things. But that’s not the norm. For so many, there is nearly no knowledge of these ways to treat and prevent HIV. A couple of weeks ago, I was in southern Georgia visiting my mother and we went on a mini-vacation to Jekyll Island. I was chatting with a young Black gay man who worked at the local hotel. Eventually, we started chatting about what I do and I off-handedly starting rambling on about PrEP and PEP. If you could have seen the look on his face, you would have thought that I had told him that aliens had landed in Times Square. For that young man, we had failed him. He should have known sooner.

The HIV prevention and treatment toolbox is filling faster today than ever before. But not everyone knows what is in it. Awareness, advocacy, and access will be the ultimate tools in the HIV toolbox to ultimately end HIV in mine and others’ communities. We must strive to continue not only raising awareness, but also advocating for access for gay men who have been disproportionately impacted by HIV for far too long.

September 27 is National Gay Men’s HIV/AIDS Awareness Day

Posted September 21, 2016 by administrator
Categories: Features, HIV care, Prevention

From the Centers for Disease Control and Prevention

September 27 is National Gay Men’s HIV/AIDS Awareness Day, a day of action to focus on what each of us can do to reduce the toll of HIV among gay, bisexual, and other men who have sex with men (MSM).

ngmhaad_456pxAlthough only 2% of the US population, gay and bisexual men account for more than half of the 1.2 million people living with HIV in the United States and two-thirds of all new diagnoses each year. If trends continue, 1 in 6 gay and bisexual men will be diagnosed with HIV in their lifetime, including 1 in 2 black gay and bisexual men, 1 in 4 Latino gay and bisexual men, and 1 in 11 white gay and bixesual men. But these rates are not inevitable. There are many actions gay and bisexual men can take to protect themselves and those they care about from HIV. And each of us can take action to help ensure gay and bisexual men know what options are available.

Go to the CDC’s Website to find out what you can do to protect yourself and your community.

New delivery strategy reduces HIV transmission

Posted September 2, 2016 by administrator
Categories: HIV care, PrEP, Prevention, Research

From ASPPH / Washington… 

Researchers delivered ART to reduce the infectiousness of HIV-infected persons and PrEP to reduce susceptibility of their uninfected partners. PrEP was offered prior to ART initiation and for the first six months of ART, until the HIV-infected partner would have been expected to achieve viral suppression. Then PrEP was discontinued.

Jared Baeten

Dr. Jared Baeten

“Our primary goals were to evaluate this delivery model, but partway through the span of the study, it became clear that HIV transmission rates were considerably lower than would have been anticipated,” said lead author Dr. Jared Baeten, vice chair and professor of global health and professor of epidemiology at the School.

Researchers examined the feasibility and acceptability of a program in Kenya and Uganda to offer medications to 1,013 couples in which one member was HIV-positive and the other was HIV-negative. The findings, published online August 23 in PLOS Medicine, showed that the observed rates of HIV transmission were 96 percent lower than simulated rates of transmission in historic controls.

“We learned that the approach is desirable and highly cost-effective and could be delivered affordably to people in that setting,” Dr. Baeten said. Researchers also noted that this study does not include a concurrent comparison population for HIV transmission because it would not have been ethical to enroll a control population and not offer access to PrEP and ART.

Link: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002099

Optimal Care Checklist available for men who have sex with men

Posted August 29, 2016 by administrator
Categories: Community, Health Alerts, HIV care, PrEP

for-men-onlyWhether you are gay, bisexual or any man who has sex with other men (MSM), there are certain health issues that are important for you to talk about with your doctor. This brochure entitled Your Sexual Health, published by the National Coalition of STD Directors and the National Alliance of State & Territorial AIDS Directors, is designed to help you get important health care specific to the wellbeing of gay and bi men.

Issues such as pre-exposure prophylaxis (PrEP), rising STD rates in the community, getting vaccinated for Hepatitis A & B and for Human Papillomavirus (HPV) are just a few of the topics you might want to discuss with your health care provider. Your Sexual Health can help you break the ice. Being informed is an important first step in protecting yourself and your community.

You can also click on the image to download the checklist brochure.



Poor kidney function associated with increased cardiovascular risk for people with HIV

Posted August 24, 2016 by administrator
Categories: HIV care, Research

From aidsmap.com

Renal impairment is associated with an increased risk of cardiovascular disease (CVD) in HIV-positive individuals, according to data from a large observational cohort study published in the online edition of the Journal of Infectious Diseases.

KidneysWithin five years of follow-up, over a fifth of people with severely impaired kidney function developed cardiovascular disease compared to less than 2% of individuals with competent kidney function. Even after taking into account age and the side-effects of antiretroviral drugs, severely impaired kidney function remained associated with cardiovascular disease, increasing rates between 30 and 40%.

“In this large heterogeneous cohort of HIV-positive individuals we found a strong association between centrally adjudicated CVD events and advanced levels of renal impairment,” write the authors. “The high rates of CVD observed in older individuals with mild to moderate renal impairment highlight the need for intensified monitoring and search for effective prophylactic measures for impaired renal function and CVD in the ageing HIV-population.”

Read the full article.

HIV/AIDS in 2016

Posted August 22, 2016 by administrator
Categories: Commentary, Features, HIV care, PrEP, Prevention, Research

From The Journal of the American Medical Association (JAMA)…

Overshadowed by the Zika epidemic, concerns about terrorism and security, and the US presidential election, the global HIV/AIDS pandemic persists, with 2.1 million new HIV infections and 1.1 million deaths worldwide in 2015 (http://bit.ly/2ambo2P). The 21st International AIDS Conference in Durban, South Africa, in July highlighted the remarkable progress since 2000, when the conference was last held in Durban and very few people in Africa received antiretroviral therapy.

patf_mentorAt present, 3.4 million people in South Africa are being treated for HIV infection, more than in any other country in the world; between 2005 and 2015 overall life expectancy at birth in South Africa increased from 53.5 years to 62.5 years (http://bit.ly/1swJbPo). In 2000, 490 000 new HIV infections occurred among children throughout the world; in 2010 the figure decreased to 290 000 and in 2015 to 150 000 (http://bit.ly/2ambo2P). Unlike the $10 000 annual cost of HIV treatment in 2000, the price tag for some first-line antiretroviral regimens now is only $100 per year.

The recent conference aimed to catalyze the work that remains—further scientific advances, addressing stigma, discrimination and other structural barriers within society, and securing the political commitment, including financial resources for prevention, diagnosis and treatment (http://bit.ly/2960ttk). However, fewer people may have been listening than in the past. Among the more than 15 000 participants from 153 countries, including 800 media delegates, few journalists from a US newspaper or television network were on-site in Durban. Although the conference was covered from afar, it was relatively underreported in the United States.

Read the full article.


NIH awards $9 million grant for study on health disparities in HIV prevention

Posted August 9, 2016 by administrator
Categories: Features, Prevention

PHILADELPHIA (August 9, 2016) – A research team from the University of Pennsylvania School of Nursing (Penn Nursing), the University of Michigan School of Nursing and Emory University’s Rollins School of Public Health has been awarded a $9 million grant from the National Institutes of Health (NIH) to adapt and test a HIV prevention intervention for adolescent men who have sex with men. The intervention, referred to as iCON (“I Connect”), builds on an Herb Ritts Foundation initiative and seeks to address the growing disparity in new HIV cases among young men by offering life skills training and community-based HIV prevention resources through an online app.

“Our aim is to empower young gay and bisexual men to find the services they need and enable them to make positive changes in their lives,” said lead researcher José Bauermeister, PhD, MPH, Presidential Associate Professor of Nursing in the Department of Family and Community Health at Penn Nursing. “By empowering change we hope to allow young men to be able to reduce their vulnerability to HIV and to seek the care they need.”

Read the full article.