Only 13% of the gay community utilize LGBT-specific clinics and providers

From the Windy City Times

A new study from the Williams Institute at UCLA School of Law (Utilization of LGBT-Specific clinics and providers across three cohorts of lesbian, gay, and bisexual people in the United Statesfound that only a minority ( 13% ) of LGB people have utilized LGBT-specific clinics and providers, but a majority ( 52% ) expressed an interest in utilizing them in the future.

Researchers examined a representative sample of LGB people in the United States from three age groups—young ( 18-25 ), middle ( 34-41 ) and older ( 52-59 )—to understand the factors that influenced past utilization of LGBT-specific clinics and providers and interest in using them in the future.

“The discrepancy between past utilization and interest in future use of LGBT-specific providers suggests there is a disconnect between the type of healthcare many LGB people would like to have and what they have access to,” said lead author Alexander J. Martos, former Research Analyst at the Williams Institute. “Younger, Black LGB people and those with lower incomes reported the greatest interest in LGBT community-based healthcare.”

Read the full article.

NIH statement for World AIDS Day 2019

From the NIH

Ending the HIV Epidemic: A Plan for America aims to close this implementation gap. NIH-funded advances in effective HIV prevention, diagnosis, treatment and care are the foundation of this effort. In addition, expanded partnerships across HHS agencies, local community organizations, health departments, and other organizations will drive new research to determine optimal implementation of these advances. This type of research is called “implementation science,” and is essential to translate proven tools and techniques into strategies that can be adopted at the community level, particularly for communities most vulnerable to HIV.

Understanding what works to prevent and treat HIV at the community level is critical to the success of the Ending the HIV Epidemic plan. More than 50% of new HIV diagnoses in 2016 and 2017 occurred in just 50 geographic areas: 48 counties; Washington, D.C.; and San Juan, Puerto Rico. Seven states also have a disproportionate occurrence of HIV in rural areas. For its first five years, the new initiative will infuse new resources, expertise, and technology into communities in those key geographic areas.

However, communities are more than just geography. On World AIDS Day, we are reminded that Ending the HIV Epidemic must take place “Community by Community.” The people affected by HIV are a part of unique communities often shaped by differences in race, ethnicity, gender, culture, and socioeconomics. To reach people who have different needs, preferences, and choices, and ensure that HIV treatment and prevention tools can work in their lives, we must go beyond a “one-size-fits-all” approach.

Read the full statement on the NIH Website.

The most insidious virus: Stigma

Stigma did not create AIDS. Yet it prepared the way and speeded its ravaging course through America and the world. First stigma delayed understanding of the disease: it’s a gay cancer, it’s a punishment from God, they brought it on themselves, so who cares? Then stigma delayed government action, research, and assistance for the sick and dying. Stigma made people afraid to get tested for HIV and treated. Stigma made people ashamed, isolating and alienating them from friends and family. Stigma cost people jobs, professional standing, housing, a seat on an airplane or in a dentist’s chair. Stigma made many afraid to live, and want to die. But then it began to make some brave people very angry and AIDS activism was born. The activists quickly realized that to end AIDS we must end stigma.

ACT UP protest at the White House on April 23, 1991

AIDS activism did more to fight the stigma on being gay or having AIDS than any other social force. In this way, AIDS activism, like the civil rights movement, became a great moral movement of our time, defending the innocent, restoring dignity to the violated, giving hope to the desperate, and reviving faith in the disillusioned. AIDS activism gave LGBT people courage, dignity, and power they had never held before.  It inspired many to stand up and proudly proclaim who they are and who they love. Twenty-six of the world’s most advanced countries now recognize gay marriage and today a gay man openly married to another man is a prominent candidate for President of the United States.

Read the full article.

Scientists detect new strain of HIV

From CNN

For the first time in 19 years, a team of scientists has detected a new strain of HIV.

The strain is a part of the Group M version of HIV-1, the same family of virus subtypes to blame for the global HIV pandemic, according to Abbott Laboratories, which conducted the research along with the University of Missouri, Kansas City. The findings were published Wednesday in the Journal of Acquired Immune Deficiency Syndromes.

HIV/AIDS Fast Facts

HIV has several different subtypes or strains, and like other viruses, it has the ability to change and mutate over time. This is the first new Group M HIV strain identified since guidelines for classifying subtypes were established in 2000. It is important to know what strains of the virus are circulating to ensure that tests used to detect the disease are effective.

“It can be a real challenge for diagnostic tests,” Mary Rodgers, a co-author of the report and a principal scientist at Abbott, said. Her company tests more than 60% of the world’s blood supply, she said, and they have to look for new strains and track those in circulation so “we can accurately detect it, no matter where it happens to be in the world.”

Health Alert: New drug-resistant STI spreading among men who have sex with men

From Out Magazine

Researchers at the University of Washington have identified a worrisome new bacterial cluster that’s growing in prevalence among men who have sex with men and is resistant to antibiotics.

The drug-resistant strains were identified in Seattle and Montreal, although researchers believe they’re common worldwide. Known as Campylobacter coli, the bacteria cause severe abdominal pain, bloody diarrhea, and fever and are estimated to affect about 1.3 million people in the United States annually. The journal Clinical Infectious Disease published the finding this month.

While the infection usually passes after a few days, it can pose a more serious threat to those with compromised immune systems.

Men who have sex with men are more prone to infection due to sexual practices like anal sex and rimming, according to the researchers. Transmission occurs when fecal matter enters another person’s body, and while it isn’t limited to any one population, gay men are more likely to experience drug-resistant infections because they’re more likely to have recieved antibiotics for similar infections in the past.

“The international spread of related isolates among MSM populations has been shown before for Shigella [another enteric pathogen], so it makes sense to see it in Campylobacter as well,” wrote the study’s lead author, Dr. Alex Greninger. “The global emergence of multidrug-resistant enteric pathogens in MSM poses an urgent public health challenge that may require new approaches for surveillance and prevention.”

Read more on Out Magazine online.

 

More evidence in support of needle exchange programs

In his State of the Union Address earlier this year, President Trump announced the laudable goal of eliminating HIV transmission by the year 2030. Needle exchange programs (also called Syringe Exchange Programs or SEPs) are a public health approach in use since the 1980s with a proven record of reducing the spread of HIV, hepatitis, and other blood-borne infectious diseases. I have presented much of the data supporting needle exchange programs here and, more recently, here. Now, new research reported in the Journal of Acquired Immune Deficiency Syndrome adds even more strength to the argument in favor of needle exchange programs.

Jeffrey A. Singer is a Senior Fellow at the Cato Institute and works in the the Department of Health Policy Studies

Because most of the averted cases would have received publicly funded health care, the study’s authors then translated averted cases into cost savings for the two cities.Using surveillance data of HIV diagnoses associated with intravenous drug use from Philadelphia and Baltimore, cities where needle exchange programs had been permitted since the early 1990s, their analysis concluded that more than 10,000 cases of HIV were averted in Philadelphia from the years 1993 to 2002, and nearly 1,900 cases were averted in Baltimore from 1995 to 2004.

The forecasts estimated an average of 1,059 HIV diagnoses in Philadelphia and 189 HIV diagnoses in Baltimore averted annually. Multiplying the lifetime costs of HIV treatment per person ($229,800) by the average number of diagnoses averted annually in both cities yields an estimated annual saving of $243.4 million for Philadelphia and $62.4 million for Baltimore. Considering diagnoses averted over the 10-year modeled period, the lifetime cost savings associated with averted HIV diagnoses stemming from policy change to support SEPs may be more than $2.4 billion and $624 million dollars for Philadelphia and Baltimore, respectively. Because SEPs are relatively inexpensive to operate, overall cost savings are substantial even when deducting program operational costs from the total amount.

Needle exchange programs have long been endorsed and encouraged by the Centers for Disease Control and Prevention, the Surgeon General of the United States, the World Health Organization, the American Public Health Association, and the American Medical Association. Nevertheless, needle exchange programs are legally permitted to operate in only 28 states and the District of Columbia. Drug paraphernalia laws make them illegal elsewhere.

Some critics argue that needle exchange programs “enable” or “endorse” intravenous drug use. Such moralizing is not appropriate in this context. Addiction is a behavioral disorder characterized by “compulsive use despite negative consequences.” Preventing organizations from providing an effective means of harm reduction to people with addiction who continue to use drugs is akin to denying insulin to diabetics who continue to make dangerous eating choices.

It is not unrealistic to set a 10-year goal for ending HIV transmission. Needle exchange programs are essential for that to happen.