From NBC News…
Prostate cancer is the most prevalent invasive cancer among men, affecting nearly one in eight at some point in their lives, according to the Centers for Disease Control. But the unique challenges facing gay and bisexual men with prostate cancer have largely gone unaddressed.
Men who have sex with men (MSM) are less likely to get regular prostate cancer screenings, and those who are diagnosed are less likely to have familial and social support, according to research cited by the National Institutes of Health. And if their health care provider is not culturally competent, gay and bisexual men are much less likely to understand how treatment will impact their quality of life.
“Those in large metropolitan areas may have the option of searching for an LGBT-welcoming provider, but most Americans don’t have a choice about who treats them.”
“Many LGBT people enter their cancer treatment wary,” Liz Margolies of the National LGBT Cancer Network told NBC News. “Those in large metropolitan areas may have the option of searching for an LGBT-welcoming provider, but most Americans don’t have a choice about who treats them.”
As a result, Margolies added, many lesbian, gay, bisexual and transgender patients go back in the closet when they begin cancer treatment. Even if they don’t, providers often don’t ask about patients’ sexual behavior or identity, forcing them to bring the subject up themselves — sometimes again and again with each new specialist.
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The Pitt Men’s Study extends its heartfelt sympathy and condolences to all those touched by the shooting at the Tree of Life Synagogue in Squirrel Hill on October 27. While all the deaths that day were tragic, the death of Dr. Jerry Rabinowitz is particularly significant to our volunteers and staff. Dr. Rabinowitz was one of the first doctors in Pittsburgh to welcome both gay men and people with HIV into his practice, a safe space and source of compassionate and accepting care for many of our volunteers for three decades. Long-time staffer Bill Buchanan remembers, “Every time volunteers completed releases to send their results to Dr. Rabinowitz – and that happened a lot – they would express their deep respect and admiration for him. I never heard a bad word about him from anybody in thirty years.” Jerry Rabinowitz was a pillar of the community, and he will be sorely missed. Donations can be made in his memory to Dor Hadash, 5898 Wilkins Avenue, Pittsburgh, PA 15217.
An online self-help intervention is effective in the treatment of mild to moderate depressive symptoms in people with HIV, according to a randomized clinical trial conducted in the Netherlands and published in the September issue of The Lancet HIV.
The trial compared the outcomes in a group who received the online self-help intervention and a control group. The internet-based intervention, available in Dutch and English, consisted of a cognitive behavioral therapy program called “Living Positive with HIV” and developed from a self-help booklet that had previously proved effective in decreasing depressive symptoms. Participants also received minimal telephone coaching by a Masters student in psychology. The control group received the telephone coaching and could access the online intervention after the trial was completed.
Sanne van Leunen and colleagues randomly assigned 188 eligible participants to the intervention (97) or the control group (91) in 2015. Depression was assessed at baseline, Month 2, Month 5 and Month 8 (the control group did not take the last assessment).
As detailed below, results show that more participants in the intervention group than in the control group demonstrated significant change in their symptoms and that this effect was maintained for six months. Anxiety symptoms were also decreased. No adverse events were reported, the rate of satisfaction with the intervention was high, and most participants reported that they would recommend “Living Positive with HIV” to others.
A session at the 2018 ID Week Annual Meeting in San Francisco explored various strategies to optimize the delivery of care to those infected with HIV. Globally, almost 37 million people are living with HIV, with close to 2 million newly infected annually; about 22 million are treated using antiretroviral therapy.1
Antiretroviral therapy can be interrupted for various reasons; however, whether this practice is wise is a contentious issue, and a trial that would directly address this is ethically dubious. To approach the issue in an ethically palatable way, investigators from the University Hospital of Cologne, Germany, and the German Center for Infection Research, also in Cologne, conducted a systematic review and meta-analysis of the literature to try to provide some clarity as to the safety and tolerability of treatment interruption.
“The meta-analysis was done to examine current evidence about treatment interruption,” explained presenter Melanie Stecher, MSc during the session attended by MD Magazine®. “These data might help in strategies for safe treatment interruption and in designing future clinical trials aimed at curing HIV infection.”
“We have the science to solve the AIDS epidemic,” Dr. Robert Redfield, the director of the CDC, himself a longtime HIV researcher and clinician, told STAT in a recent interview. “We’ve invested in it. Let’s put it into action.‘’
Other leaders in the HIV field have been musing about the idea, buoyed by the astonishing impact effective HIV medications have wrought, both on the lives of people infected with or at risk of contracting the virus, and on the trajectory of the epidemic.
“It’s certainly doable in the United States,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a researcher whose study focused on HIV from the earliest days of the AIDS epidemic.
Fauci and other health experts are quick to point out that the goal of stopping transmission entirely is largely theoretical. There will always be some new cases, and the barriers to providing treatment to existing cases remain significant. There are still just under 40,000 people in the U.S. each year contracting HIV. As Fauci put it: “We live in a real world, we don’t live in a theoretical world.”
But “if we implement all the tools that we have and if we can theoretically, conceptually, get everybody who’s HIV infected on antiretroviral drug so that they will not transmit the infection to anyone else, theoretically you could end the epidemic tomorrow by doing that,” he added.
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