HIV strikes Black gay men more, despite safer behaviors

“Our study illuminates how HIV disparities emerge from complex social and sexual networks and inequalities in access to medical care for those who are HIV-positive,” said senior study author Brian Mustanski. He is director of the Northwestern Institute for Sexual and Gender Minority Health and Wellbeing at Northwestern University’s Feinberg School of Medicine in Chicago.

“Their social and sexual networks are more dense and interconnected, which from an infectious disease standpoint makes infections transmitted more efficiently through the group,” Mustanski explained in a university news release.

“That, coupled with the higher HIV prevalence in the population, means any sexual act has a higher chance of HIV transmission,” he added.

If this trend continues, 1 out of every 2 black gay men will become infected with HIV at some point in life, compared to 1 in 5 Hispanic gay men and 1 in 11 white gay men, according to the U.S. Centers for Disease Control and Prevention.

In the study, researchers analyzed data from more than 1,000 gay men, aged 16 to 29, in Chicago.

Among their other findings: black gay men were less likely to have close relationships with their sexual partners, more likely to have hazardous marijuana use, and more likely to have experienced more stigma, trauma and childhood sexual abuse. White gay men were more likely to have alcohol problems.

The study was published Dec. 4 in the Journal of Acquired Immunodeficiency Syndromes.

For more information, check out the U.S. Centers for Disease Control and Prevention.

Pitt Men’s Study honors 31st annual World AIDS Day

From Pitt News

Rabbi James Gibson stood before a small, quiet congregation in Heinz Chapel Wednesday night with a dedication. “We remember our friends, lovers and spouses,” he said. “Our mothers, fathers, brothers and sisters, daughters and sons lost to HIV and AIDS.” He gave the room permission to rise. “Please come forward and place the names of those for whom you are still aching on the Circle of Love,” he said.

Nearly everyone in the room came forward. They waited in line to reach the front of the chapel and place a sticker on a large white cardboard circle that read “Circle of Love.” Each sticker held a name of a friend or relative who had been lost to AIDS. Some had four or five.

More than 60 attended the commemoration service, sponsored by the Pitt Men’s Study in honor of the 31st annual World AIDS Day. Nearly 40 years after the start of the AIDS crisis, mourners and survivors gathered in memory of those lost to the disease.

The first AIDS patients appeared in New York and California in the early 1980s. Young gay men showed up at doctors’ offices with rare forms of cancer and pneumonia. Slowly, doctors came to the realization that the patients’ immune systems had been compromised by an unknown virus.

Cases began to emerge across the country, including Pittsburgh. Doctors soon knew enough to recognize the symptoms, but there was no name for the disease.

Later, scientists discovered human immunodeficiency virus, or HIV, was at the root, attacking the immune system’s T-cells and making the patient extremely susceptible to other types of disease and infection. They put a name to autoimmune deficiency syndrome, or AIDS, the third stage of the virus, when HIV has devastated the immune system.

The Pitt Men’s Study is an investigation into HIV/AIDS that has received funding from the National Institutes of Health since 1984. Its principal investigator is founder Dr. Charles Rinaldo, who chairs the department of infectious diseases and microbiology at Pitt’s School of Public Health. Rinaldo gave a short account of the beginnings of the study, thanking those who had made it possible.

Among those who made it possible were a doctor who identifies as gay and worked on the study as a medical student, and the owners of the Pittsburgh gay bars who allowed Rinaldo and his colleagues to advertise their study.

He also thanked Dr. Jerry Rabinowitz, a victim of last month’s shooting at the Tree of Life Synagogue. In the days following the shooting, many remembered Rabinowitz for his treatment of Pittsburgh HIV/AIDS patients in a time when compassionate care was difficult to come by.

“Back in the 1980s, we referred many of our men to his practice,” Rinaldo said.

Rinaldo said he and Bill Buchanan, the clinic coordinator for the Pitt Men’s Study, wrote an obituary for Rabinowitz to appear this December in AIDS, a scientific journal focused on HIV/AIDS.

Above all, Rinaldo thanked study participants. “It was 1982, at the beginning of the epidemic, when fear of AIDS was rampant, when 60 gay men in Pittsburgh answered our hand-drawn recruitment posters,” Rinaldo said. “These 60 men in our pilot study knew we had no treatment or care. They knew we had no magical elixir. Without those 60 men, there would be no Pitt Men’s Study.”

1,736 men have enrolled in the study since 1982, according to Rinaldo. Out of these, 465 have died, most due to complications from AIDS. And although AIDS is no longer a death sentence, there is no cure and the Pitt Men’s Study continues to investigate HIV/AIDS.

Sean DeYoung represented Allies for Health + Wellbeing, the HIV testing location and health center, of which he is CEO. During the service, which was themed “The Changing Face of AIDS,” he spoke about the group’s 2017 decision to change its name from the Pittsburgh AIDS Task Force. “The community let us know that the word ‘AIDS’ was too stigmatized,” DeYoung said. “And we weren’t a task force anymore.”

Allies’ mission has expanded since its 1985 beginnings. Then, it existed to provide support and information to the infected in the Pittsburgh area. Now, it offers HIV testing, health care for transgender people and access to PrEP, one of the most reliable methods of HIV prevention.

At the end of the service, some attendees traveled across the street to the basement of the Community of Reconciliation Church, where they caught up with one another at a small reception. For some, like partners Robert Flaherty and Robert Maxin from Emsworth, the service is an annual occurrence. “My partner was part of the original Pitt Men’s Study,” Maxin said. Now, he and Flaherty attend the event nearly every year. Both are HIV positive and both had names to add to the Circle of Love. “I put two up, but I could have easily put up 12 or 15,” Flaherty said

When it comes to prostate cancer, ‘gay men are erased,’ patients say

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.

Read the full article.

Historic Increase in Syphilis Infections

The Pennsylvania Department of Health is reporting an historic increase in the number of new Syphilis infections in the state.

The Health Department is asking anyone who fits the criteria listed here to have a Syphilis test…

  • A rash on the palms of the hands or on the soles of the feet, back, chest, or stomach
  • A lesion (red sore) in the genital, rectal, or oral area
  • Moist papules in the mouth
  • Sudden scalp alopecia (loss of hair)
  • Sudden loss of eyelashes and eyebrows
  • Swelling of the lymph nodes
  • A recent positive test for another STD such as gonorrhea, chlamydia, HIV or Hepatitis C

Syphilis is a sexually transmitted infection. If it goes untreated, it can lead to serious health problems including paralysis, blindness, and dementia. However, Syphilis is 100% curable with simple antibiotics.

Syphilis is spread through direct contact with a Syphilis sore during vaginal, anal, or oral sex. You can get Syphilis and not have any symptoms so the only way to know for sure you’re not infected is to get tested.

Several locations around the state have free Syphilis testing. Click on this link to find free testing at a State Health Center near you.

To find out more about Syphilis, go to www.cdc.gov/std/syphilis/stdfact-syphilis.htm

Dr. Rabinowitz one of the first doctors in Pittsburgh to treat gay men and people with HIV

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.

 

 

 

Online intervention effective in the treatment of depressive symptoms in people with HIV

From aidsmap.com

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.

Optimizing HIV care

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.”