Monthly Archives: August 2013

A fifth of gay men in a relationship with an HIV-negative male partner have not had an HIV test


A fifth of gay men in a relationship with an HIV-negative male partner have not had an HIV test while in their present relationship, results of US research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes show. Factors associated with not having a test included younger age, lower levels of education, having a sexually “closed” relationship and greater levels of trust. “Interventions are urgently needed that not only encourage and assist at-risk HIV-negative partnered MSM [men who have sex with men] to test for HIV, but to also develop and sustain an interval testing plan that accurately reflects the dynamics of their individual risk and relationship profile,” comment the authors.

Previous research suggests that between 33 and 66% of HIV infections among gay and bisexual men in the US are transmitted within the context of a primary relationship. The Centers for Disease Control and Prevention (CDC) recommend that all sexually active gay men should have an HIV test at least annually, and more frequent screening – every three to six months – is recommended for men with known risk factors for HIV infection, for instance multiple or anonymous sexual partners.

However, relatively little is known about patterns of HIV testing among gay men in relationships. Investigators therefore designed a study to ascertain the frequency of HIV testing among gay men in a relationship with another HIV-negative man. They also examined the demographic and relationship characteristics associated with testing. A total of 275 HIV-negative male couples (550 gay men) were recruited in 2011 via Facebook. All were aged 18 or over, lived in the US and were in a relationship with another man and had had oral or anal sex with their primary partner in the previous three months. Couples where one partner was HIV negative and the other HIV positive were excluded from the study.

Participants completed an online questionnaire. They were prompted to describe their HIV testing history since establishing their current relationship. Demographic data were also collected, and the men were asked to provide information regarding the characteristics of their relationship, including duration, the presence of a sexual agreement (an explicit mutual understanding between the two partners about permitted sexual behaviour), and also levels of trust, communication and commitment.

Almost all the participants identified as gay, and the majority were white, employed and lived in an urban environment.

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HIV still and epidemic among men who have sex with men

A fact sheet released at the end of June by the US Centers for Disease Control (CDC) warns that HIV rates, already at epidemic proportions, are continuing to climb steadily among men who have sex with men (MSM). “Gay and bisexual men remain at the epicenter of the HIV/AIDS epidemic,” says Jonathan Mermin, the director of the CDC’s division of HIV/AIDS prevention.

Screen_Shot_2013-07-08_at_2_51_11_PM-240x234The CDC notes that while homosexual men make up only a very small percentage of the male population (4%), MSM account for over three-quarters of all new HIV infections among men, and nearly two-thirds (66 percent) of all new infections in 2010 (29,800). “Men who have sex with men remain the group most heavily affected by HIV in the United   States,” the fact sheet states.

If HIV infections among MSM continue to rise at the current rates, more than half of college-aged homosexual men will have HIV by the age of 50. When broken down by age group, the CDC reported that new infections among the youngest MSM, aged 13-24, increased from 7,200 infections in 2008 to 8,800 in 2010, which translates into a 22 percent increase in that time span. Young black MSM continue to have the highest infection rate, according to the CDC, accounting for more than half (55 percent) of new infections among young MSM.

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Obama orders stepped up effort against U.S. HIV/AIDS epidemic

(Reuters) – After fresh criticism of his record on combating HIV/AIDS, President Barack Obama on Monday ordered a stepped up effort to deal with the HIV/AIDS epidemic in the United States. An executive order from the White House, which follows renewed criticism of Obama’s AIDS strategy during his visit to Africa in late June and early July, called for better coordination of the national effort. Obama’s order said that recent studies had shown that aggressive testing and early treatment can have a significant impact in preventing transmission of the human immunodeficiency virus that causes AIDS.

“In light of these data, we must further clarify and focus our national efforts to prevent and treat HIV infection,” it said. “This acceleration will enable us to meet the goals of the Strategy and move closer to an AIDS-free generation.”

The order said a working group chaired by Grant Colfax, director of the Office of National AIDS Policy, and Health and Human Services Secretary Kathleen Sebelius would have 180 days to deliver recommendations to the president. The HIV Care Continuum Working Group will gather information from federal agencies on HIV testing and care, review HIV research, and recommend ways to accelerate and improve HIV treatment and care, it said. The new order follows recommendations this year from the U.S. Preventive Service Task Force that all 15 to 65 year olds be screened for HIV infection, something that will be covered under Obama’s signature heath reform, the Affordable Care Act.

Nearly one in five of the estimated 1.1 million people with HIV in the United States are undiagnosed, and a third are still not receiving medical care, even though antiretroviral drugs can forestall long-term health risks of the disease and cut the risk of transmission by as much as 96 percent.

Obama announced a National AIDS Strategy in 2010, but activists have expressed disappointment at the administration’s work on HIV/AIDS. They said they were not optimistic that the new drive would bring significant improvement. “There are many countries in the world where the infection rate is going down – why can’t the United States be one of them?” said Michael Weinstein, president of the AIDS Healthcare Foundation. Over the past 10 years, the rate of new HIV infections in the United States has remained at about 50,000, according to the Centers for Disease Control and Prevention. A study published last July by a team at Atlanta’s Emory University found that overall infection rates among U.S. black, gay and bisexual men rival those seen in sub-Saharan African countries that are hardest hit by HIV.

The 2010 AIDS strategy aims to slow the spread of HIV by 25 percent over five years. It focuses especially on African Americans, gay and bisexual men, Latinos, and substance abusers, groups most at-risk of infection.

Critics have said that Obama has not shown the same level of commitment to fighting AIDS as his predecessor, former President George W. Bush. Bush poured $15 billion into the President’s Emergency Plan for AIDS Relief, known as PEPFAR, to combat AIDS worldwide. “It’s no coincidence this is happening after all the bad publicity about AIDS during Obama’s trip to Africa,” Weinstein said.

Obama has argued that his administration has expanded the scope of PEPFAR without increasing spending. Earlier this month in Tanzania, Obama said the administration had “gotten better” and “more efficient” at implementing PEPFAR, saying the program has served four times as many people than when it began in 2003.

Reporting By Yasmeen Abutaleb; Editing by Julie Steenhuysen and David Brunnstrom