A study that looked at the way risk of HIV transmission changed over time in a group of gay men during a six- to eight-year period has found that there was vast variation in the degree of risk men subjected themselves to, the length of time they were at risk and, as a result, HIV incidence.
The researchers analysed the number of times cohort members took sexual risks over the study period (by allocating a “risk score” to each six-month period) and found that men’s risk scores tended to be consistent, and to fall into three different groups. It found that one-in-seven men belonged to a very high risk group, a third of whom became infected with HIV over the study period. Just under a quarter belonged to a moderate risk group, of whom 10% became HIV positive. The other two-thirds were at low risk of HIV, except for short periods; 3% of them acquired HIV. Being in the one-third of the cohort that did take more risks was associated with being white, having a high income, and being younger; in addition, being in the most at-risk one-seventh of the group was associated with depression and taking recreational drugs.
The authors specifically did this cohort analysis because they wanted better information that could help in the targeting of pre-exposure prophylaxis (PrEP) at the right groups: one of the reasons this prevention method has taken off slowly in the US and not yet received approval elsewhere is concern about its cost. Cost-effectiveness studies suggest that PrEP will only be economical if taken by people with the highest risk of HIV infection (see this report for one example). It is, however, of broader interest, as the first-ever study to demonstrate a relationship between specific characteristics and what the authors call “risk trajectories” – longitudinal patterns of risk over time.
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To read the study abstract, click here.
From the Pittsburgh Post Gazette…
African-American men who have sex with other men typically are more conservative in sexual behavior than gay men in general. So why are they far more likely to contract HIV/AIDS?
“Generally, they take far fewer risks than white guys. They are much more conservative than gay men in general. But it’s a 30-year-long epidemiological puzzle,” said Ron Stall, in the department of behavioral and community health sciences at the University of Pittsburgh Graduate School of Public Health. “Where’s all the virus coming from? If you can’t answer that question, you can’t do HIV prevention.”
The graduate school and the Center for Black Equity in Washington, D.C., now hope to answer that question. They’ve landed a $3.2 million grant through the National Institute of Nursing Research at the National Institutes of Health to answer the question and help put the brakes on the national epidemic of human immunodeficiency virus and the deadly disease that HIV causes — acquired immune deficiency syndrome, known as AIDS. The research team plans to survey nearly 6,000 African-American men who attend annual Black Gay Pride events in Atlanta, Chicago, Los Angeles, Philadelphia and Washington, D.C., which draw about 300,000 participants annually.
“We will bring the community, and Pitt will bring the science,” said Earl Fowlkes, president and CEO of CBE. “We hope to get answers to help both institutions and all of society. This is the most important thing we’ve done in the history of our organization.” The study will create the largest sample of HIV-related data ever collected from African-American MSM, “and that will yield important data about the health and well-being of our community,” Mr. Fowlkes said.
Read more: http://www.post-gazette.com/
Friday, February 7 is National Black HIV AIDS Awareness Day (NBHAAD). There are many ways you can help increase HIV awareness and work to reduce the impact of HIV in the black community in support of NBHAAD. Check out this list of Ten Things You Can Do for NBHAAD. Also, please join the Twitter Town Hall sponsored by the Centers for Disease Control and Prevention (CDC) and AIDSVu, with the NBHAAD Strategic Leadership Committee (Twitter: @NatBlackAIDSDay) and the National Association for the Advancement of Colored People (NAACP) (Twitter: @NAACP). The theme is “How do we end the HIV epidemic in Black America?”and will take place on Friday, February 7 at 12 pm Eastern Time.
The hashtag #NBHAADchat will be used for the Twitter Town Hall. Everyone is encouraged to participate. For more information on NBHAAD or to find and NBHAAD event, go to http://nationalblackaidsday.org/.
An analysis of data from a six-city study of Black gay, bisexual and other men who have sex with men (MSM), and published January 31 in the academic journal PLOS ONE shows a correlation between HIV infection and a number of factors including higher rates of unemployment, lower socioeconomic status, and other sexually transmitted infections. The study, HPTN 061, was coordinated by the HIV Prevention Trials Network (HPTN) and funded by the National Institutes of Health.
The analysis, led by Dr. Kenneth Mayer of Boston’s Fenway Health found that:
- Newly diagnosed HIV-positive Black MSM were significantly more likely to be unemployed compared to HIV-uninfected Black MSM;
- More than half of the Black MSM participants reported being poor and experiencing depression and internalized homophobia;
- Newly diagnosed Black MSM were more likely to have unprotected receptive anal sex with a male partner in the last six months; and to be diagnosed with syphilis, rectal gonorrhea, and urethral or rectal chlamydia.
Black MSM account for more than 20 percent of new HIV infections in the United States despite being a very small percentage of the overall population. Enhanced understanding of factors associated with undiagnosed infections can help inform programs needed to address this epidemic. Culturally-tailored approaches that address economic disenfranchisement, increase engagement in care, offer routine screening for sexually transmitted infections, provide earlier treatment for HIV-infection and chemoprophylaxis for high-risk uninfected Black MSM, in conjunction with evidence-based prevention interventions to reduce unprotected anal sex, may help decrease further transmission in this heavily impacted community.
Read more: http://www.digitaljournal.com