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University of Pittsburgh Research Assistant and Technical Writer

PBS airs series The End of AIDS: Far from Over

PBS NewsHour is airing a series called The End of AIDS: Far from Over from correspondent William Brangham and producer Jason Kane. The five reports describe why, despite major advances in the treatment of HIV and AIDS, places such as Russia, Nigeria and Florida are still struggling to contain the virus.

While the series explores some of the impediments to successful treatment in these places, it also shows promising developments — like several Russians who are promoting treatment and battling discrimination in their communities.

TV Rain news anchor Pavel Lobkov, who went public with his HIV-positive status three years ago, became one of the only public figures in Russia to disclose their status. Lobkov said he wanted to show people that one can live a healthy life with HIV treatment.

Tatiana Vinogradova, deputy director of the St. Petersburg AIDS center, and her husband Andrei Skvortsov, who is living with the virus, appeared in a public ad campaign that says “People with HIV are just like you and me.”

And Alexander Chebin runs an informal network of activists in Russia collecting antiretroviral drugs and mailing them for free to HIV-positive people throughout Russia who can’t otherwise access them.

Here is a look at other efforts that are exploring new treatments or trying to lift the stigma around HIV and AIDS.

These gay men have spent 30 years learning how to be long-term HIV survivors

From the Huffington Post

Sean McKenna, 55, was diagnosed with HIV in 1992. He takes 22 pills a day and deals with diarrhea, joint pain and HPV. He’s been on disability, unable to work, for over 20 years. Luigi Ferrer, 59, has been HIV-positive since 1985, but he works full time and takes only one pill a day. McKenna has survived bouts of pneumocystis pneumonia and other HIV-related complications that have killed many of his peers. Ferrer has never had a life-threatening complication. Scott Kramer, 50, was diagnosed in 1988. He survived a bout of PCP in 1992 but was able to return to work full time.

“There’s no one way to be a long-term HIV survivor,” said Kramer, a therapist who specializes in people with HIV and runs support groups in New York City for gay men with the virus. “We’ve all been through trauma, but with a mix of support and luck, we’ve survived longer than we ever imagined.”

Sean McKenna shortly after learning he was HIV-positive in 1992.

Long-term HIV survivors ― generally defined as those diagnosed before lifesaving drugs were released in 1996 ― face their own set of physical and emotional challenges as they age. Some were lucky to have relatively mild bodily symptoms. Others became isolated by illness, stigma and the inability to work. But all dealt with a terrifying diagnosis at a time when doctors had little to offer.

In recent years, a few survivors have emerged to speak up for their peers, whose lives and stories they say are unappreciated or forgotten by today’s gay community.

Read the full article.

Syphilis in people with HIV increased through 2015

From Infectious Disease Adviser

The incidence rate of syphilis in people with HIV increased through 2015, according to new research published in Clinical Infectious Diseases.

Since 2000, the incidence of syphilis has increased among gay, bisexual, and other men who have sex with men (MSM) in the United States. This represents an ongoing sexual risk, and temporal trends and associated risk factors for newly diagnosed syphilis infections among people with HIV were therefore investigated.

Data from HIV Outpatient Study cohort participants visiting 10 clinics in the United States from 1999 to 2015 were analyzed. A total of 6888 participants with HIV were included, and 641 had one or more new syphilis diagnoses during a median follow period of 5.2 years. Participants were mostly male, age 31 to 50 years (78%), and the majority were MSM (56%).

Read the full article.

By 2030, top cancers among people with HIV expected to be prostate and lung

From POZ Magazine online

By 2030, the most common cancers among people with HIV are projected to be prostate and lung cancer.

Publishing their findings in the Annals of Internal Medicine, researchers analyzed data from the National Cancer Institute’s HIV/AIDS Cancer Match study, modeling cancer diagnosis rates during 2000 to 2012 to make projections about how rates will change from 2013 to 2030.

The U.S. HIV population is steadily aging, thanks to effective antiretroviral treatment. In 2006, an estimated 27 percent of the population was age 50 or older, a proportion that increased to 45 percent in 2014. Between 2010 and 2030, the proportion of the population age 65 and older is expected to increase from 8.5 percent to 21.4 percent, while the proportion that is age 45 to 64 is expected to increase from 39.4 percent to 47.7 percent.

Between 2000 and 2012, the 463,300 HIV-positive adults in the HIV/AIDS Cancer Match Study were diagnosed with 23,907 cancers. During this period, the annual diagnosis rates (known as incidence) declined for Kaposi sarcoma (KS), non–Hodgkin lymphoma (NHL), cervical cancer, anal cancer (among men who have sex with men), lung cancer, Hodgkin lymphoma and other cancers among all age types. Colon cancer incidence decreased among those age 65 and older. Meanwhile, prostate cancer incidence increased among men ages 35 to 64.

Overall, cancer incidence among the U.S. HIV population is expected to decline through the next decade.

Among three AIDS-defining cancers, the estimated numbers of diagnoses seen in the U.S. HIV population in 2010 and projected to occur in 2020 and 2030, respectively, according to the study authors’ analysis were: 8,150, 7,490 and 6,690 diagnoses of NHL; 1,490, 750 and 450 diagnoses of KS; and 120, 50 and 30 diagnoses of cervical cancer.

As for non-AIDS-defining cancers, the respective numbers of diagnoses seen in 2010 and projected to occur in 2020 and 2030 were: 5,420, 6,150 and 5,980 diagnoses of lung cancer; 830, 910 and 1,030 diagnoses of prostate cancer; 750, 1,340, 1,590 diagnoses of anal cancer; 360, 460 and 480 diagnoses of liver cancer; 300, 200 and 120 diagnoses of Hodgkin lymphoma; 250, 320 and 340 diagnoses of oral cavity/pharyngeal cancer; 220, 260 and 260 diagnoses of breast cancer; 220, 230 and 200 diagnoses of colon cancer; and 1,910, 1,880 and 1,510 diagnoses of other types of cancers.

The study authors concluded that their findings stress the importance of expanding access to HIV treatment and cancer prevention, screening and treatment.

To read a press release about the study, click here.

To read the study abstract, click here.

Who we are…

The Pitt Men’s Study (PMS) is a confidential research study of the natural history of HIV/AIDS, funded by the National Institutes of Health that has been ongoing in Pittsburgh since 1984. The Study is part of the Department of Infectious Diseases and Microbiology in the Graduate School of Public Health, University of Pittsburgh. The study followed a cohort of approximately 3000 men to gather information on the epidemiology, virology, immunology, and pathology of HIV and is part of the Multicenter AIDS Cohort Study (MACS) with sites in Los Angeles, Chicago, Baltimore as well as Pittsburgh.

Scroll down for the latest news and information about the study and HIV research.

State-level PrEP utilization data now available from AIDSVu

From HIV.gov

Since PrEP is one of the newer HIV prevention tools, understanding more about who is using it is important to better tailoring HIV prevention efforts at the national, state, and community levels. PrEP, or pre-exposure prophylaxis, is when people at high risk for HIV take HIV medicine daily to lower their chances of getting infected with HIV. AIDSVu has released the first-ever publicly available data and interactive maps of PrEP use by state from 2012 through 2016, stratified by sex and age.

 

The new maps from AIDSVu show more than 77,000 people were prescribed PrEP in 2016, with an average 73 percent increase year over year in persons using PrEP across the U.S. from 2012 – when the drug TDF/FTC was approved by the FDA for use as PrEP – to 2016. However, approximately 1.1 million people in the U.S. are at substantial risk for HIV exposure and could benefit from PrEP, according to analysis presented by the Centers for Disease Control and Prevention (CDC) at CROI 2018 earlier this year.

The data presented on AIDSVu reveal that the growth and distribution of PrEP use has been inconsistent across different sexes, age groups, and geographic regions. For example, the Southern U.S. accounted for more than half (52 percent) of all new HIV diagnoses in 2016 but represented only 30 percent of all PrEP users in 2016. That same year, women comprised 19 percent of all new HIV diagnoses but made up only seven percent of all PrEP users.

Read the full article.

HIV damages the Brain, but treatment halts progression

From Poz Magazine

Not long after an individual contracts HIV, the virus penetrates the brain and begins to cause progressive damage to the volume of the organ as well as cortical thickness. Antiretroviral (ARV) treatment apparently halts this progression and is able to dial back some of the damage.

Publishing their findings in Clinical Infectious Diseases, researchers studied 65 people who entered the study soon after they contracted HIV, in a period known as primary HIV infection. These participants, 30 of whom started ARV treatment during the study, received multiple MRIs of their brains over time.

The researchers compared the brain scans of the participants with scans of 16 people with long-term, or chronic, HIV infection as well as 19 HIV-negative individuals.

The study authors found that before participants began ARV treatment, a longer time spent with untreated HIV was associated with loss in volume in various parts of the brain, including the thalamus, caudate and cerebellum. More time living with untreated HIV was also linked with cortical thinning in the frontal and temporal lobes and the cingulate cortex.

After individuals started ARVs, the progression of such brain damage stopped, and there were some small increases in cortical thickness measures.

“We knew HIV could cause neurological damage, but we did not know it happened so early in the infection,” Serena Spudich, MD, MA, a professor of neurology at Yale and a co–senior author of the paper, said in a press release. “The findings emphasize the importance of identifying infected people early and treating them so we can halt its progression.”

To read a press release about the study, click here.

To read the study abstract, click here.