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University of Pittsburgh Research Assistant and Technical Writer

Despite ART, Immune System Ages Faster Among People Living With HIV, Study Finds

From thebodypro.com

Today’s powerful antiretroviral therapy (ART) helps fight back HIV infection and restore normal immune function. However, clinical evidence suggests that people with HIV who are virologically suppressed still have higher rates of comorbid viral infections than the general population.

Now, a new study in the Journal of Infectious Diseases suggests that ART does not restore the immune system completely back to normal. Instead, people with HIV may experience “immune amnesia,” in which the immune system slowly loses its capacity to recognize and fight off viral infections introduced during childhood or through a vaccine.

“Even with therapy, there’s something not quite fixed about the immune system,” said lead author Michael Augenbraun, M.D., FACP, FIDSA, who is vice chair of the Department of Medicine and director of the Division of Infectious Diseases at SUNY Downstate Health Sciences University and Kings County Hospital Center.

In the study, Augenbraun and his colleagues compared immune response among a group of 50 HIV-negative women and a group of 50 HIV-positive women on ART with low viral load. Each of these women had been vaccinated against smallpox during childhood, so they should all theoretically have similar levels of lingering protection against the smallpox virus.

Read the full article.

Trust and stigma affect gay couples’ choices on PrEP and PEP

From aidsmap.com

Both relationship-specific and structural factors influence whether coupled gay men living in New York City choose to use pre- and post-exposure prophylaxis (PrEP/PEP) for HIV prevention. Some men – particularly those in monogamous relationships – felt that discussing PrEP and PEP in the context of a relationship could threaten the relationship by raising issues of trust, while others felt that it had the potential to enhance sexual health and satisfaction.

Stigma from the gay community and healthcare providers around promiscuity also presented barriers to PrEP uptake. This qualitative research was conducted by Stephen Bosco, Dr Tyrel Starks and colleagues at City University New York and published in the Journal of Homosexuality.

Gay and bisexual men accounted for 66% of all new HIV diagnoses in the US in 2017. It is estimated that 35-68% of these infections happen within the context of a long-term relationship. This indicates that coupled gay men have the potential to benefit significantly from biomedical prevention strategies, such as PrEP (taken on an ongoing basis) and PEP (taken shortly after a suspected infection). However, only 7% of the potential 1.1 million gay and bisexual men who could benefit from PrEP were prescribed it in 2016. Black and minority men in the US remain most at-risk for HIV infection, while also having the lowest rates of PrEP uptake.

Read the full article.

Facebook disables some misleading ads on HIV prevention drugs, responding to growing outcry

From the Washington Post

Facebook has quietly started removing some misleading ads about HIV prevention medication, responding to a deluge of activists, health experts and government regulators who said the tech giant had created the conditions for a public-health crisis.

The ads at issue — purchased by pages affiliated with personal-injury lawyers and seen millions of times — linked drugs designed to stop the spread of HIV with severe bone and kidney damage. Lesbian, gay, bisexual and transgender advocates long have said such claims are “false,” pointing to multiple studies showing the class of medication, known as PrEP, is safe.

After initially declining to disable the ads, Facebook began on Friday retroactively labeling some of them as rule violations in its archive, limiting their visibility. The company’s third-party fact-checkers concluded the ads were misleading and lacked context, according to a copy of an email sent by those fact-checkers to LGBT groups that was shared with The Washington Post, which first reported on the matter earlier this month.

The change in course at Facebook drew praise from LGBT organizations that had worked since September to stop the spread of HIV misinformation on the social media platform. But many activists said they remain uneasy that it took so long to get Facebook’s attention in the first place — and worried the company’s policy on such ads in the future remains unclear.

“The removal of select ads is a strong first step given the findings of Facebook’s own fact-checking agency and the dozens of organizations that spoke out,” said Sarah Kate Ellis, the leader of GLAAD. She added the “time is now for Facebook to take action on other very similar ads which target at-risk community members with misleading and inaccurate claims about PrEP and HIV prevention.”

Facebook spokeswoman Devon Kearns confirmed that the company had taken action against some of the ads. “After a review, our independent fact-checking partners have determined some of the ads in question mislead people about the effects of Truvada,” she said, referring to the name of the drug. “As a result we have rejected these ads and they can no longer run on Facebook.”

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Unsung heroes: Pittsburgh men, decades-long study impact HIV/AIDS research

From the Triblive.com

As they have for more than three decades, the Pitt Men’s Study leaders gathered with about four dozen men and women. They remembered those who have died and gave thanks for the 1,743 men who have participated in the nation’s longest-running HIV/AIDS research project.

World AIDS Day observance at the Heinz Memorial Chapel—an event sponsored by the Pitt Men’s Study

Charles Rinaldo, a Ph.D. scientist who has led the effort since the virus surfaced here in 1981, walked solemnly down the center aisle with a group of clergy.

“So here we are again to honor our participants,” the soft-spoken Rinaldo said, welcoming the sparse group. “For 35 years now, you have supported our study for HIV/AIDS. … We can’t thank you enough. Without you, there is no study.”

Every six months, year after year, participants have trekked to Oakland to offer blood and bodily fluids. Their alms have become the foundation of hundreds of research projects.

The Pitt study, conducted in the halls of the university where Jonas Salk developed the world’s first polio vaccine, began before the affliction that has killed an estimated 32 million people worldwide even had a name: human immunodeficiency virus. Or simply, HIV.
Neither the virus nor its final, deadly stage — acquired immunodeficiency syndrome, or AIDS — dominates the news and national fears as they did decades ago. Yet around the world, about 38 million people remain infected. Many are living longer lives thanks to lifesaving, though expensive, medical treatments. But there is no cure — yet.
Worldwide, an estimated 1.7 million people became infected with HIV last year. Another 770,000 died from AIDS-related illnesses.

In the United States, just more than 1 million people are believed to be living with HIV. Although the number of new infections has declined dramatically, nearly 40,000 in the U.S. still contract HIV every year. And about 16,000 people died from AIDS in the United States in 2016.

Because of that, work on the Pitt Men’s Study continues.

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Studies firmly establish “undetectable equals untransmittable”

From NIH.gov

Extensive evidence from HIV prevention research studies has firmly established that “Undetectable Equals Untransmittable,” or U=U. This means that people living with HIV who achieve and maintain an undetectable viral load — the amount of virus in their blood — by taking antiretroviral therapy (ART) as prescribed do not sexually transmit HIV to others. The U.S. Centers for Disease Control and Prevention estimates this strategy is 100% effective against the sexual transmission of HIV.

Now, a new study of nearly 112,000 men who have sex with men in the United States has found increasing acceptance of the U=U message in this population. Overall, 54% of HIV-negative participants and 84% of participants with HIV correctly identified U=U as accurate. The study was supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Study results were published online in the Journal of Acquired Immune Deficiency Syndromes.

“U=U has been validated repeatedly by numerous studies as a safe and effective means of preventing the sexual transmission of HIV,” said Anthony S. Fauci, M.D., NIAID Director. “The increased understanding and acceptance of U=U is encouraging because HIV treatment as prevention is a foundation of efforts to end the epidemic in the United States and around the world. This public health message has the power to reduce stigma, protect the health of people living with HIV and prevent sexual transmission of HIV to others.”

Read the full article.

Only 13% of the gay community utilize LGBT-specific clinics and providers

From the Windy City Times

A new study from the Williams Institute at UCLA School of Law (Utilization of LGBT-Specific clinics and providers across three cohorts of lesbian, gay, and bisexual people in the United Statesfound that only a minority ( 13% ) of LGB people have utilized LGBT-specific clinics and providers, but a majority ( 52% ) expressed an interest in utilizing them in the future.

Researchers examined a representative sample of LGB people in the United States from three age groups—young ( 18-25 ), middle ( 34-41 ) and older ( 52-59 )—to understand the factors that influenced past utilization of LGBT-specific clinics and providers and interest in using them in the future.

“The discrepancy between past utilization and interest in future use of LGBT-specific providers suggests there is a disconnect between the type of healthcare many LGB people would like to have and what they have access to,” said lead author Alexander J. Martos, former Research Analyst at the Williams Institute. “Younger, Black LGB people and those with lower incomes reported the greatest interest in LGBT community-based healthcare.”

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NIH statement for World AIDS Day 2019

From the NIH

Ending the HIV Epidemic: A Plan for America aims to close this implementation gap. NIH-funded advances in effective HIV prevention, diagnosis, treatment and care are the foundation of this effort. In addition, expanded partnerships across HHS agencies, local community organizations, health departments, and other organizations will drive new research to determine optimal implementation of these advances. This type of research is called “implementation science,” and is essential to translate proven tools and techniques into strategies that can be adopted at the community level, particularly for communities most vulnerable to HIV.

Understanding what works to prevent and treat HIV at the community level is critical to the success of the Ending the HIV Epidemic plan. More than 50% of new HIV diagnoses in 2016 and 2017 occurred in just 50 geographic areas: 48 counties; Washington, D.C.; and San Juan, Puerto Rico. Seven states also have a disproportionate occurrence of HIV in rural areas. For its first five years, the new initiative will infuse new resources, expertise, and technology into communities in those key geographic areas.

However, communities are more than just geography. On World AIDS Day, we are reminded that Ending the HIV Epidemic must take place “Community by Community.” The people affected by HIV are a part of unique communities often shaped by differences in race, ethnicity, gender, culture, and socioeconomics. To reach people who have different needs, preferences, and choices, and ensure that HIV treatment and prevention tools can work in their lives, we must go beyond a “one-size-fits-all” approach.

Read the full statement on the NIH Website.