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University of Pittsburgh Research Assistant and Technical Writer

Care providers reluctant to tell HIV patients *undetectable equals untransmittable*

From Medscape

WASHINGTON, DC — HIV treatment that leads to viral suppression for at least 6 months is 100% effective in preventing the transmission of HIV, even in the absence of condoms or HIV prevention drugs, according to the Centers for Disease Control and Prevention. But not all care providers tell their patients that.

A survey in the Midwest showed that 22% of HIV physicians still don’t feel comfortable explaining to patients the science behind what is known in the community as U=U, or undetectable equals untransmittable.

And that number is even higher among the physician assistants, nurse practitioners, advanced practice nurses, and traditional registered nurses who serve people living with HIV, said Emily Petran, MPH, from the Minnesota site of the Midwest AIDS Training and Education Center (MATEC) in Minneapolis.

The survey — which was more of a needs assessment than a scientific survey — points to the need for education so that people with HIV have all the information they need to care for themselves and their partners, she said here at the United States Conference on AIDS 2019.

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NIH bolsters funding for HIV implementation research in high-burden U.S. areas

From HIV.gov

The National Institutes of Health has awarded approximately $11.3 million to 23 institutions across the United States to collaborate with community partners to develop locally relevant plans for diagnosing, treating and preventing HIV in areas with high rates of new HIV cases.

The awards will help enhance the implementation science knowledge base needed for the proposed Ending the HIV Epidemic: A Plan for America. The plan aims to leverage the powerful data and tools now available to reduce new HIV diagnoses in the United States by 75 percent in five years and by 90 percent by 2030. President Donald J. Trump announced this bold new initiative during the State of the Union Address in February. If funds are appropriated by Congress, the 10-year initiative will begin in fiscal year 2020. The awards announced today are one-year awards to support pilot and formative studies to prepare for more extensive implementation science research proposals expected in 2020.

“With existing, powerful HIV treatment and prevention tools, we can end the epidemic in the United States,” said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID) at NIH. “The new initiative is a practical, achievable implementation plan. By working directly with health departments and other community organizations, researchers can find the best ways to use the highly effective methods at our disposal to diagnose, prevent and treat HIV in the United States.”

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Study: People with HIV more likely to have high blood pressure

From MyHIVteam

People with HIV are more likely than people without the virus to have high blood pressure, in part because of treatments and repercussions of the condition itself, a new review of research shows.

Learning more about the underlying mechanisms of high blood pressure in people with HIV is critical in preventing one of the leading conditions that can cause premature cardiovascular disease in those adults, the researchers said. The implications are important in a population that has seen the rate of people dying from heart disease and stroke skyrocket over the last decade.

“I think that we really need to pay special attention to this population,” said Dr. Sasha Fahme, the study’s lead author and a global health research fellow at Weill Cornell Medical College in New York City. “Now that people [with HIV] are living longer, we are seeing the non-infectious consequences of HIV, and hypertension [high blood pressure] is one of them.”

In the Weill Cornell Medicine-led research review, published May 18 in the American Heart Association journal Hypertension, Fahme and her colleagues included 24 medical articles published between 2005 and 2017 that looked at high blood pressure among adults with HIV and those who didn’t have the virus. The study populations included the United States, Brazil, China, Italy, Tanzaniaand other countries.

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Living with HIV

From U.S. News and World Report

According to the Centers for Disease Control and Prevention, an estimated 1.1 million people in the United States are living with HIV. In 2017, 38,739 people received an HIV diagnosis, and when they first heard the word “positive,” many were thrust into feelings of anger, sadness, denial and fear.

“There are some people who suspect they are HIV-positive but go a very long time without testing, and then there are other people who test for whatever reason and turn out positive,” says Mallory Johnson, a clinical psychologist and professor at the University of California–San Francisco School of Medicine and co-director of the NIH-funded Center for AIDS Prevention Studies. “Those tend to be the extremes of the experience.” Disbelief and shock, Johnson says, are the most common responses.

Of those living with the virus in the U.S., about 14%, or 1 in 7, are unaware of their infection. HIV weakens the immune system by destroying cells meant to combat infection and disease; AIDS is the final stage of the infection, when the immune system has been severely damaged. Not all HIV-positive individuals will develop AIDS – antiretroviral therapies and other medications now allow people with the virus to live long, healthy lives.

Still, receiving a chronic diagnosis like HIV is likely to produce emotional distress. Here’s a look at the toll such a diagnosis takes, as well as how patients can tend to their psychological health.

University of Pittsburgh: Scarcity of LGBTQ youth health research

From HealthNewsDigest.com

There is a dearth of scientifically investigated, evidence-based interventions to address substance use, mental health conditions and violence victimization in sexual and gender minority youth, according to a research review led by the University of Pittsburgh Graduate School of Public Health, recently published in the journal Pediatrics.

After poring over thousands of research publications spanning nearly two decades, the scientists identified only nine studies that evaluated such interventions, and most of these used suboptimal study designs, thereby limiting the validity of the findings. None of the programs would be sufficient to mitigate the substantial inequities faced by lesbian, gay, bisexual, transgender and queer (LGBTQ) youth, the scientists concluded.

“While this knowledge gap is distressing, I think we can look at it as an opportunity,” said lead author Robert W.S. Coulter, Ph.D., M.P.H., assistant professor in Pitt Public Health’s Department of Behavioral and Community Health Sciences. “Promising programs are being created by community-based organizations that are ripe for rigorous evaluation by scientists to determine if they are successfully improving health among LGBTQ youth and, if so, whether they can be replicated in other communities.”

Compared with their heterosexual peers, sexual minority youth have up to 623% higher odds of substance use in their lifetimes; up to 317% higher odds of mental health conditions, such as suicidality and depression; and up to 280% higher odds of violence victimization, such as being bullied at school, or sexually or physically abused. Due to these health inequities, the federal government has designated LGBTQ youth as a priority population for research focused on preventing, reducing and treating these health issues.

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Finding out he was “undetectable” was a game changer

In 2012, Bruce Richman received news about his health that would set him on an unexpected path.

His doctor explained to him that he was “undetectable,” meaning that by adhering to his HIV antiretroviral therapy, the viral load in his blood was so low that it could no longer be detected.

This was a game changer for him. The news meant that Richman, who first found out he had HIV in 2003, would be unable to pass the virus on to any sexual partner.

Bruce Richman, founder of Prevention Access Campaign, is working to change the way the world views people living with HIV

“I found out nine years after my diagnosis that I can’t transmit the disease. My doctor told me and, here I am, a privileged white guy with a support system. I’m privileged with this information, and I started looking around and saw that nothing confirmed it was true,” Richman told Healthline. “I started doing research. There was no information out there to the general public that was clear and inclusive and accepted that this was true.”

Richman’s realization that this information, which could benefit thousands upon thousands of people living with HIV, rested mainly within medical circles — accessible to those with connections and privilege — awakened something within him.

Continue reading on Healthline.com.

Use of HIV prevention pill rising among men who have sex with men

From Reuters Health

A growing proportion of American men who have sex with men know they can take a daily pill to avoid infection with HIV and more of them are using it, a U.S. study suggests.

HIV pre-exposure prophylaxis (PrEP) is highly protective against the virus that causes AIDS, but many people worldwide don’t get this pill because they aren’t aware of it, don’t think they need it, or because it’s unavailable or unaffordable. Efforts to raise awareness among one high-risk group – men who have sex with men – have been complicated because some of these men don’t identify as gay or bisexual and mistakenly think heterosexual people don’t need PrEP.

In 2014, the U.S. Centers for Disease Control and Prevention (CDC) launched an effort to get PrEP to all men who have sex with men who might benefit from the pill, not just gay and bisexual individuals. The current study looked at national health survey data to track changes in awareness and use of PrEP from 2014 to 2017 in 20 American cities.

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