Category Archives: PrEP

New delivery strategy reduces HIV transmission

From ASPPH / Washington… 

Researchers delivered ART to reduce the infectiousness of HIV-infected persons and PrEP to reduce susceptibility of their uninfected partners. PrEP was offered prior to ART initiation and for the first six months of ART, until the HIV-infected partner would have been expected to achieve viral suppression. Then PrEP was discontinued.

Jared Baeten

Dr. Jared Baeten

“Our primary goals were to evaluate this delivery model, but partway through the span of the study, it became clear that HIV transmission rates were considerably lower than would have been anticipated,” said lead author Dr. Jared Baeten, vice chair and professor of global health and professor of epidemiology at the School.

Researchers examined the feasibility and acceptability of a program in Kenya and Uganda to offer medications to 1,013 couples in which one member was HIV-positive and the other was HIV-negative. The findings, published online August 23 in PLOS Medicine, showed that the observed rates of HIV transmission were 96 percent lower than simulated rates of transmission in historic controls.

“We learned that the approach is desirable and highly cost-effective and could be delivered affordably to people in that setting,” Dr. Baeten said. Researchers also noted that this study does not include a concurrent comparison population for HIV transmission because it would not have been ethical to enroll a control population and not offer access to PrEP and ART.

Link: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002099

Optimal Care Checklist available for men who have sex with men

for-men-onlyWhether you are gay, bisexual or any man who has sex with other men (MSM), there are certain health issues that are important for you to talk about with your doctor. This brochure entitled Your Sexual Health, published by the National Coalition of STD Directors and the National Alliance of State & Territorial AIDS Directors, is designed to help you get important health care specific to the wellbeing of gay and bi men.

Issues such as pre-exposure prophylaxis (PrEP), rising STD rates in the community, getting vaccinated for Hepatitis A & B and for Human Papillomavirus (HPV) are just a few of the topics you might want to discuss with your health care provider. Your Sexual Health can help you break the ice. Being informed is an important first step in protecting yourself and your community.

You can also click on the image to download the checklist brochure.

 

 

HIV/AIDS in 2016

From The Journal of the American Medical Association (JAMA)…

Overshadowed by the Zika epidemic, concerns about terrorism and security, and the US presidential election, the global HIV/AIDS pandemic persists, with 2.1 million new HIV infections and 1.1 million deaths worldwide in 2015 (http://bit.ly/2ambo2P). The 21st International AIDS Conference in Durban, South Africa, in July highlighted the remarkable progress since 2000, when the conference was last held in Durban and very few people in Africa received antiretroviral therapy.

patf_mentorAt present, 3.4 million people in South Africa are being treated for HIV infection, more than in any other country in the world; between 2005 and 2015 overall life expectancy at birth in South Africa increased from 53.5 years to 62.5 years (http://bit.ly/1swJbPo). In 2000, 490 000 new HIV infections occurred among children throughout the world; in 2010 the figure decreased to 290 000 and in 2015 to 150 000 (http://bit.ly/2ambo2P). Unlike the $10 000 annual cost of HIV treatment in 2000, the price tag for some first-line antiretroviral regimens now is only $100 per year.

The recent conference aimed to catalyze the work that remains—further scientific advances, addressing stigma, discrimination and other structural barriers within society, and securing the political commitment, including financial resources for prevention, diagnosis and treatment (http://bit.ly/2960ttk). However, fewer people may have been listening than in the past. Among the more than 15 000 participants from 153 countries, including 800 media delegates, few journalists from a US newspaper or television network were on-site in Durban. Although the conference was covered from afar, it was relatively underreported in the United States.

Read the full article.

 

PrEP researchers now focusing on the best ways to get PrEP to people who need it

From aidsmap.com

Speaking to a meeting on pre-exposure prophylaxis (PrEP) yesterday, ahead of the 21st International AIDS Conference (AIDS 2016), Chris Beyrer, president of the International AIDS Society, reminded delegates that the last time the conference was held in Durban, South Africa, in the year 2000, the event was notable for drawing attention to the enormous gap in access to HIV treatment between rich and poorer countries. That conference began the treatment access era.

Chris Beyrer, president of the International AIDS Society

Chris Beyrer, president of the International AIDS Society

“Now is really the time to start the PrEP access era,” Beyrer said.

The questions about whether PrEP works have been resolved. But a host of questions about the best way to implement PrEP remain, including who to offer PrEP to, where to provide it and how to stimulate demand.

To help health services and countries answer those questions, the World Health Organization (WHO) will soon issue implementation guidance, outlined to the meeting by Rachel Baggaley of WHO and Robert Grant of the University of California. The document is designed to be practical, addressing in separate chapters the needs and interests of political leaders, medicines regulators, community educators, public health officials, clinic administrators, clinicians, counsellors, testing providers, pharmacists, and monitoring and evaluation staff. A specific chapter addressed to individuals taking PrEP will answer their frequently asked questions.

Read the full article.

Meet the man who got HIV while on daily PrEP

From POZ.com

Ever since July 2012, when the FDA approved Truvada as PrEP, a pre-exposure prophylaxis to prevent getting HIV, its success rate has been, well, perfect. In fact, not a single person adhering to the daily regimen has ever tested HIV positive—and that includes everyone in clinical trials and studies, and the more than 40,000 people taking Truvada as PrEP in the United States. But PrEP researchers, like most scientists, rarely speak in absolutes and guarantees; they’ve acknowledged that, under rare circumstances, an infection is feasible. Last week, that hypothetical situation became a known reality.

HIV pos while on daily PrEPOn February 25 at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, David C. Knox, MD, an HIV specialist at the Maple Leaf Medical Clinic in Toronto, presented data on a patient who, after two years of good PrEP adherence, tested HIV positive (for more on that, read this article by POZ’s Benjamin Ryan).

In Knox’s presentation, his patient remained anonymous, but many of us in the PrEP and HIV communities had followed his seroconversion story in real time as he posted about it last May in the Facebook group PrEP Facts: Rethinking HIV Prevention and Sex, in which he was an active member. Since then, Joe—as he prefers to be called here—dropped off the discussion boards. I had kept his information and interviewed him earlier this year for a potential POZ feature. At that time, the 44-year-old was excited to put 2015 behind him (more on that later). We chatted about gentrification in Toronto’s “gay village,” and he described himself as a “foreigner” whose family had lived in Kuwait and Denmark before moving to Canada when he was 11, experiences that resulted in his speaking several languages and working as an international flight attendant for 14 years. Now employed at a telecommunications giant, Joe sounded optimistic about his future job prospects and he was devoting energy to the new love of his life: Oliver, a Lhaso Apso-Maltese-Yorkie mix. Importantly, Joe had acclimated to a new HIV regimen, taking his meds each morning, and his viral load had remained undetectable.

Read the full article on POZ.

Pitt Men’s Study medical director, Dr. Ken Ho, talks about PrEP

Pitt's Dr. Ken Ho

Pitt’s Dr. Ken Ho

The Centers for Disease Control and Prevention are working to inform patients and health care providers of a new, anti-viral pill that they estimate can drastically reduce the risk of infection.  Here to tell us more about this treatment and discuss why it hasn’t been adopted by clinicians in the region are Dr. Ken Ho, an HIV specialist at the University of Pittsburgh and Jason Herring, director of programs and communications at the Pittsburgh AIDS Task Force.

Listen to the broadcast on Essential Pittsburgh 90.5 WESA, Pittsburgh’s NPR station.