Category Archives: Prevention

CDC’s Eugene McCray discusses HIV prevention advances from AIDS 2018 in Amsterdam

Eugene McCray MD

From AIDS.gov

Advances in HIV prevention and program implementation were among the topics in the spotlight at the 22nd International AIDS Conference (AIDS 2018) this week. Eugene McCray, MD, Director of CDC’s Division of HIV/AIDS Prevention (DHAP)

reflects on some of the conference highlights. The division he oversees works to prevent HIV infections and reduce the incidence of HIV-related illness and death across the United States. Read more about their work.

During a live interview on Facebook, Dr. McCray discussed research being presented by CDC researchers at the conference, other HIV prevention research findings shared here at the conference, and shares his personal reflection on what how it feels like to be at this conference at this stage of the epidemic.

Watch the video.

Why don’t more Americans use PrEP?

From the New York Times

Truvada was approved by the Food and Drug Administration in 2012. But over six years later, the United States is failing miserably in expanding its use. Less than 10 percent of the 1.2 million Americans who might benefit from PrEP are actually getting it. The major reason is quite clear: pricing. With a list price over $20,000 a year, Truvada, the only PrEP drug available in the United States, is simply too expensive to become the public health tool it should be.

[…] The disparities in PrEP access are astounding: Its use in black and Hispanic populations is a small fraction of that among whites. In the South, where a majority of H.I.V. infections occur, use is half what it is in the Northeast. Women use PrEP at drastically lower rates than men, and while there’s no national data on PrEP and transgender Americans, it’s almost certainly underused. The issue of PrEP access has become an issue of privilege.

The ability of PrEP to greatly reduce new H.I.V. infections is no longer in question. In New South Wales, Australia, a program providing free access to PrEP led to a drop in H.I.V. diagnoses in the most vulnerable communities by a third in just six months, one of the fastest declines recorded since the global AIDS crisis began.

Read the full article on New York Times online.

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 rate among gay and bi men between the age of 25 to 34 rose 45% between 2008 and 2015

During that time, the rate dropped 15 percent nationally and rose 25 percent among Latino men who have sex with men.

From Poz Magazine online

While the national annual HIV infection rate dropped by an estimated 15 percent between 2008 and 2015, a few key subgroups saw a rise in yearly new HIV infections, also known as HIV incidence. During this period, HIV incidence among 25- to 34-year-old men who have sex with men (MSM) increased by an estimated 45 percent while the rate increased 25 percent among Latino MSM.

These figures come from the Centers for Disease Control and Prevention’s (CDC) new, in-depth analysis of epidemic trends in the United States. Published in the Annals of Internal Medicine, the report is a more precise and granular version of reports on epidemic trends that CDC officials presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle a year ago.

At that time, the agency estimated that HIV incidence declined 18 percent between 2008 and 2014. This new estimate, therefore, represents a disappointing reduction in that hopeful figure.

Prior to 2008, HIV incidence was essentially stable in the United States for the two decades since the beginning of the modern era of combination antiretroviral (ARV) treatment.

Read the full article.

Many at-risk men still don’t take HIV prevention pill

From The Associated Press…

From gritty neighborhoods in New York and Los Angeles to clinics in Kenya and Brazil, health workers are trying to popularize a pill that has proven highly effective in preventing HIV but which — in their view — remains woefully underused.

Marketed in the United States as Truvada, and sometimes available abroad in generic versions, the pill has been shown to reduce the risk of getting HIV from sex by more than 90 percent if taken daily. Yet worldwide, only about a dozen countries have aggressive, government-backed programs to promote the pill. In the U.S., there are problems related to Truvada’s high cost, lingering skepticism among some doctors and low usage rates among black gays and bisexuals who have the highest rates of HIV infection.

“Truvada works,” said James Krellenstein, a New York-based activist. “We have to start thinking of it not as a luxury but as an essential public health component of this nation’s response to HIV.”

A few large U.S. cities are promoting Truvada, often with sexually charged ads. In New York, “Bare It All” was among the slogans urging gay men to consult their doctors. The Los Angeles LGBT Center — using what it called “raw, real language” — launched a campaign to increase use among young Latino and black gay men and transgender women.

“We’ve got the tools to not only end the fear of HIV, but to end it as an epidemic,” said the center’s chief of staff, Darrel Cummings. “Those at risk have to know about the tools, though, and they need honest information about them.”

In New York, roughly 30 percent of gay and bisexual men are using Truvada now, up dramatically from a few years ago, according to Dr. Demetre Daskalakis, a deputy commissioner of the city’s health department.

However, Daskalakis said use among young black and Hispanic men — who account for a majority of new HIV diagnoses — lags behind. To address that, the city is making Truvada readily available in some clinics in or near heavily black and Hispanic neighborhoods.

Read the full article on Newsday.com.

The WHO public health approach to HIV treatment and care: looking back and looking ahead

From the Lancet

In 2006, WHO set forth its vision for a public health approach to delivering antiretroviral therapy. This approach has been broadly adopted in resource-poor settings and has provided the foundation for scaling up treatment to over 19·5 million people. There is a global commitment to end the AIDS epidemic as a public health threat by 2030 and, to support this goal, there are opportunities to adapt the public health approach to meet the ensuing challenges. These challenges include the need to improve identification of people with HIV infection through expanded approaches to testing; further simplify and improve treatment and laboratory monitoring; adapt the public health approach to concentrated epidemics; and link HIV testing, treatment, and care to HIV prevention. Implementation of these key public health principles will bring countries closer to the goals of controlling the HIV epidemic and providing universal health coverage.

Read the full paper here.

 

m4mHealthySex.org: Using social media to reach men who have sex with men in Pennsylvania

In a recent study published in the September issue of AIDS Behavior, researchers were able to shed some light on the use of dating aps and Websites by men who have sex with men (MSM). The study showed that 3 in 4 MSM use Internet-based social media venues for the purpose of meeting other men. More than half reported frequent use.

Considering that gay and bi men make up less than 2 percent of the population but account for roughly 70 percent of new HIV infections (based on surveillance data obtained in 2014), and given the recent announcement by the Centers for Disease Control and Prevention that the number of reported chlamydia, gonorrhea and syphilis infections are at an all-time high in the United States (with gay and bi men making up a disproportionate number of new syphilis infections), it makes sense that gay-related dating aps and Websites would be a logical place to reach out to MSM with important prevention and testing information. In fact, the previously mentioned study’s authors concluded the ability to target MSM through social media “ensures that the right prevention message can be received by the intended audience…and could be an effective strategy for sexual health prevention research, interventions, and communication efforts.”

That’s our mission in a nutshell.

As part of the HIV Prevention and Care Project, and with the experienced input of the Pitt Men’s Study medical staff (both housed within the University of Pittsburgh Graduate School of Public Health), m4mHhealthySex.org strives to get important health information to the people who need it, via the social media venues they frequent the most. Our sexual health educators reach out on Grindr, Scruff, Jack’d, Adam4Adam and Craigslist, in areas around the state that are particularly hard hit by HIV and other STDs. In 2016, we referred more than 600 MSM in Pennsylvania to free HIV/STD testing, sent a variety of Health Alerts (short bulletins alerting MSM to critical health issues) to more than 8,000 recipients, and added to our archive of 450-plus informative posts concerning HIV and other STDs, PrEP, sexual health and the general wellbeing of men who have sex with men.

Being informed about sexual health can protect you from serious sexually transmitted infections. It can also keep our community healthy and strong. So if you see us online, don’t be afraid to ask questions. You can also browse through our helpful links related to STD/HIV testing, PrEP and general health.

For more information about m4mHealthySex.org, the HIV Prevention and Care Project, and/or sexual health in general, contact us at m4mInformation@pitt.edu. We’re here to help.