Getting a flu vaccine during 2020-2021 is more important than ever because of the ongoing COVID-19 pandemic. When you get vaccinated, you reduce your risk of getting sick with flu and possibly being hospitalized or dying from flu. This season, getting a flu vaccine has the added benefit of reducing the overall burden on the health care system and saving medical resources for care of COVID-19 patients.
People with HIV—especially those who have a very low CD4 cell count or who are not taking antiretroviral therapy—are at high risk for serious flu-related complications. For this reason, it is especially important that people with HIV get a flu shot annually. (The nasal spray flu vaccine is not recommended for people with HIV.)
In addition to getting a flu shot every year, people with HIV should take the same everyday preventive actions CDC recommends of everyone, including avoiding people who are sick, covering coughs, and washing hands often.
People with HIV who switch from a stable antiretroviral (ARV) regimen to Delstrigo (doravirine/tenofovir disoproxil fumarate/lamivudine) had a high rate of full suppression of the virus at the three-year mark in a large Phase III clinical trial.
Princy Kumar, MD, of Georgetown University, presented findings from the open-label, randomized, active-controlled, noninferiority DRIVE-SHIFT trial at the virtual HIV Drug Therapy Glasgow meeting.
Delstrigo contains the relatively new non-nucleoside reverse transcriptase inhibitor (NNRTI) Pifeltro (doravirine), which, like Delstrigo, was approved in September 2019.
The HIV population in the United States is aging. This can be seen as a sign of success as people with HIV are living longer because they are engaged in care and benefiting from effective treatments. Consider these data from the HRSA Ryan White HIV/AIDS Program (RWHAP) fact sheet, Older Adult Clients: Ryan White HIV/AIDS Program, 2018
46.1% of individuals getting RWHAP care are over 50 years old, similar to the age demographics of all Americans diagnosed with HIV
91.5% of those aged over 50 are virally suppressed, exceeding the RWHAP average of 87%.
The aging trend has been underway for many years and is projected to continue. In 2018, RWHAP clients aged 55 and older accounted for 31% of all clients, up significantly from 16.6% in 2010. A large proportion of RWHAP clients (45-54 years old) are on the cusp of joining the 55+ age group.
Initial data from a large NIH-supported clinical trial offer a detailed look at the health status of people aging with HIV around the world. With 7,770 participants enrolled in 12 countries across five continents, the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE ) is evaluating the ability of a statin medication, pitavastatin, to reduce the risk of heart disease among people with HIV. By leveraging data collected from this diverse group of study participants, researchers also are learning more about the long-term health effects of HIV. They report their initial findings in an August supplement for The Journal of Infectious Diseases.
For women, accelerated reproductive aging—a natural process that eventually leads to menopause—may heighten risk for heart disease and stroke. Among women with HIV in the REPRIEVE study, more advanced reproductive age was associated with two risk factors for cardiovascular disease: high waist circumference and high blood levels of hemoglobin. Women living in sub-Saharan Africa or Latin America and the Caribbean were more likely to experience accelerated reproductive aging than those living in high-income countries.
The initial REPRIEVE findings also provide insight into the relationship between HIV and heart disease among transgender people, about which little is known. Transgender people are disproportionately affected by HIV, and studies have suggested that hormone use as part of gender-affirming therapy may increase cardiovascular disease risk. By collecting data on gender identity and use of gender-affirming therapy, the REPRIEVE investigators aim to address this knowledge gap. Notably, their initial analysis revealed that high waist circumference was more common among transgender women, particularly those who were receiving gender-affirming therapy.
[On July 2, 2020], the U.S. Food and Drug Administration approved Rukobia (fostemsavir), a new type of antiretroviral medication for adults living with HIV who have tried multiple HIV medications and whose HIV infection cannot be successfully treated with other therapies because of resistance, intolerance or safety considerations.
“This approval marks a new class of antiretroviral medications that may benefit patients who have run out of HIV treatment options,” said Jeff Murray, M.D., deputy director of the Division of Antivirals in the FDA’s Center for Drug Evaluation and Research. “The availability of new classes of antiretroviral drugs is critical for heavily treatment-experienced patients living with multidrug resistant HIV infection—helping people living with hard-to-treat HIV who are at greater risk for HIV-related complications, to potentially live longer, healthier lives.”
When Rabbi James Gibson arrived at Temple Sinai in 1988 at age 34, the Squirrel Hill congregation had seen a succession of rabbis come and go in short order.
Rabbi James Gibson of Temple Sinai in Pittsburgh
“The betting money was not on me,” Rabbi Gibson recalled. But he soon made clear he was committed to staying and fulfilling basic commitments to teaching, pastoral work and community service.
After 32 years as not only Temple Sinai’s rabbi but also as one of the most prominent participants in building interfaith and inter-racial ties in Pittsburgh’s religious communities, Rabbi Gibson will bring that tenure to a close when he retires following this weekend’s Shabbat services. The congregation had planned big celebrations, including a dinner and concerts, but the pandemic changed all that.
Instead, he’ll be leading the final Friday night service via livestream from Temple Sinai and other activities via Zoom on Saturday. “I cannot imagine ending my career and not being in sacred space,” he said. On Sunday, members will hold an outdoor “drive-bye” farewell, he said.
“It has been a 32-year love affair,” he added. “There have certainly been challenges, but … every time we confronted something difficult and acted on our best values, we have ended up where we were supposed to be.”
Rabbi Gibson, known to friends as Jamie, grew up mostly in northern New Jersey and Minnesota.
After graduating from the University of Michigan, “I spent three years doing every job under the sun,” he recalled.
At 24, he entered Hebrew Union College-Jewish Institute of Religion — the rabbinical school for the liberal Reform Jewish movement. He studied at its programs in Cincinnati and Jerusalem and earned a master’s degree.
He then served a congregation in Wausau, Wis., for five years. “I was the only rabbi in around 100 miles in every direction,” he recalled, even traveling as far as Michigan’s Upper Peninsula to conduct funerals.
A denominational official who had grown up at Temple Sinai put him in contact with current leaders. Knowing it had gone through an unhappy succession of short-term rabbis, he told Rabbi Gibson: “Why don’t you go and make peace in Pittsburgh and be my mother’s rabbi?”
When he first met temple leaders at a conference, “he looked really, really young” but proved to be “mature beyond his years,” recalled Rhoda Dorfzaun, who was president of Temple Sinai at the time.
“He seemed to have the same philosophy that our temple had,” she added, which has included being welcoming to interfaith couples and LGBT people.
Earlier today the Department of Health and Human Services released a final rule that eliminates federal regulations ensuring nondiscrimination in healthcare for transgender people and LGB people, people who are pregnant or seeking an abortion, those who require healthcare services in a language other than English, and other marginalized communities. In its announcement, HHS noted it was “restoring the rule of law” by interpreting sex discrimination “according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.”
GLMA President Scott Nass, MD, MPA, issued the following statement in response:
“It is unconscionable that the Administration would take this action to encourage and promote discrimination during a pandemic that is already severely impacting vulnerable communities, including LGBTQ people. The fear of discrimination can have very real health consequences, especially in a public health crisis. These discriminatory measures are not only cruel, they also undermine public health and will assuredly result in poorer health outcomes for LGBTQ people.
By the end of 1984, AIDS had already ravaged the United States for a few years, affecting at least 7,700 people and killing more than 3,500. Scientists had identified the cause of AIDS—HIV—and the U.S. Centers for Disease Control and Prevention (CDC) identified all of its major transmission routes.
Yet, U.S. leaders had remained largely silent and unresponsive to the health emergency. And it wasn’t until September 1985, four years after the crisis began, that President Ronald Reagan first publicly mentioned AIDS.
But by then, AIDS was already a full-blown epidemic.
HIV originated in 1920 in Kinshasa, Democratic Republic of Congo. It spread to Haiti and the Caribbean before jumping to New York City around 1970 and California within the decade.
Health officials first became aware of AIDS in the summer of 1981. Young and otherwise healthy gay men in Los Angeles and New York began getting sick and dying of unusual illnesses normally associated with people with weakened immune systems.
It didn’t take long for fear of the “gay plague” to spread quickly among the gay community. Beyond the mortal danger from the disease, they also dealt with potentially being “outed” as homosexual if they had AIDS or an illness resembling it.
In fall 1982, the CDC described the disease as AIDS for the first time. Despite the growing cases and a new name, news outlets struggled with the disease, or at least how to cover it—some even shied away from giving it too much attention. Though the New York Times initially reported on the mysterious illnesses in July 1981, it would take almost two years before the prestigious paper gave AIDS front-page space on May 25, 1983. By that time, almost 600 people had died from it.
David W. Dunlap, a reporter in the Metro section at the time, told the New York Times Style Magazine: “There were strong messages that you got that were not written on any whiteboard. You knew to avoid it. It was a self-reinforcing edict: Don’t write about queers.”
In a letter to Robert Torres, Secretary of Aging Pennsylvania Department of Aging, representatives of the PA Commission on LGBT Affairs wrote:
In February, the Aging Workgroup of the Commission on LGBTQ Affairs developed a survey to hear from aging service providers and LGBTQ consumers across the Commonwealth. The survey was completed by over 400 individuals, representing both service providers and older Pennsylvanians. The Workgroup used this survey data to craft the recommendations […] LGBTQ older adult respondents expressed great concern over being able to access LGBTQ-friendly resources and services. A strong majority indicated they would more readily access these services if they knew providers had completed LGBTQ cultural competence training. Providers also identified the need for greater training within the aging network to develop the knowledge and skills needed to more effectively serve LGBTQ older adults and individuals living with HIV. They reported wanting more resources that they could share with co-workers to improve their agencies, and resources to share with clients to help them connect to LGBTQ-friendly services. Providers and consumers both identified the need for non-discrimination protections, improved data collection, and greater support for LGBTQ people in the long-term care system.
A formal document regarding recommendations to the Department of Aging, at the Pennsylvania Department of Health, include:
Expanding LGBTQ cultural competence within all levels of care providers
Develop training opportunities and resources on the topic of HIV & Aging
Support advocacy efforts for LGBTQ older Pennsylvanians
Establish mechanisms for collecting data on sexual orientation and gender identity
Provide training materials for aging services providers
Identify opportunities to partner and support LGBTQ affordable, inclusive housing initiatives
Develop and share resources related to LGBTQ aging with all levels of care providers
Develop programs that deal with social isolation, including training seniors on the use of social media technologies
You can find out more in the official document, with the full list of recommendations, submitted to the Department of Aging here. For more information about the Department of Aging, go here.
AIDS Free Pittsburgh wants to hear YOUR ideas about how we can work together to end the HIV epidemic in Allegheny County, whether or not you know someone affected by HIV. This is an ambitious goal, and we are hard at work developing an updated plan to dramatically reduce HIV in our community.
Your input is important to make sure that this project is successful. This survey will take about 15 minutes to complete, is completely anonymous and voluntary. Your responses will not be shared with others and you may stop at any point.
What is AIDS Free Pittsburgh? It is a community public health project that began in 2015 to decrease new HIV cases by 75% and eliminate new AIDS cases in Allegheny County, Pennsylvania by the year 2020. AIDS Free Pittsburgh partners have committed to a three-pronged strategy with the goal of creating a community where new HIV infections are rare:
TEST: Identify people with HIV who remain undiagnosed and connect them to care.
PREVENT: Increase education about and access to Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) for people who are at higher risk for HIV.
TREAT: Support immediate linkage to care for people diagnosed with HIV to maximize viral suppression so they can remain healthy and prevent further HIV transmission.
As of 2018, new HIV cases have decreased by 39% and new AIDS cases have decreased by 43% in Allegheny County. It is exciting that we are about halfway to meeting these goals, but we still need your help to cross the finish line. We are currently planning a second phase of the project (2021-2025) and are looking for your input!
Questions or concerns?
Contact AIDS Free Pittsburgh by email at firstname.lastname@example.org.