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HIV care, Research

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

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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.

Read the full article.

PrEP, Prevention, Research, Stigma

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

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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.

Health Alerts, HIV Activism, PrEP

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

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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.

Facebook logoThe 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.

Read the full article.

Prevention, Research

Studies firmly establish “undetectable equals untransmittable”

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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.

undetectable equals untransmitable logo 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.

PrEP, Prevention

Ending the HIV Epidemic: Ready, Set, PrEP

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From the Department of Health and Human Services…

Pre-exposure prophylaxis (or PrEP) medications are prescription medications that people take daily to significantly reduce their risk of acquiring HIV through sex. PrEP can stop HIV from taking hold and spreading throughout the body. Two medications are FDA-approved for use as PrEP: TRUVADA and DESCOVY. When taken daily, PrEP is highly effective for preventing HIV from sex.

The Ready, Set, PrEP program makes PrEP medication available at no cost for qualifying recipients. To receive PrEP medication through this program, you must:

  • Lack prescription drug coverage
  • Be tested for HIV with a negative result
  • Have a prescription for PrEP

Talk to your healthcare provider or find a provider at HIV.gov Locator to find out if PrEP is right for you. If PrEP is a good option for you, click below to apply.

 

Health Alerts, Research, STIs

Health Alert: Get tested for HIV and other Sexually transmitted infections

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According to a CDC report, HIV continues to have a disproportionate impact on racial and ethnic minorities, gay and bisexual men, and other men who have sex with men. Yet, 15% of men who are infected with HIV don’t know it.
several images depicting a variety of gay male couples
Also, according to CDC research, cases of gonorrhea, chlamydia and syphilis have risen for the fifth consecutive year.Some STIs (including HIV) can go unnoticed since symptoms can be mistaken for minor health problems like a cold or sore throat. Some may have no symptoms at all. The only way to know for sure if you’re infected is to get tested.
If you send us your zip code, we can help find local testing near you. Most are free. You can also ask us questions about basic sexual health, including PrEP. Send a message to m4mInformation@pitt.edu. We’re here to help. 
Commentary, HIV Activism

NIH Statement on World AIDS Day 2019

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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.

Research

A Nurse Care Management Program for HIV Prevention Among Youth Experiencing Homelessness

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From Contagionlive…

HIV prevalence is as high as 12% in young people experiencing homelessness. This population is also 6 to 12 times more likely to become infected with HIV than housed youth. Obstacles to HIV prevention and care among youth experiencing homelessness are compounded by substance use, housing instability, and mental illness. These obstacles present a need to develop targeted interventions for this population.

Few HIV prevention programs prioritize the prevention needs of youth experiencing homelessness, but an oral abstract session at the Association of Nurses in AIDS Care Conference (ANAC 2019) discussed the development of a protocol for nurse care management for HIV prevention called NCM4HIV.

NCM4HIV integrates a theoretical framework, methodology for behavioral change, and practical strategies designed to engage youth experiencing homelessness, with an outcome evaluation plan. The program builds on past nurse care management using the Comprehensive Health Seeking and Coping Framework. NCM4HIV also incorporates the psychological modality known as motivational interviewing. Results of behavioral interventions will then be accounted for through behavioral feedback technology, allowing case management specialists to further tailor the intervention through goal setting and patient response.

Read the full article.

Commentary, HIV Activism, Stigma

The most insidious virus: stigma

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From the Washington Blade…

Stigma did not create AIDS. Yet it prepared the way and speeded its ravaging course through America and the world. First stigma delayed understanding of the disease: it’s a gay cancer, it’s a punishment from God, they brought it on themselves, so who cares? Then stigma delayed government action, research, and assistance for the sick and dying. Stigma made people afraid to get tested for HIV and treated. Stigma made people ashamed, isolating and alienating them from friends and family. Stigma cost people jobs, professional standing, housing, a seat on an airplane or in a dentist’s chair. Stigma made many afraid to live, and want to die. But then it began to make some brave people very angry and AIDS activism was born. The activists quickly realized that to end AIDS we must end stigma.

AIDS activism did more to fight the stigma on being gay or having AIDS than any other social force. In this way, AIDS activism, like the civil rights movement, became a great moral movement of our time, defending the innocent, restoring dignity to the violated, giving hope to the desperate, and reviving faith in the disillusioned. AIDS activism gave LGBT people courage, dignity, and power they had never held before.  It inspired many to stand up and proudly proclaim who they are and who they love. Twenty-six of the world’s most advanced countries now recognize gay marriage and today a gay man openly married to another man is a prominent candidate for President of the United States.

Read the full article.

Research

Scientists detect a new strain of HIV

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From CNN…

The strain is a part of the Group M version of HIV-1, the same family of virus subtypes to blame for the global HIV pandemic, according to Abbott Laboratories, which conducted the research along with the University of Missouri, Kansas City. The findings were published Wednesday in the Journal of Acquired Immune Deficiency Syndromes.

HIV has several different subtypes or strains, and like other viruses, it has the ability to change and mutate over time. This is the first new Group M HIV strain identified since guidelines for classifying subtypes were established in 2000. It is important to know what strains of the virus are circulating to ensure that tests used to detect the disease are effective.
“It can be a real challenge for diagnostic tests,” Mary Rodgers, a co-author of the report and a principal scientist at Abbott, said. Her company tests more than 60% of the world’s blood supply, she said, and they have to look for new strains and track those in circulation so “we can accurately detect it, no matter where it happens to be in the world.”