Rates of HIV infection still going up in U.S. among young gay males

From philly.com

A new report offers good and bad news about the AIDS epidemic in the United States: The annual diagnosis rate of HIV, the virus that causes the disease, has dropped by one-third in the general population but has climbed among young gay and bisexual males.

Significantly fewer heterosexuals, drug users and women were diagnosed each year with HIV, according to the report from the U.S. Centers for Disease Control and Prevention. However, the annual diagnosis rate more than doubled for young gay and bisexual males.

The push for safer sex may be falling on deaf ears in a generation too young to have seen the ravages of AIDS, said report co-author Amy Lansky, deputy director for surveillance, epidemiology and laboratory sciences at the CDC’s Division of HIV/AIDS Prevention.

“It’s been more than 30 years since the first cases were reported,” she said. “It’s harder to maintain that sense of urgency.”

The report only looked at people diagnosed with HIV, and health officials think many more are infected with the virus but don’t know it. The statistics also don’t say anything about when these people were infected, making it hard to pinpoint trends in efforts to prevent transmission of the virus.

Still, “we’re making significant progress and seeing declines overall,” said Lansky. However, she added, the rising numbers of diagnoses among young men who have sex with other men are “a considerable problem.”

The AIDS epidemic began more than 30 years ago. While the last two decades have brought great advances in drugs that prevent AIDS from developing in HIV-positive people, an estimated 1.1 million people are still living with HIV in the United States, Lansky said. Officials believe about 16 percent of those people — or about 176,000 — don’t know they’re infected, she said.

In the new report, published in the July 23/30 issue of the Journal of the American Medical Association, researchers examined HIV diagnoses in the United States from 2002 to 2011 in people aged 13 and older.

Although almost 500,000 people were diagnosed with HIV during that time, the annual rate of diagnoses fell from 24 out of every 100,000 people to 16 — a decline of 33 percent.

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WHO recommends PrEP for gay and bi men at risk for HIV

From the Bay Area Reporter online

Gay and bisexual men who are at risk for HIV infection should consider using antiretroviral drugs for pre-exposure prophylaxis, better known as PrEP, according to new guidelines from the World Health Organization.

The WHO recommendation is similar to U.S. Centers for Disease Control and Prevention guidelines released in May, which state that health care providers should consider advising people at “substantial risk” to use PrEP to prevent HIV infection.

“With the WHO’s recommendation, two of the world’s most important public health institutions have recommended that gay and bisexual men who could become infected by HIV carefully consider PrEP,” said Project Inform Executive Director Dana Van Gorder. “In Project Inform’s view, this would especially include men and transgender women who ever bottom without condoms.”

Noting that HIV infection rates among gay and bi men remain high almost everywhere and new prevention options are urgently needed, WHO strongly recommended that men who have sex with men consider taking antiretroviral drugs as an additional method of protection along with condoms.

Continue reading here.

Newer, safer antiretrovirals an option for majority of HIV patients

From aidsmap.com

The majority of patients taking antiretroviral therapy (ART) that includes drugs associated with long-term side-effects may have the option of switching to a novel regimen that uses newer and safer anti-HIV drugs, according to Australian research published in PLOS One. The single-site study showed that up to 89% of patients had the option of changing to a combination that includes three active newer agents with improved safety and side-effect profiles.

The drugs associated with long-term side-effects evaluated in this study comprise the core antiretroviral drugs prescribed to the majority of people taking antiretroviral treatment today. But the authors acknowledge “most of the regimens considered as ‘viable’ in this study have not been rigorously tested in clinical trials and might be regarded as unconventional.” Nevertheless, they stress “the growing interest in testing novel combinations of ART agents, which exclude nucleoside(tide) and older non-nucleoside reverser transcriptase inhibitors (N(t)RTIs and NNRTIs, respectively), as well as ritonavir (booster dose).” Most patients taking HIV therapy have an excellent life expectancy. However, there is concern about the safety and tolerability of many routinely used anti-HIV drugs.

Investigators at St Vincent’s Hospital, Sydney, Australia, called these the “RATE” drugs: ritonavir (Norvir), which is associated with drug interactions, diarrhoea and lipid disturbances; abacavir (Ziagen), which can involve a hypersensitivity reaction, has reduced potency at higher viral loads and may involve a risk of cardiovascular disease; tenofovir (Viread), which can cause bone and kidney problems; and efavirenz (Sustiva), associated with neuropsychiatric side-effects and increased lipids. Moreover, these drugs are usually used in combination, compounding their toxicity profiles.

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Smoking and HIV – One man’s story


Smoking is especially dangerous for people who are living with HIV, the virus that can cause AIDS. Brian learned that lesson the hard way, when he had a stroke—a brain attack—at age 43. In this video, Brian talks about surviving HIV-related medical problems—then nearly losing his life because of smoking.  See All Brian’s videos.

And from LOGO online…

Smoking now leads to more deaths in the LGBT community than HIV according to the Centers for Disease Control, which also reports that while 20.5% of heterosexuals smoke, 30.8% of  gay people use tobacco products. “We know that approximately one million LGBT people [in the U.S.] will die early from tobacco-related causes,” says Dr. Scout from the Network for LGBT Health Equity. “We want to save those lives instead.”

I you’re HIV-positive and smoke, the combination can take even more years off your life: According to the Network for LGBT Health Equity, being HIV-positive takes an average of 5.1 years off one’s life, but people who smoke and have HIV die 12.3 years earlier on average. Yet the smoking rate is two to three times higher among adults who are HIV-positive than in the general public.

 

AIDSVu shows the level of infections in your area

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Click on the image to view the interactive map

AIDSVu is an interactive online map illustrating the prevalence of HIV in the United States. The national, state and local map views on AIDSVu allow users to visually explore the HIV epidemic alongside critical resources such as HIV testing center locations, HIV treatment center locations, and NIH-Funded HIV Prevention & Vaccine Trials Sites. The map also lets users filter HIV prevalence data by race/ethnicity, sex and age, and see how HIV prevalence is related to various social determinants of health, such as educational attainment and poverty.

The state- and county-level data on AIDSVu come from the U.S. Centers for Disease Control and Prevention’s (CDC) national HIV surveillance database, which is comprised of HIV surveillance reports from state and local health departments. ZIP code and census tract data come directly from state, county and city health departments, depending on which entity is responsible for HIV surveillance in a particular geographic area. AIDSVu is updated on an ongoing basis with HIV surveillance data released by CDC, as well as with new data and information from other sources as they become available.

HIV drug may boost suicide risk

From philly.com

sustiva 3A medication commonly used to treat HIV appears to double the risk that patients will develop suicidal thoughts or take their lives, new research contends. The finding concerns the anti-HIV drug efavirenz, which is marketed as Sustiva. Prior investigations indicated that efavirenz might boost suicide risk because of a negative impact on the central nervous system. The new investigation is the first to pinpoint a link to suicidal thoughts, attempts and completion, the researchers said.

“Efavirenz is a very important and effective antiretroviral medication that is the foundation for much of HIV therapy worldwide,” said study co-author Dr. Joseph Eron, of the University of North Carolina Center for AIDS Research at Chapel Hill. “Our study demonstrated a clear association between efavirenz and suicidality,” he said.

Although that risk seems very small, he said, it appears to be persistent, lasting as long as patients take the drug.sustiva 2 Antiretroviral treatment typically is lifelong, helping people with the AIDS-causing virus live healthier lives. “Clinicians should be aware of this ongoing risk, and talk to their patients to assess suicidality,” Eron added. That means looking for any history of depression or suicidal thoughts or attempts, the study noted.

Continue reading on philly.com.

 

 

 

GLMA concerned about LGBT health implications of Supreme Court ruling

In response to the US Supreme Court ruling allowing closely held corporations to deny insurance coverage of contraceptives to their employees based on religious beliefs, GLMA executive director Hector Vargas issued the following statement:

“We are disappointed at today’s troubling ruling. This decision opens the door to employers interfering with the healthcare decisions that should be between the employee and their healthcare provider. We are very worried about the potential implications this decision could have on LGBT-related healthcare, such as HIV and transgender-related care.

“Earlier this year, GLMA joined Lambda Legal and Pride at Work in submitting a friend-of-the-court brief to the Supreme Court because we know all too well how allowing personal beliefs to interfere with healthcare services can result in biased care or departure from scientifically sound standards of care, and can have disastrous effects for LGBT patients.

“The Affordable Care Act (ACA), which includes the contraceptive coverage provision at issue in this case, is incredibly beneficial to the health and well-being of the LGBT community, including important non-discrimination provisions covering LGBT people. A decision, like the one today, chipping away at benefits provided by the ACA is extremely concerning.

“The attempts by the majority decision to limit the effect of its ruling are of little comfort to LGBT people and make GLMA’s educational and policy work to expand access to healthcare for LGBT people, including ensuring non-discrimination in healthcare, all the more critical.”