Preventing HIV with medicine can carry a stigma

From GPB News

In order to slow the spread of HIV, certain people who do not have the virus but are at risk should take medicine to prevent becoming infected. That’s the recommendation of the Centers for Disease Control and Prevention and, just recently, the World Health Organization. The preventive treatment is known as PrEP, for pre-exposure prophylaxis.

Eric McCulley made the decision to start PrEP. He’s 40, gay and HIV-negative. Outside an Atlanta coffee shop, he pulls out a plastic baggy with a few blue pills. “They’re a decent size, actually,” he says. “Some people might call them a horse pill.” The pill is called Truvada, a combination of two drugs used to treat HIV. Despite McCulley’s negative HIV status, he’s taken the pill daily for the past few months.

After hearing about the treatment and doing extensive research on his own, McCulley made an appointment with his primary care doctor earlier this year. “He was very supportive about it. He encouraged me to do it,” he says. “He gave me a lot of stuff to read, gave me a lot of stuff to think about, and told me I was a good candidate for it. So off we went.”

So far, McCulley says, the only change the drug has made in his life is in his attitude. “I have what I was looking for. I have peace of mind. I feel like I’ve taken responsibility for my health,” he says.

But some PrEP users worry that not everybody in the medical community is up to speed. Although Truvada has been on the market for a decade, only recently have prescribing guidelines been available. Dylan West is a 25-year-old Atlanta resident and works in international aid. He is also gay and recently found out firsthand that not every doctor is as familiar with PrEP as McCulley’s is.

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HIV + patients more likely to be untreated for early-stage cancer

From Oncology Nurse Advisor

Life expectancy for HIV-infected people is now similar to uninfected people, but survival for infected patients who develop cancer is not. Many studies have attempted to understand why HIV-infected cancer patients have worse outcomes; however, this new study, the largest of its size and scope, examined differences in cancer treatment as one potential explanation. It was conducted by researchers in Penn Medicine’s Abramson Cancer Center in Philadelphia, Pennsylvania, and the National Cancer Institute (NCI), and published in the Journal of Clinical Oncology (2014; doi:10.1200/JCO.2013.54.8644).

For early stage cancers that have the highest chance of cure with appropriate treatment, those with HIV were twice to four times as likely to not receive appropriate cancer treatment, the researchers found. HIV-infected people with lymphoma, lung cancer, prostate cancer, and colorectal cancer were almost twice as likely to be untreated for cancer, even after considering differences in age, gender, race, and stage.

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Only 1 in 5 doctors offers routine HIV screening for patients

From Edge on the Net

A new Centers for Disease Control and Prevention analysis shows that while most primary care physicians offer regular, routine HIV testing to gay and bisexual men, only 1 in 5 provides routine screening for all patients.

“Testing remains an important HIV prevention tool. It is the first step toward ensuring that those living with HIV get the treatment and care they need to protect their health and reduce their likelihood of transmission. Yet the majority of Americans have never been tested, and nearly 1 in 6 people who are HIV-infected do not know it,” writes the CDC in their analysis.

The CDC recommends that everyone be tested at least once — and for gay men, at least once a year — to ensure those living with HIV get the care and treatment they need to protect their health and reduce the likelihood of transmission.

Young people with HIV respond well to human papillomavirus vaccine

aidsmap.com reports…

The quadrivalent human papillomavirus (HPV) vaccine worked as well for teens and young adults with HIV as it did for their HIV-negative counterparts, according to study findings presented the 20th International AIDS Conference last week in Melbourne.

Human papillomavirus is a common sexually transmitted infection that causes abnormal cell growth. High-risk strains, including type 16 and 18, can cause cervical and anal cancer. People typically become infected with HPV shortly after they become sexually active, regardless of HIV status. But HIV-positive people tend to harbour more HPV types, are less likely to spontaneously clear HPV and may experience faster disease progression from dysplasia (abnormal cell changes) to cancer.

Continue reading on aidsmap.com

Stigma still a factor in fighting HIV

From the Huffington Post

The International Lesbian, Gay, Bisexual, Trans and Intersex Association reminds us that 12 U.S. states with some of the highest HIV incidence rates in the country still have not repealed their anti-sodomy laws, including Alabama, Florida, Louisiana, Mississippi, North and South Carolina, Utah, Kansas, Texas, Oklahoma, Michigan and Idaho. That’s despite a 2003 ruling by the U.S. Supreme Court declaring such laws unconstitutional.

Homophobia, racism, sexism, ageism, stigma and violence clearly contribute to the spread of HIV around the globe. Why get tested for HIV if you will be harmed because of your status? Why link to healthcare that may give you inadequate care or cause you harm? Why stay in care in a place that is hostile? How can you possibly remain 90 percent adherent to HIV meds if you have no place to live or store your medications, or a safe and confidential pharmacy to get them from? Why indeed. The HIV epidemic, no matter how close it comes to becoming a medicalized, chronic and manageable illness through the intervention of science will never come to an end unless these parallel social diseases are also defeated.

Read the full article on the Huffington Post.