Less than half of HIV-pos U.S. Hispanics getting proper care

From U.S. News and World Report

Even though Hispanics in the United States become infected with HIV at rates triple those of whites, less than half of Hispanics with the virus are receiving adequate treatment, a new report finds. The report, based on 2010 U.S. government health data, finds that while 80 percent of HIV-infected Hispanics do receive care soon after their diagnosis, only about 54 percent continue that care and only about 44 percent receive the virus-suppressing drugs they need to stay healthy.

The researchers, led by epidemiologist Zanetta Gant of the U.S. Centers for Disease Control and Prevention (CDC), also found that only 37 percent of the more than 172,000 HIV-positive Hispanic adults in the United States have the virus under control. HIV is the virus that causes AIDS. The findings “underscore the need for enhanced linkage to care, retention in care, and viral suppression for Hispanics or Latinos,” Gant’s team writes in the Oct. 10 issue of the CDC journal Morbidity and Mortality Weekly Report.
Continue reading on U.S. News and World Report.

Giving doctors guidance on drugs to prevent H.I.V.

From the New York Times

truvadaThe medical school at the University of California, San Francisco, has opened a free telephone consulting service for doctors who are not H.I.V. specialists and want help prescribing the right AIDS drugs for preventing infection in healthy patients.The service, known as PrEPline for pre-exposure prophylaxis line, was announced last week.

In pre-exposure prophylaxis, patients at high risk for H.I.V., such as gay men who frequently have unprotected sex with strangers, ward off infection by taking Truvada, a pill containing two antiretroviral drugs. Uninfected men, if they have doctors at all, usually see general practitioners, who rarely prescribe antiretrovirals. By contrast, doctors at U.C.S.F. have decades of experience in treating H.I.V. because San Francisco was an early center of the outbreak.

The new hotline is aimed at American doctors, but if PrEP is rolled out around the world, it could be a model for other countries, said Dr. Ronald H. Goldschmidt, the director of the school’s clinical consultation center. Since 1993, he said, the center has fielded phone calls from doctors seeking help. Typically, they are obstetricians treating pregnant women infected with H.I.V.; emergency-room doctors treating nurses who have had a needle injury; or patients who had sex with someone they suspect is infected.

South Africa and Ethiopia have sent doctors for training to offer similar services at home, he said; prophylaxis is still rare in poor countries because they are struggling to pay for medicine even for those with advanced AIDS.

Find out why these gay and bi men have decided to go on PrEP

From the Advocate online

Despite recommendation by the Centers for Disease Control and Prevention, and studies that indicate that PrEP can reduce HIV transmission by 96 and up to 99 percent, there are still relatively few gay and bisexual men on the drug.

It can be hard to find anyone among your friends to ask about it. And what makes a person decide they want to go on the once-daily pill varies a lot. The Advocate reached out to gay and bi men, as well as serodiscordant couples, who use the drug to hear their reasons. They offered advice for those on the fence about it. Read their stories in their own words.

The treatment cascade in the United States – good in Ryan White programmes, but overall picture for gay men is poor

From aidsmap.com

People living with HIV in the United States who receive their care through the Ryan White HIV/AIDS Program have good rates of retention and virological suppression, investigators report in the online edition of Clinical Infectious Diseases. Of the patients seen at least once in 2011, some 82% were retained in care and 73% achieved virological suppression.

These outcomes dwarf those seen for most people living with HIV in the US – previous reports have estimated that as few as 40% were retained in care and 19% had achieved virological suppression.

A second new report focuses on gay, bisexual and other men who have sex with men, demonstrating that outcomes continue to be unacceptably poor in this group. Of those who have ever been diagnosed with HIV, 51% were retained in care and 42% achieved virological suppression.

However, both new studies found that outcomes were poorer in younger people, African American people and some other ethnic groups.

Continue reading on aidsmap.com

HIV pandemic’s roots traced back to 1920s Kinshasa

Posted on Reuters...

Bustling transport networks, migrant labor and changes to the sex trade in early 20th-century Congo created a “perfect storm” that gave rise to an HIV pandemic that has now infected 75 million people worldwide, researchers said on Thursday. In an analysis of the genetic history of the human immunodeficiency virus (HIV) that causes AIDS, the scientists said the global pandemic almost certainly began its global spread in the 1920s in Kinshasa in Democratic Republic of Congo (DRC).

Here, a confluence of factors including urban growth, extensive railway links during Belgian colonial rule and changes in sexual behavior combined to see HIV emerge in Congo’s capital and spread across the globe. Oliver Pybus, a professor at Oxford University’s zoology department who co-led the research, said that until now most studies have taken a piecemeal approach to HIV’s genetic history and looked only at certain HIV genomes in particular locations. “For the first time, we have analyzed all the available evidence using the latest phylogeographic techniques, which enable us to statistically estimate where a virus comes from,” he said. “This means we can say with a high degree of certainty where and when the HIV pandemic originated.”

United Nations AIDS agency (UNAIDS) data show that more than 35 million people worldwide are currently infected with HIV, and some 1.5 million people died of AIDS-related illness in 2013. Since the HIV/AIDS pandemic began, it has killed up to 40 million people worldwide. The disease is spread in blood, semen and breast milk. No cure exists, but AIDS can be kept at bay for many years in people with HIV who take cocktails of antiretroviral drugs.Various strains of HIV are known to have been transmitted from primates and apes to humans at least 13 times in history, but only one of those transmissions – of a strain known as HIV-1 Group M – led to the current human pandemic.

Pybus said the key questions centered on how this happened.”Why did most of (the HIV strains) die out, and why did some of them — like HIV-2 — go on to generate local epidemics in Africa, and why did only one go to become a global pandemic?” he said in a telephone interview. “To answer that, we needed to try to reconstruct the spread through space and time of the global pandemic strain.”

Pybus and an international team of researchers analyzed HIV-1 group M sequences from a major HIV sequence database and then combining these analyses with spatial and epidemiological data. Their study will be published in the journal “Science” on Thursday. Philippe Lemey, a professor at Belgium’s University of Leuven who worked on the study, explained that genetic analysis had helped establish the time and place of the pandemic’s origins. The team then compared that with historical data “and it became evident that the early spread of HIV-1 from Kinshasa to other population centers followed predictable patterns.”

A key factor, the analysis suggests, was the DRC’s transport networks, particularly its railways, which made Kinshasa one of the best-connected of all central African cities. “Data from colonial archives tells us that by the end of 1940s over one million people were traveling through Kinshasa on the railways each year,” said Nuno Faria of Oxford University, who also worked on the team. He said the genetic data showed that HIV rapidly spread across the DRC — a country the size of Western Europe — traveling with people along railways and waterways to reach Mbuji-Mayi and Lubumbashi in the extreme south and Kisangani in the far north between the end of the 1930s and early 1950s.

The team’s findings also suggest that along with transport, social changes such as the changing behavior of sex workers and public health initiatives against other diseases that led to the unsafe use of needles may have contributed to turning HIV into a full-blown epidemic. “We think it is likely that the social changes around the independence in 1960 saw the virus break out from small groups of infected people to infect the wider population and eventually the world,” said Faria.

Come out against stigma, live out proud

by  – Executive Director of the National Minority AIDS Council

 

The fight against HIV/AIDS has always been about more than the search for medicine or a cure. It has been a battle for human dignity, to demonstrate that each life, regardless of race, sexual orientation, gender identity, nation of origin, or religion, has inherent value. From the beginning, this epidemic has taken the largest toll on our most marginalized communities. From gay men and transgender women to injection-drug users and people of color, those who are most often shut out of our nation’s halls of affluence and power are also the most vulnerable to a whole host of health challenges, including HIV.

A few days ago I had the honor of participating in a panel on HIV sponsored by U.S. Rep. Barbara Lee (D-California) at the Congressional Black Caucus Foundation’s Annual Legislative Caucus. During the event the always-inspiring Douglas Brooks, who is the first black gay man living with HIV to head the White House Office of National AIDS Policy, gave brief opening remarks in which he quoted the Bible, saying, “He came unto his own, and his own received him not” (John 1:11). As we once again marked National Gay Men’s HIV/AIDS Awareness Day (Sept. 27), this simple verse resonated with me in a powerful way and seemed to reflect the position that so many gay men, especially gay men living with HIV, find themselves in.

Continue reading on the Huffington Post.

Kaiser Family Foundation releases new alarming report reflecting gay and bisexual men’s attitudes, knowledge, and experiences with HIV/AIDS

From Gay Men’s Health Crisis

On Thursday, September 25, 2014, the Kaiser Family Foundation released a new alarming report reflecting gay and bisexual men’s attitudes, knowledge, and experiences with HIV/AIDS and new HIV therapies in the United States. Their survey on HIV/AIDS in the lives of gay and bisexual men in the United States reports that 56% of gay and bisexual men are not personally concerned about HIV or AIDS affecting them and 30% have never been tested for HIV.

“HIV/AIDS might not be a death sentence anymore, but there are still 50,000 new infections in the United States every year-and gay and bisexual men are still among those most at risk,” said GMHC CEO Kelsey Louie. ” The Kaiser Family Foundation study is a needed wake-up call that communicating the correct information about HIV and AIDS to the public has never been more critical. We must do more to educate our gay and bisexual men about how HIV and AIDS can affect them, and how life-saving medications like PrEP and PEP can help them prevent HIV infections and stay healthy.”

Additional Background:
Eight out ten gay and bisexual men surveyed also said that they have heard a little or nothing about PrEP, a life-saving medication that can prevent HIV-infections. Additional findings from the survey can be found here. The Foundation’s survey comes on the heels of a new CDC report showing that 58% of gay and bisexual men diagnosed with HIV are not virally suppressed.