Daily post-exposure prophylaxis (PEP) with single tablet emtricitabine/tenofovir/rilpivirine (Complera, Eviplera) has excellent completion rates and good side-effect and safety profiles, Australian investigators report in the online edition of Clinical Infectious Diseases.
The open-label, non-randomised study involved 100 men who have sex with men (MSM) requiring PEP after possible sexual exposure to HIV. Treatment lasted 28 days and was completed by 92% of participants. Side-effects were mild, the most common being nausea and tiredness. There were no serious adverse events.
Prompt PEP, after possible sexual or occupational exposure to HIV, can reduce the risk of infection. Guidelines recommend triple-drug therapy, ideally commenced within 72 hours of exposure. Failure of PEP has been linked to poor treatment adherence or the premature discontinuation of treatment. A recent analysis of 97 PEP studies found that only 57% of patients completed their four-week course of treatment.
The combination pill emtricitabine/tenofovir/rilpivirine provides well tolerated and easy-to-take once-daily HIV therapy. Though it must be taken with food, investigators from Australia hypothesised that the combination pill would provide convenient and safe PEP.
From the Advocate.com…
Professors of Sociology at Rice University have found that bisexual Americans face higher health disparities than their gay, lesbian, and straight counterparts. A variety of these health issues stem from systemic socioeconomic vulnerability in the bisexual community, according to the new study.
“As a group, bisexual men and women have higher rates of a variety of factors that can lead to poor health — things like poverty or involvement with lifestyle activities that can lead to poor health, ” lead author Bridget Gorman tells The Advocate.“A big thing was emotional support. When you compare relative to other groups, bisexuals reported lower rates of getting the emotional support that they felt they needed.”
Bisexual respondents also reported a higher propensity for smoking and using alcohol than straight or gay counterparts — health risks that can be amplified by the higher rates of poverty among the bisexual community compared with other peers. Among gay, lesbian, and straight counterparts, researchers found members of the bisexual community were the least likely to be educated at a university level.
Continue reading on the Advocate.com.
A Yale University study of 38 European countries’ attitudes about homosexuality has uncovered homophobia was associated with gay and bisexual men not seeking HIV-prevention services, HIV testing, and disclosing their orientation to doctors. The authors believed their study highlighted a dangerous trend: One where men who live in more homophobic countries were not only becoming less knowledgeable about HIV treatment, prevention, and resources, but also that this demographic seemingly had more opportunities for sexual activity through “hook-up” mobile applications and websites, a Yale University statement pointed out.
For their study published in the June 19 issue of AIDS, investigators used data from the European MSM Internet Survey (EMIS), a questionnaire that delved into gay and bisexual participants’ HIV-related knowledge, behaviors, and healthcare use.
Continue reading on hcplive.com.
From Reuters Health…
Participants were recruited from the New York City area between 2009 and 2011 and were 18 or 19 when they entered the study. At that point they were all HIV-negative. Over the next three years, 43 participants became infected with HIV. About a third of black, Hispanic and mixed or other race participants became HIV-positive during the study, compared to about 7 percent of white participants. People who described themselves as being in low to average social and economic groups were more likely to become HIV-positive than those in higher socioeconomic groups.
Also, the authors found, young age at first sexual experience with another male was tied to an increased risk of becoming HIV-positive, compared to a first encounter at an older age. “The bigger point here is that it’s just too simplistic to (blame) everything on race,” Halkitis said. “We’re trying to get at the reason that’s happening. This paper starts to point to it.”
The researchers point out that social and economic status is closely tied to race in the U.S. People with lower social and economic status likely live in areas with more poverty, less access to healthcare and more untreated sexually transmitted infections (STI), they write. They also point out that young gay and bisexual men may not be properly educated about STIs, and their heterosexual parents may not be equipped to educate on those topics.
“I think that one way we can begin to address this issue is through comprehensive sexual health education,” said Jason Coleman, an expert on HIV and STI prevention at the University of Nebraska-Omaha.
Read the full article.
From Latinos Health…
In the report by the Rhode Island Department of Health, researchers highlighted the alarming rise of STD’s in the state between 2013 and 2014, with HIV infections up by 33 percent, gonorrhea up 30 percent, and syphilis rising an alarming 79 percent.
“New cases of HIV and syphilis continued to increase among gay, bisexual, and other men who have sex with men at a faster rate than in other populations,” the report noted, adding that “infection rates of all STDs continued to have a greater impact on the African-American, Hispanic, and young adult populations.”
While better testing partly explains the increase, health officials also highlighted “high-risk behaviors that have become more common in recent years,” such as “using social media to arrange casual and often anonymous sexual encounters.”
Read the full article.
From the New York Times…
People with H.I.V. should be put on antiretroviral drugs as soon as they learn they are infected, federal health officials said Wednesday as they announced that they were halting the largest ever clinical trial of early treatment because its benefits were already so clear.
The study was stopped more than a year early because preliminary data already showed that those who got treatment immediately were 53 percent less likely to die during the trial or develop AIDS or a serious illness than those who waited.
The study is strong evidence that early treatment saves more lives, the officials said. Fewer than 14 million of the estimated 35 million people infected with H.I.V. around the world are on treatment now, according to U.N.AIDS, the United Nations AIDS-fighting agency. In the United States, only about 450,000 of the estimated 1.2 million with H.I.V. are on treatment, according to the Centers for Disease Control and Prevention.
“This is another incentive to seek out testing and start therapy early, because you will benefit,” said Dr. Anthony S. Fauci, director of the National Institute for Allergy and Infectious Disease, which sponsored the trial. “The sooner, the better.”
Continue reading on the New York Times.
The New York City Department of Health and Mental Hygiene’s recent fear-based HIV prevention campaign may have led to unintended consequences by stigmatizing young black and Latino men who have sex with men (MSM). Publishing their findings in Health Affairs, researchers analyzed the 2010 “It’s Never Just HIV” campaign, which used fearful, horror-movie-like imagery and messaging to highlight health problems tied to HIV or its treatment, such as osteoporosis, dementia and anal cancer.
“Relying on fear is risky business,” the authors write in the paper. The health department came to appreciate that its analysis of the campaign’s success could not be governed simply by HIV rates among the target population. Rather, the department needed to consider the campaign’s social and political impact. Not only was there a huge amount of controversy among people in the HIV community, but according to certain criticisms, people at risk of HIV and those living with the virus may have suffered stigma as a result of the campaign.
New York City has since moved away from fear-based HIV prevention campaigns. For example, “Be HIV Sure,” which launched on World AIDS Day 2014, encourages HIV testing as part of sexual intimacy.
To read a press release on the study, click here.