Mental health issues put gay and bi men at increased risk for HIV

(Reuters Health) – Gay and bisexual men are at increased risk of acquiring the virus that leads to AIDS if they have mental health problems, according to a new study. What’s more, their risk of acquiring HIV increases with the number of mental health factors they report, researchers found. Past studies have found that mental disorders, ranging from depression to substance abuse, are often seen among men with HIV, but “nothing about whether these factors predict HIV risk behaviors or becoming infected with HIV,” said study leader Matthew Mimiaga, from Harvard Medical School and Massachusetts General Hospital in Boston.

The Centers for Disease Control and Prevention (CDC) estimates that some 1.1 million people in the U.S. are living with HIV. About one case in six is undiagnosed. While the CDC says only about 4 percent of U.S. males have sex with other men, they represent about two-thirds of the country’s new infections. Additionally, it’s known that the lesbian, gay, bisexual and transgender (LGBT) community also suffers from an increased burden of mental health problems.

When two health conditions tend to occur together in one population, researchers call them “syndemic.” For the new study in the Journal of Acquired Immune Deficiency Syndromes, the researchers looked at how five conditions – depression, alcohol abuse, stimulant use, multi-drug abuse and exposure to childhood sexual violence – affect men’s risk of acquiring HIV. They analyzed data on 4,295 men who reported having sex with men within the previous year. The participants were asked about depressive symptoms, heavy alcohol and drug use and childhood sexual abuse.

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Smoking doubles risk of death for patients taking HIV therapy

From aidsmap.com

Smoking doubles the mortality risk for people with HIV taking antiretroviral therapy, a study published in AIDS shows. Smokers had an increased risk of death from cardiovascular disease (CVD) and non-AIDS-related cancers, and the life expectancy of a 35-year-old man with HIV was reduced by almost eight years due to smoking. “Smoking was associated with a two-fold increase in mortality,” comment the authors. “More than a third of all non-AIDS related malignant deaths were from lung cancer and all deaths from lung cancer were in smokers.”

The benefits of not smoking were clear. HIV-positive non-smokers who were doing well on antiretroviral therapy had a similar life expectancy to non-smokers in the general population.

With the right treatment and care, people living with HIV can have a normal life expectancy. However, mortality rates remain higher among people with HIV compared to the background population. The reasons for this are unclear, but important causes of death among people with HIV now include smoking-related diseases such as heart and lung complaints and non-AIDS-related malignancies.

Investigators therefore wanted to determine the association between smoking and mortality risk among people taking HIV therapy.

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U.S. HIV ‘Treatment Cascade’ stats dismal among western nations

From AIDSmeds.com

Compared with other high-income Western nations, the United States fares remarkably poorly in getting people with HIV diagnosed, into stable care, on treatment and to an undetectable viral load, aidsmap reports. Researchers conducted an analysis of the “treatment cascade” figures for Australia, British Columbia (statistics for all of Canada were not available), Denmark, France, the Netherlands, the United Kingdom and the United States. Results were presented at the HIV Drug Therapy Glasgow conference in Scotland.

The estimated rates of HIV diagnosis among the countries ranged from a low of 71 percent in British Columbia to a high of 86 percent in Australia, with the United States at 82 percent. The United States had the lowest rate of linkage to care, at 66 percent, and Denmark had the highest at 81 percent. The United States had by far the lowest rate of HIV-positive people retained in care at 37 percent, with British Columbia the next lowest at 57 percent. Australia’s 76 percent care-retention rate was the highest. 

Because of the United States’ low retention figures, the remainder of the nation’s figures were also markedly lower than the other countries’. The U.S. rate of people with HIV taking antiretrovirals was 33 percent. The high for that figure was the United Kingdom’s 67 percent. The rates of viral suppression were as follows: the United States, 25 percent; British Columbia, 35 percent; France, 52 percent, the Netherlands, 53 percent, the United Kingdom, 58 percent; Denmark, 59 percent; and Australia, 62 percent.

To read the aidsmap story, click here.

To read the conference abstract, click here.

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.
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More than half of gay and bi men haven’t been asked by a doctor to take an HIV test

Find free HIV testing locations near you by entering your zip code at http://hivtest.cdc.gov

Find free HIV testing locations near you by entering your zip code at http://hivtest.cdc.gov

From the New York Times

Gay men and their doctors aren’t talking enough about sex, and that’s making it harder to control the spread of H.I.V.

That’s the conclusion of a new survey of gay and bisexual men by the Kaiser Family Foundation released on Thursday. It found that 47 percent of the men have never discussed their sexual orientation with their doctors, and 56 percent have never been advised by a doctor to be tested for H.I.V.

For decades we’ve been hearing that H.I.V. is not a gay disease, and that’s true globally, but it’s a misrepresentation of the epidemic in the United States. That misunderstanding can lead to a complacency that furthers its spread, public health officials warn. A majority of new infections occur among men who have sex with men. Kaiser estimates that 12 to 13 percent of gay and bisexual men in the United States are living with H.I.V., more than 20 times the rate among the general population.

“It’s in the highest bracket of prevalence that you see in some of the hardest-hit countries in sub-Saharan Africa,” says Jen Kates, Kaiser’s director of global health and H.I.V. policy. “It’s not that America shouldn’t care about H.I.V., but that gay and bisexual men should care more.”

Continue reading on the New York Times online.

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.

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