US guidelines on “prevention with positives” now emphasize engagement with care, HIV treatment and social factors

From aidsmap.com

The American public health agency, the Centers for Disease Control and Prevention (CDC) has published new recommendations on the HIV prevention interventions and advice that should be offered to people who are HIV positive.

The CDC last issued guidelines on what is sometimes called ‘prevention with positives’ in 2003. Those guidelines ran to 24 pages and emphasised screening for behavioural risk factors and sexually transmitted infections, one-to-one prevention counselling and advice delivered by clinicians, other behavioural interventions, and partner notification.

All those elements remain but the scope of the new guidelines is much broader, with the recommendations now running to 240 pages. Whereas previous guidelines were clearly focused on the individual’s knowledge and behaviour, the new recommendations take greater account of social and structural factors as well as the profound impact that antiretrovirals have on HIV transmission. For example, an individual may need support with poverty, mental illness, substance use or unstable housing in order to be able to fully engage with medical care and adhere to HIV treatment.

Continue reading on aidsmap.com.

“Syphilis is like the canary in the coal mine for HIV”

From Queerty.com

Think twice before hooking up with that out-of-towner this holiday weekend. And, if you do, be safe.

The CDC has just released reports that number of syphilis infections in the United States jumped a whopping 10 percent from 2012 to 2013, with gay and bisexual men accounting for 75 percent of the increase.

According to the report, 17,357 cases of syphilis were reported last year. That’s 5.5 cases per every 100,000 people.

Dr. Jill Rabin, co-chief of the division of ambulatory care in the Women’s Health Programs-PCAP Services at North Shore-LIJ Health System in New Hyde Park, N.Y., called the rise in syphilis cases “very alarming.”

“Syphilis is like the canary in the coal mine for HIV,” she said. “People are going to be positive for syphilis before they are diagnosed with HIV. This means that there is a potential increase in HIV cases.”

According to MedicalXpress, the sores caused by syphilis make HIV transmission easier. In rare cases, syphilis can lead to serious health problems, including death. Though it’s easy to cure with antibiotics if caught early.

“Having an STD doesn’t mean someone is dirty or broken,” said Fred Wyand, spokesperson for the American Sexual Health Association. “Far from it.”

Wyand urged people not to let the stigma of a STD prevent them from being tested and treated.

“One of the great barriers to having sexual health conversations is the sense of embarrassment. People need to have frank, open conversations,” he said. “It’s not about sex. It’s about health.”

Syphilis on the rise among gay, bisexual men: CDC

From HealthDay.com
By Steven Reinberg

The number of cases of syphilis in the United States jumped 10 percent from 2012 to 2013, with gay and bisexual men accounting for 75 percent of the increase, U.S health officials reported Tuesday.

Rates of another sexually transmitted disease — chlamydia — fell for the first time in 30 years, with more than 1.4 million reported cases in 2013. This represented a 1.5 percent decrease from 2012, according to the U.S. Centers for Disease Control and Prevention.

“There are over 20 million cases of sexually transmitted diseases [STDs] every year in the United States, and they continue to pose a risk of lifelong complications for millions of Americans,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

According to the report, 17,357 cases of syphilis were reported in 2013 — a rate of 5.5 per 100,000 people.

There are a variety of reasons that put gay and bisexual men at high risk for syphilis, said Mermin.

“Some are the high number of sexual partners and sexual networks that create a vicious cycle where the prevalence of syphilis is higher. And that leads to higher incidence, which leads to higher prevalence, and that cycle can increase the frequency of infection,” he said.

Continue reading on HealthDay.

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.

Continue reading on aidsmap.com.

Young gay men describe trust as an HIV prevention strategy

What constitutes safer sex? Sex with a condom? Sex with PrEP (pre-exposure prophylaxis)? Oral sex? At GAYCON 2014, an annual conference on gay and bisexual men’s health in Scotland, researcher Nicola Boydell presented the results of a study that sought to discern young gay men’s attitudes toward safer sex, Aidsmap reports.

The good news: Young gay men see safer sex as more than just condom use. The bad news? Many consider condomless sex within the context of a relationship as being relatively safe, even when they knew nothing about their partner’s HIV testing history.

Yet, the majority of HIV transmissions among gay men happen within the context of a relationship, according to data from a 2009 U.S. study. When speaking of these relationships, men cite trust as the number one reason to take off the condom.

Continue reading on The Body.

 

26th World AIDS Day: Get in there, do something, change things

From Huffington Post…
by

red ribbonPre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) have successfully returned sexual health to the national and international headlines. Not since the early years of the HIV epidemic has there been so much constructive dialogue, progress, and involvement by the public.

Long-term survivors, HIV organizations, scientists, public-health experts, and the generation that never knew a world without HIV joined hands on the 26th World AIDS Day in an effort to educate and advocate in commemoration of those we have lost to HIV and the people living with the infection today.

While a few still wage a lonely and wasteful fight against science and progress itself, it is time to acknowledge that we finally have the opportunity to move on from a monotonous, one-way conversation and use these new tools as catalysts for serious and much-needed change.

Of course, it doesn’t help when one of our favorite Star Trek actors throws all logic overboard and simply dismisses today’s generation as lazy, complacent and irresponsible, but it certainly shows that we haven’t progressed much since President Reagan’s infamous call to abstinence 27 years ago.

Six of the estimated 39 million people we lost worldwide to HIV were my friends and mentors. All six would have agreed with Meryl Streep’s Margaret Thatcher when she says in The Iron Lady, [I]f something’s wrong, they shouldn’t just whine about it. They should get in there and do something about it. Change things.”

Keep reading on Huffington Post.

Having HIV/AIDS: Fighting stigma

From the Windy City Media Group
by Lawrence Ferber

Hearing the words “I’m HIV-positive” made Bryan* ( names and some details have been changed ) freeze. A 23-year-old graphic designer, Bryan had met a guy at a Boystown gay club, a svelte 25-year-old tourist, Zach, with whom he danced, drank and laughed. Around 1 a.m., just before heading to Zach’s hotel for more private activities together, Zach disclosed his positive HIV status. His viral load was undetectable—successfully suppressed with a drug regimen to the point it was low to no risk for transmission; also, he was clear of other STDs and he packed an ample supply of condoms.

Bryan declined to go back with him, though, offering a politely worded excuse rather than saying what he really thought: “I don’t sleep with HIV-positive guys.” Zach, however, had heard those words, or variations of the same, more than a few times since his diagnosis a couple of years ago, and he could see them clearly in Bryan’s green eyes. He felt like shit—judged and tainted—and while Zach wouldn’t lie and tell someone he was negative, he understood why so many others in his shoes have and do. Bryan ended up getting lucky a couple of hours later at another bar with Alex, an architect-in-training who said he was negative.

There’s a twist: Bryan, in fact, was positive, although he wouldn’t find out that until six months later, when he got tested for the first time in almost three years—something he put off because, in the back of his mind, he was concerned about a bareback encounter with someone he met on Grindr who, the next day, deleted his profile and disappeared, as if in a magic poof of smoke.

“Stigma is really damaging on both ends,” said Matthew Rodriguez of the comprehensive HIV/AIDS resource site The Body. “For negative people, stigma can sometimes stop them from getting tested. If they feel they did anything that put them at risk, they may not want to get tested because the result may be devastating. I think it also stops people from interacting with those living with HIV as full people. People just look at you as a status, as a virus.”

Continue reading on Windy City Media Group.