Study finds H.I.V. drugs priced out of reach

From the New York Times

Drugs to treat H.I.V. and AIDS are being priced out of reach for many patients enrolled in insurance plans through the new health care exchanges, despite warnings that such practices are illegal under the Obama administration’s health care law, according to a new analysis by Harvard researchers.

The study, to be published on Wednesday in an article in The New England Journal of Medicine, looked at 48 health plans in 12 states and found that a quarter of the plans showed evidence of what researchers called “adverse tiering,” or placing all of the drugs used to treat H.I.V. in a specialty tier where consumers are required to pay at least 30 percent of the cost of the drug.

The financial impact can be drastic, the researchers found: A patient taking a common H.I.V. treatment, Atripla, would pay about $3,000 more a year in a restrictive plan compared with someone enrolled in a more generous plan, even after accounting for the fact that the more restrictive plans tended to charge lower monthly premiums.

“That’s really a large cost difference, and really is a very significant financial constraint for those with chronic conditions, particularly H.I.V.,” said Douglas B. Jacobs, the lead author of the study, who is pursuing degrees in public health at the Harvard T. H. Chan School of Public Health and medicine at the University of California, San Francisco.

Continue reading on The New York Times.

10 questions to ask yourself before you begin HIV treatment

puzzle man_white backgroundFrom thebody.com

An HIV diagnosis comes with its very own set of questions to ask yourself and decisions to make. Among the biggest is: When should you start treatment? It’s a Russian nesting doll of a decision, with many other questions tucked inside. Here, in no particular order, are 10 of the most important questions to ask yourself before you begin taking HIV medications.

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Introducing #standOUTpgh

10933879_658281264281364_9173789996442469325_nThe #standOUTpgh campaign is a new media driven initiative to help prevent substance abuse and HIV and STDs as well as fight minority stigma among gay and bisexual youth of color and all that self identify as trans no matter their race or age.
#standOUTpgh seeks to change the conversation around subculture and different expressions by giving young minority gay and bisexual men and trans individuals a digital platform to share their stories of uniqueness and responsibility for the world to see!
We hope to engage all community organizations that care about and serve these individuals to participate in support by spreading the word to those who may wish to participate. By defeating stigma and promoting self worth, we can break down one of the largest barriers to getting tested for HIV and STDs, getting prevention messages, and living healthier and happier lives.
How can you help? Learn about the campaign and its corresponding awareness events at www.standout.hiv and follow our social media pages
and share as the pageant unfolds. That’s it! Find us at:
The #standOUTpgh campaign will culminate in 6 events held in celebration of uniqueness and responsibility built around relevant national awareness days. These events will feature HIV/STD testing and prevention counseling. Information on these events will be broadcast via social media and standout.hiv. They are as follows:
  • World AIDS Day: Dec 1, 2014.
  • National Black HIV/AIDS Awareness Day: Feb 7, 2015.
  • National Youth Violence Prevention Week: March 18-22.
  • National Youth HIV Awareness Day: April 10, 2015.
  • National Prevention Week: May 12-18, 2015.
  • National HIV Testing Day: June 15.
We hope you will join us in building a positive movement behind these communities and shining a spotlight on what makes them stand out!

Op-ed: “Looking” at HIV Testing in 2015

051711HIVtestFrom The Advocate online…

HBO’s Looking just aired an episode focusing in part on one character’s journey with HIV testing. The scene, filmed at one of AIDS Healthcare Foundation’s Out of the Closet thrift stores and HIV testing sites in the Bay Area, serves as a timely reminder why HIV testing is an important act for people individually and for the gay community in particular. Indeed, HIV testing is important for all Americans, as over 50,000 people of all stripes acquire HIV annually — a number we have had difficulty bringing down.

On an individual basis, folks fall into a wide spectrum of motivation in seeking HIV testing services. Some seek HIV testing because they have had an unprotected moment, some have been told by someone they were with, or perhaps another, that they may be at risk … or had something happen that caused them concern. Others use testing services as an element of their sexual health routine. I would suggest that wherever folks fall in the spectrum of risk or motivation in testing, every time someone seeks knowledge about their health status, it has a beneficial effect for them and for our community.

Why? Because gay men in particular and the LGBT community in general are working to emerge from two fog banks. One is the fog of the bitter war against a disease the community has been fighting for over 30 years to arrest its ravages on our friends, family, and community. The other, the haze of prejudice and ignorance, clouds our ability to truly value ourselves and form real, trusting bonds with each other irrespective of our HIV status.

Every time we test, every time we find out our status and share that with those with whom we share our bodies (whatever the result), we remove a teaspoon of that fog. Each step taken to know and disclose our status is another action that will slow the spread of HIV in our community and affirm that there is nothing to hide from. Our decisions with whom to be intimate in whatever way we choose in 2015, need not be apologized for, nor the subject of shame.

Continue reading.

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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CDC annual STD surveillance report: MSM bear a disproportionate burden

From the EdgeMediaNetwork

While anyone can become infected with an STD, certain groups, including young people and gay and bisexual men, are at greatest risk. Gonorrhea and chlamydia primarily affect young people. While surveillance data show signs of potential progress in reducing chlamydia and gonorrhea among young people aged 15-24, both the numbers and rates of reported cases of these two diseases continue to be highest in this group compared to other age groups. 

Both young men and young women are heavily affected by STDs, but young women face the most serious long-term health consequences. It is estimated that undiagnosed STDs cause 24,000 women to become infertile each year. The other group facing the burden of STDs are men who have sex with men (MSM). There has been a troubling rise in syphilis infections among gay, bisexual, and other MSM. Trend data show that MSM account for three quarters (75 percent) of all primary and secondary syphilis cases. 

Primary and secondary syphilis are the most infectious stages of the disease, and if not adequately treated, can lead to long-term infection, which can cause visual impairment and stroke. Syphilis infection can also place a person at increased risk for acquiring or transmitting HIV infection. In fact, available surveillance data indicate that an average of half of MSM with syphilis are also infected with HIV. 

Read the full article here.
Read the CDC report here.

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.