Opinion: Why don’t more Americans use PrEP?

From the New York Times

Truvada was approved by the Food and Drug Administration in 2012. But over six years later, the United States is failing miserably in expanding its use. Less than 10 percent of the 1.2 million Americans who might benefit from PrEP are actually getting it. The major reason is quite clear: pricing. With a list price over $20,000 a year, Truvada, the only PrEP drug available in the United States, is simply too expensive to become the public health tool it should be.

[…] The disparities in PrEP access are astounding: Its use in black and Hispanic populations is a small fraction of that among whites. In the South, where a majority of H.I.V. infections occur, use is half what it is in the Northeast. Women use PrEP at drastically lower rates than men, and while there’s no national data on PrEP and transgender Americans, it’s almost certainly underused. The issue of PrEP access has become an issue of privilege.

The ability of PrEP to greatly reduce new H.I.V. infections is no longer in question. In New South Wales, Australia, a program providing free access to PrEP led to a drop in H.I.V. diagnoses in the most vulnerable communities by a third in just six months, one of the fastest declines recorded since the global AIDS crisis began.

Read the full article on New York Times online.

High numbers of HIV-positive MSM not being tested for syphilis

From healio.com

Nearly one-third of sexually active HIV-positive men who have sex with men are not tested for syphilis at least annually, researchers reported in a recent study, calling the finding “concerning.”

Alex de Voux, PhDan Epidemiologist in the CDC’s Division of STD Prevention, and colleagues sought to examine the proportion of sexually active HIV-positive men who have sex with men (MSM) currently in care who were tested for syphilis in the past 3, 6 and 12 months by their HIV care provider.

A 2017 study showed that MSM accounted for more than 60% of syphilis cases nationwide in 2015. In that study, researchers determined that the rate of primary and secondary syphilis in the United States among MSM was 106 times that of men who have sex with women only.

In the current study, the authors noted that guidelines recommend that sexually active MSM, including HIV-positive MSM, be tested at least annually for syphilis, with testing every 3 to 6 months for MSM at elevated risk, and used this timeline to evaluate the group.

De Voux and colleagues used the most recent medical record and interview data collected by the Medical Monitoring Project, a population-based HIV surveillance system, from 2013 to 2014. The data showed that 71% of all sexually active HIV-positive MSM had at least one test for syphilis in the past 12 months. In the past 6 months, only 43% had been tested, and the number dropped to 22% in the past 3 months.

Researchers also examined the frequency of testing in MSM who reported risk factors, including having condomless sex and having sex with two or more partners.

Read the full article.

To find free syphilis testing near you, search by zip code on the CDC testing Website: gettested.cdc.gov

For more information about syphilis, its symptoms and treatment, click here.

Here’s how to get good healthcare as a queer person

From Seventeen.com

Navigating the healthcare world as a queer person can be tricky, which is why HERE asked aspiring healthcare professionals who have *been there* to share their advice for how to make trips to the doc work best for you. A little about this duo: Mia is enrolled in an accelerated nursing program and Maggie is taking pre-requisites for a future degree in occupational therapy. And one thing that they agree on is that their roles as future providers will be heavily influenced by their experiences as queer patients. “Now in our early 20’s, we have grown up navigating doctors’ visits and other healthcare experiences that were not always LGBTQ+ friendly, if we even ‘outed’ ourselves to our doctors at all,” says Mia. “In reflecting on some of these experiences, we’ve realized how important and rewarding, albeit difficult, advocating for your own care can be.”

Here are their tips for getting proper healthcare as a queer person.

 

 

Bisexual men have higher risk of heart disease

From Medical Daily

The research team analyzed data on 7,731 male participants between the ages of 20 to 59. They were divided into four groups based on their sexual identities: gay men, heterosexual men, bisexual men, and heterosexual men who have sex with men.

The two objectives of the study were to examine heart disease diagnoses among men of different sexual orientations and also measure their modifiable risk factors for heart disease.

While no correlation was found between sexual identities and heart disease diagnoses, bisexual men were found to have higher rates of several risk factors for heart disease compared to heterosexual men. These included mental distress, obesity, elevated blood pressure, etc.

The other three groups were found to have similar heart disease risk. The only difference observed in health behavior was that gay men reported lower binge drinking than straight men.

“Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of men and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in bisexual men,” said lead author Billy Caceres, an adjunct faculty member at Rory Meyers College of Nursing, New York University.

Read the full article.

Gay men experience more depression and suicide

From Psychology Today

It’s well known to the point of stereotype that gay men experience higher rates of HIV, substance abuse, and suicide. But it’s less known, and hardly talked about, that we also have much higher rates of depression, especially those of us living with HIV, despite the causal relationship of depression and self-medicating and self-harming behavior.

You might call depression the big gray elephant in the room staring us in the face as we do our best to ignore it.

The 2013 fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual  (DSM) defines depression clinically as a depressive mood or loss of interest or pleasure in nearly all activities over a two-week period, along with four of these symptoms: “changes in appetite or weight, sleep, and psychomotor activity; decreased energy; feelings of worthlessness or guilt; difficulty thinking, concentrating, or making decisions; or recurrent thoughts of death or suicidal ideation or suicide plans or attempts.”

Although depression affects both men and women, men kill themselves at rates four times higher than women. Of the 41,149 suicides in the U.S. in 2013, nearly 80 percent were men.

[…]

An American study of gay men found that those who perceived increased homophobia and danger were more likely to report depressive symptoms. Feeling unaccepted and rejected by the gay community—as do too many gay and bisexual men of color and those living with HIV—were also found to increase the risk for depression.

Read the full article.

Thousands gather Downtown as Pittsburgh shows its Pride

From the Pittsburgh Post Gazette

Members of the LGBTQ community and supporters came out in full force Sunday for the EQT Equality March and Pride Fest in Downtown Pittsburgh — events that celebrate gay rights.

This year’s parade had an attendance of tens of thousands. At one point, an announcement over the loudspeaker said this year’s parade was larger than the city’s St. Patrick’s Day festivities. It also was supported by a number of corporate sponsors and religious organizations.

Click here to go to the Post Gazette Video

“To see all these companies coming out and supporting us indicates there is more inclusiveness in the workplace,” said Craig Skvarka, 42, of Banksville. “There were a few [corporate sponsors] in years past. But there are more now.

The Pride march is an opportunity for people in the gay community to express their individuality. The streets were teeming with rainbow colors — representing the coming together of different sexual orientations — worn on capes, T-shirts and flags.

“It’s a way of expressing who we really are and allowing everyone to be comfortable in Untitled-3our own skin,” said Alayna Mott, 23, of Ambridge. “It means a lot to me because I am part of this community and I feel accepted by all around me.

See the video and read the article here.