Why aren’t HIV prevention pills going to the people who need them?

From Rolling Stone online

When Truvada was introduced four years ago as a way to prevent HIV, public health leaders didn’t welcome the drug with open arms. The head of the AIDS Healthcare Foundation panned the once-daily pill as a “party drug.” Other health officials claimed that taking Truvada would cause a wave of wild unprotected sex. Even members of the LGBTQ community parroted the criticism, with one gay journalist (regretfully) labeling some users “Truvada whores.”

But the last four years has seen a shift in attitude. More andgetting-prep-to-people-who-need-it more Americans are embracing pre-exposure prophylaxis (PrEP), the HIV prevention method that requires a daily dose of Truvada to reduce viral risk. And more and more prescriptions are being written for the antiretroviral drug. While PrEP is growing in popularity, a new study out of the University of California released last month suggests that the populations most at risk of HIV infection are not the ones benefitting from the prevention strategy.

In a survey of gay and bisexual men in California, only a handful of participants reported having taken PrEP. PrEP use was highest among young white men, at 13.9 percent. For young Latino men, that figure was cut by more than half, while young black men represented less than 10 percent of people who started PrEP.

“This is not reflective of the HIV epidemic at all,” says Shannon Weber, founder of Please PrEP Me, an online directory of over 230 clinics in California that provide PrEP. “It is reflective about access, and where and how people are getting that information.”

Read the full article.

STDs at an all-time high in the U.S.

From CBSnews.com

Rates of sexually transmitted diseases in the United States continue to rise, and total combined cases of chlamydia, gonorrhea, and syphilis have reached the highest ever, according to a new report from the Centers for Disease Control and Prevention.

std-at-all-time-high-in-usThe data, released today, shows that in 2015, there were more than 1.5 million cases of chlamydia reported, nearly 400,000 cases of gonorrhea, and nearly 24,000 cases of primary and secondary (P&S) syphilis – the most infectious stages of the disease.

“We have reached a decisive moment for the nation,” Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a statement. “STD rates are rising, and many of the country’s systems for preventing STDs have eroded. We must mobilize, rebuild and expand services – or the human and economic burden will continue to grow.”

Researchers found that from 2014 to 2015, syphilis rates rose 19 percent, gonorrhea rates rose nearly 13 percent, and chlamydia increased by almost 6 percent.

These infections are normally curable with antibiotics – but there is growing concern about drug-resistant strains of gonorrhea that don’t respond to standard treatment.

In many cases, people with STDs continue to go undiagnosed and untreated, putting many at risk for severe health complications, including infertility, chronic pain and increased risk for HIV.

Young people and gay and bisexual men continue to be disproportionately affected by STDs. The data shows that Americans aged 15 to 24 accounted for nearly two-thirds of chlamydia diagnoses and half of gonorrhea diagnoses.

Gay and bisexual men accounted for the majority of new gonorrhea and syphilis cases.

The CDC also said it continues to see “troubling” increases in syphilis among newborns.

The syphilis rate among women increased by more than 27 percent from 2014 to 2015, while congenital syphilis – which occurs when the infection is transmitted from a pregnant woman to her baby – increased by 6 percent.

“The health outcomes of syphilis – miscarriage, stillbirth, blindness or stroke – can be devastating,” said Dr. Gail Bolan, director of CDC’s Division of STD Prevention. “The resurgence of congenital syphilis and the increasing impact of syphilis among gay and bisexual men makes it clear that many Americans are not getting the preventive services they need. Every pregnant woman should be tested for syphilis, and sexually active gay and bisexual men should be tested for syphilis at least once a year.”

To reverse this dangerous trend and stop the spread of STDs, the CDC says health care providers, state and local health departments, and the public all need to play a role.

“We should all learn to talk more openly about STDs – with our partners, parents, and providers,” Bolan said. “People who are sexually active should talk to their medical providers about getting tested and reducing their risk by using condoms or practicing mutual monogamy. It is critical that providers ask about their patients’ sexual history and ensure STD screening is a standard part of medical care.”

NIH awards $7.9 million to test mobile HIV prevention app for young gay and bi men

From the Rainbow Times

1The National Institutes of Health (NIH) has awarded a $7.9 million grant to the Columbia University School of Nursing to test an HIV prevention mobile app specifically developed for high-risk young men. In the five-year project, Columbia researchers will adapt and test a new mobile version of MyPEEPS, an existing HIV education intervention that covers topics including correct condom use, dealing with stigma and shame, and communicating effectively about safer sex. MyPEEPS Mobile will be a web-based version of the intervention that will be accessible by mobile and desktop devices and that will feature games, videos, and interactive scenarios. The app will be evaluated in a randomized controlled trial involving 700 racially and ethnically diverse 13- to 18-year-old men with HIV-negative or unknown status at four geographically diverse sites: Birmingham, Alabama; Chicago, Illinois; New York, New York; and Seattle, Washington.

“Our aim is to provide this population with information to make better health decisions,” says Rebecca Schnall, a co-principal investigator for the project. “Young, diverse MSM are the most at-risk for HIV infection, and there is a dearth of evidence-based interventions targeting this community. There is much evidence that mobile tech is a great way to connect with this generation. By meeting them where they are, we are hopeful about the intervention’s potential to decrease infections.”

Carnegie Mellon University recruiting HIV-negative individuals at risk of getting HIV

carnegiemellonuniversity_wordmarkSocial scientists at Carnegie Mellon University are recruiting HIV-negative individuals who are at risk of contracting HIV for one-hour interviews about their daily lives, their view on their personal HIV risk, and their thoughts about the costs, risks and benefits of taking PrEP.

You are eligible to participate if you:

Are HIV negative and between the ages of 18-60, AND;

* Have had sex without a condom in the last 6 months, OR
* Have been diagnosed with a sexually transmitted infection within the last 6 months, OR
* Use a needle to inject drugs

All participants will receive $50 cash.

This study is sponsored by the Center for Inclusion Health at Allegheny Health Network

For more information or to schedule an interview, contact: 

The PrEP Study
Phone: 412-336-8993

‘His Health’ is a new platform helping doctors tackle implicit bias in treating Black gay men

From OUT.com

While the threat of HIV/AIDS has decreased significantly thanks to advances in antiretroviral therapy, treatment as prevention, and pre-exposure prophylaxis (PrEP), black men who have sex with men (MSM) are still affected at a disproportionate rate.

In February, the CDC released an eye-opening study which claimed at the current rate of infection, one in two black MSM will contract HIV in his lifetime.

4605712d88d88917ae31f918cee6fbaaOne of the reasons for the virus’s prevalence in the black community is a lack of quality healthcare. The National Alliance of State and Territorial AIDS Directors (NASTAD) is addressing this with a new online training platform, HisHealth.org. His Health aims to help doctors, nurses, and medical professionals unlearn racial bias and elevate the quality of healthcare for black MSM.

Recent research found that white healthcare providers harbored “implicit or “subconscious” bias to patients of color which led to their patients receiving inferior care. Furthermore, LGBT people can often face stigma or discrimination in access to healthcare as well as unique health challenges their providers are not always apt to deal with—for instance, one in three primary care physicians and nurses have never even heard of PrEP. And that’s certainly not helping the 60 percent of gay and bi men who don’t know that PrEP can help prevent the transmission of HIV.

According to a press release, His Health does the following:

– Provides accredited and expert-led continuing education courses that count towards the credits medical professionals already need to maintain their medical licensure.

– Offers portraits of innovative models of care including Project Silk—a CDC funded, Pittsburgh-based recreational safe space and sexual health center rooted in house ball culture—and Connecting Resources for Urban Sexual Health, a sexual health clinic created by and for LGBTQ youth of color.

– Gives easy access to evidence-based resources to support the delivery of high quality, culturally affirming healthcare services for black men who have sex with men.

“There is a lot of discussion right now about implicit bias and police brutality in the U.S.—but the truth is, this is a huge challenge for health care providers as well,” said Omoro Omoighe, Associate Director of Health Equity and Health Care Access at NASTAD.

“We know doctors and nurses desperately wish to offer culturally affirming healthcare that is stigma-free to black LGBT patients. With the advent of His Health, they now have the tools necessary to tackle implicit bias and feel more confident in their ability to uplift the standard of care for black gay men while maintaining their licensure to practice medicine.”

For more on His Health, click here.

Why the HIV battle continues for gay men

From the Huffington Post

Ace Robinson
Global Health Policy Analyst

September 27th was National Gay Men’s HIV/AIDS Awareness Day. It’s the day that approximately 80 gay and bisexual men will become infected with HIV. Thirty (30) of those men will be Black. Twenty-five (25) will be White and twenty-one (21) will be Latino. Some of those men will find out about their status very early, will be engaged in competent healthcare, and will live a full productive life while managing this chronic illness. But to this day, that will be the exception and not the rule.

Ace Robinson   Global Health Advocate Focused on Reducing the Impact of Infectious Diseases on Marginalised Populations

Ace Robinson
Global Health Advocate Focused on Reducing the Impact of Infectious Diseases on Marginalized Populations

Like just about all viral illnesses life the flu, treating HIV right away and staying on treatment will not only stop you from getting sicker, but stop you from being able to transmit that virus to others. The same is true for HIV. Last month, Dr. Carl Dieffenbach, Director of the Division of AIDS at the National Institutes of Health confirmed what global experts had been saying for years: “Once you begin therapy and you stay on therapy…you are NOT capable of transmitting HIV to a sexual partner.” It is called Treatment as Prevention (TasP). That is excellent news. But that is only true for 30% of Americans. The vast majority of People Living with HIV (PLWH) are not benefitting from the advances in treatment due to not knowing their HIV status, lacking access to care and treatment, lacking social support, or a mix of all the above.

Of those infected each day in the United States, two-thirds are gay and bisexual men. In vast parts of the USA, gay and bisexual men do not receive the type of needed support to access and stay on treatment which puts them at risk for HIV progression and potentially transmitting the virus to another person. Due to homophobia, some men do not have support from their families, have reduced access to jobs and housing, and have had poor experiences in healthcare settings. That creates the perfect storm for the continued epidemic that has gripped this globe for over 35 years.

Today, we live in an age that PLWH can live nearly their entire expected life span IF they receive sustained treatment. We also live in an age that people can take a daily pill (PrEP) that can prevent HIV infection before exposure. And if that is not enough, we also live in an age that people can take a course of treatment that can prevent HIV infection after exposure(PEP).

But what good does TasP, PrEP, and PEP do if people most at-risk for infection are not aware of it. They are really just a jumble of letters. In my circles, it seems that everyone know about these things. But that’s not the norm. For so many, there is nearly no knowledge of these ways to treat and prevent HIV. A couple of weeks ago, I was in southern Georgia visiting my mother and we went on a mini-vacation to Jekyll Island. I was chatting with a young Black gay man who worked at the local hotel. Eventually, we started chatting about what I do and I off-handedly starting rambling on about PrEP and PEP. If you could have seen the look on his face, you would have thought that I had told him that aliens had landed in Times Square. For that young man, we had failed him. He should have known sooner.

The HIV prevention and treatment toolbox is filling faster today than ever before. But not everyone knows what is in it. Awareness, advocacy, and access will be the ultimate tools in the HIV toolbox to ultimately end HIV in mine and others’ communities. We must strive to continue not only raising awareness, but also advocating for access for gay men who have been disproportionately impacted by HIV for far too long.