Overwhelming evidence shows HIV undetectable = untransmittable

From Gay Star News

HIV positive people with an undetectable viral load cannot sexually transmit HIV. That’s the unequivocal conclusion from one of the leading health agencies in the US.

Researchers from the National Institute of Allergy and Infectious Diseases (NIAID) undertook a review of recent research. Their conclusion is simple: Undetectable = Untransmittable (U=U). It’s the same message now backed by over 300 health agencies all around the world.

The results of the NIAID review were published yesterday in the Journal of the American Medical Association (JAMA). One of the reports co-authors is NIAID Director, Dr Anthony Fauci. He is widely regarded as one of the world’s leading HIV experts.

In a statement, NIAID called evidence for Undetectable = Untransmittable ‘overwhelming’. Not only does getting those diagnosed with HIV on to Antiretroviral Therapy (ART) ensure their long term health. But it also significantly reduces HIV transmission rates. This is because those with the virus suppressed in their body cannot pass it on.

The authors pointed to research that looked at over 77,000 examples of condomless sex between serodiscordant male couples. One half of the couple had HIV and the other did not. There was not a single transmission of the virus from the HIV positive person to the negative person.

Read the full article.

HIV infections among black gay men taking PrEP, probably due to poor adherence

From aidsmap.com

Awareness and use of HIV pre-exposure prophylaxis (PrEP) among black gay, bisexual and other men who have sex with men (MSM) in the United States increased significantly between 2014 and 2017, according to research published in the 1 November edition of the Journal of Acquired Immune Deficiency Syndromes. The study also showed that PrEP was reaching individuals with high levels of sexual risk, sexually transmitted infections (STIs) and substance use, the very individuals most in need of this highly effective form of HIV prevention.

However, HIV prevalence was significantly higher among PrEP users compared to individuals who were not on PrEP. The investigators stress this does not show PrEP failure but is likely due to factors such as poor medication adherence and lack of engagement with healthcare providers.

“It is imperative to recognize that our findings reflect challenges to maintain proper usage of PrEP rather than biological failure of PrEP to protect against HIV,” write the authors. “HIV infections that have occurred among PrEP users are the result of suboptimal levels of drug concentrations because of challenges in adhering to PrEP medical regimens.”

Black MSM account for the largest proportion of new HIV infections in the US. If current epidemiological trends continue, 60% of black MSM will be HIV positive by the age of 40. Tackling the HIV epidemic among black MSM is therefore an urgent public health priority.

Read the full article.

New STDs emerging

From the New York Daily News

The first worrisome pathogen is Neisseria meningitides, a bacteria that “can cause invasive meningitis, a potentially deadly infection of the brain and spinal cord’s protective membranes,” the health website Mosaic informs us. “More commonly, it’s gaining a reputation as a cause of urogenital infections.”

N meningitides resides in the back of the nose and throat of between 5% and 10% of adults, the site said. There’s a chance people can transmit the bacteria via oral sex or deep kissing.

In 2015, Mosaic said, the bacterial strain mixed with the closely related N gonorrhoeae, which causes gonorrhea — a mutation that allowed the disease to spread more readily.

On the upside, vaccines are available that can protect against all five strains of the gonorrhea bacterium.

Second on the list is Mycoplasma genitalium, one of the world’s smallest bacteria. Between 1% and 2% of people are infected, most of them teens and young adults. Many times it doesn’t cause symptoms, but it can irritate the urethra and cervix, just as gonorrhea and chlamydia do. In women this can lead, like chlamydia, to pelvic inflammatory disease and its associated potential for infertility, miscarriage, premature birth and stillbirth.

While antibiotics exist that will eradicate it, resistant strains are developing, which means it could morph into a superbug.

Third on the list is Shigella flexneri, which one contracts from feces. Shigellosis is one of the bacteria causing dysentery, so is not exclusively contracted via sexual contact. But it might have found a new avenue in anal-oral sex, reported Medscape and the CDC. And given that it is becoming resistant to azithromycin, which also treats gonorrhea, the potential for a superbug is there.

Lymphogranuloma venereum (LGV) is number four on the emerging-STD list, caused by acute Chlamydia trachomatis strains. Its incidence is increasing in Europe and North America, especially among gay and bisexual men, Mosaic reports. A 2016 CDC report documented a cluster of cases among men having sex with men in Michigan. Its symptoms can be subtle, with a fast-disappearing lesion in the genital area, but they can also be even less noticeable, according to the CDC.

Who we are…

m4mHealthySex.org is a joint effort between the HIV Prevention and Care Project and the Pitt Men’s Study at the Graduate School of Public Health, University of Pittsburgh. Our goal is to provide up-to-date sexual health information for men who have sex with men. Page links include information about free HIV and STD testing, referrals to LGBTQ-friendly care providers, and information about PrEP.

Scroll down for the most recent news and information about sexual health. Or click on links from the menu above to find health resources in Pennsylvania.

HIV strikes Black gay men more, despite safer behaviors

Young black gay men are 16 times more likely to have HIV than whites, even though they have fewer partners, have less unsafe sex, and get tested for HIV more often, a new study shows.

“Our study illuminates how HIV disparities emerge from complex social and sexual networks and inequalities in access to medical care for those who are HIV-positive,” said senior study author Brian Mustanski. He is director of the Northwestern Institute for Sexual and Gender Minority Health and Wellbeing at Northwestern University’s Feinberg School of Medicine in Chicago.

“Their social and sexual networks are more dense and interconnected, which from an infectious disease standpoint makes infections transmitted more efficiently through the group,” Mustanski explained in a university news release.

“That, coupled with the higher HIV prevalence in the population, means any sexual act has a higher chance of HIV transmission,” he added.

If this trend continues, 1 out of every 2 black gay men will become infected with HIV at some point in life, compared to 1 in 5 Hispanic gay men and 1 in 11 white gay men, according to the U.S. Centers for Disease Control and Prevention.

In the study, researchers analyzed data from more than 1,000 gay men, aged 16 to 29, in Chicago.

Among their other findings: black gay men were less likely to have close relationships with their sexual partners, more likely to have hazardous marijuana use, and more likely to have experienced more stigma, trauma and childhood sexual abuse. White gay men were more likely to have alcohol problems.

The study was published Dec. 4 in the Journal of Acquired Immunodeficiency Syndromes.

For more information, check out the U.S. Centers for Disease Control and Prevention.

Help combat HIV in Pennsylvania by volunteering your feedback to the Department of Health

The Pennsylvania Department of Health and the HIV Prevention and Care Project (HPCP) are looking for community members interested in HIV prevention, education, and treatment; We need people affected by HIV and AIDS to provide feedback regarding the state’s efforts in combating HIV/AIDS.

As part of the HIV Prevention and Care Plan, our goals include reducing new HIV infections, increasing access to care, improving health outcomes for people living with HIV, and reducing HIV-related disparities and health inequalities.

As a community member effected by HIV, your feedback regarding the plan will help provide a road map in meeting the goals set out by the State Department of Health and the National HIV/AIDS Strategy. Volunteering can involve reading a short paragraph and providing feedback or just completing a brief survey.

For more information, and to find out how to get involved, check out the most recent copy of the Pennsylvania HV Prevention and Care News Bulletin and click on the Join Our List button.

You can also contact Daniel Hinkson at dlh49@pitt.edu for more information about the HPCP, the Prevention and Care Plan, and how to volunteer.

Your voice can make a difference!

When it comes to prostate cancer, ‘gay men are erased,’ patients say

From NBC News

Prostate cancer is the most prevalent invasive cancer among men, affecting nearly one in eight at some point in their lives, according to the Centers for Disease Control. But the unique challenges facing gay and bisexual men with prostate cancer have largely gone unaddressed.

Men who have sex with men (MSM) are less likely to get regular prostate cancer screenings, and those who are diagnosed are less likely to have familial and social support, according to research cited by the National Institutes of Health. And if their health care provider is not culturally competent, gay and bisexual men are much less likely to understand how treatment will impact their quality of life.

“Those in large metropolitan areas may have the option of searching for an LGBT-welcoming provider, but most Americans don’t have a choice about who treats them.”

“Many LGBT people enter their cancer treatment wary,” Liz Margolies of the National LGBT Cancer Network told NBC News. “Those in large metropolitan areas may have the option of searching for an LGBT-welcoming provider, but most Americans don’t have a choice about who treats them.”

As a result, Margolies added, many lesbian, gay, bisexual and transgender patients go back in the closet when they begin cancer treatment. Even if they don’t, providers often don’t ask about patients’ sexual behavior or identity, forcing them to bring the subject up themselves — sometimes again and again with each new specialist.

Read the full article.