Research may explain the connection between substance use and sexual risk taking in gay men

From GoodTherapy.org:

substance use and sexual risk taking Several associations between substance use and risk taking have been clearly established in psychological and behavioral research. Among them is the trend for sexual risk taking in individuals who misuse substances, including alcohol and drugs. The negative health consequences of both substance use and sexually risky behavior are significant. For gay and bisexual men, the risk of sexually transmitted diseases and HIV are especially high. One theory for uninhibited sexual activity is the alcohol myopia theory, which suggests that alcohol intoxication creates a short-range outlook relying on immediate stimulation. In other words, intoxicated individuals don’t always look at a person’s morals or personality when considering sex. Instead, they look for instant gratification.

Some experts believe that drug and alcohol misuse and addiction impair executive functioning (EF), resulting in higher rates of impulsivity and skewed reward motivation processes. In an effort to determine if EF contributes to sexual risk taking, Sarit A. Golub of the Department of Psychology at Hunter College of the City University of New York led a study examining the EF of 104 bisexual and gay men, all of whom had a history of substance misuse and were HIV negative. Golub conducted neurological and psychological tests on the participants and evaluated their levels of substance use and sexual activity in the 30 days preceding the interview.

She discovered three unique classifications of EF. They included poor performing, indicated by impairment in some, but not all tasks, low performing, indicated by impairment across all tasks, and high performing as evidenced by successful performance on all tasks. Although all three classes had the same levels of substance misuse, substance dependency was highest among the low performing group. These individuals also reported the highest levels of sexual risk taking. In contrast, the poor performing group, which only exhibited EF deficits on the Iowa Gambling Task, had the lowest levels of risky sexual behavior. The results from the high-performing group suggested that the link between substance misuse and sexually risky behavior was episodic and not chronic. Golub added, “These findings underscore the importance of identifying different EF subtypes—rather than simply examining specific EF tasks individuals—in the development of interventions to reduce risk behavior among substance users.”

GoodTherapy.org is an association of mental health professionals from over 30 countries worldwide who support efforts to reduce harm in therapy.

International health panel says treat all HIV infections

From “Gay Today“…

An international health panel has recommended for the first time that all HIV patients be treated with antiretroviral drugs, even when the virus’s impact on their immune system is shown to be small.

The nonprofit International Antiviral Society-USA cited new evidence that untreated infection with the human immunodeficiency virus that causes AIDS can also lead to a range of other conditions, including cardiovascular disease and kidney disease. In addition, data have shown that suppressing HIV reduces the risk of an infected person passing the virus to another person.

“We are no longer only focused on traditional AIDS-defining infections. We know that HIV is doing damage to the body all the time when it is not controlled,” said Dr. Melanie Thompson, principal investigator of the AIDS Research Consortium of Atlanta and a member of the Antiviral Society panel.

The recommendations are global, but mainly aimed at “resource-rich” countries who can cover the cost of the medications, she said. The guidelines were published in the Journal of the American Medical Association at the start of the International AIDS Society’s 2012 conference, which runs from Sunday through Friday in Washington, DC.

Go to Gay Today for the full article.

Rutgers is looking for a few good men

From G PHILLY online:

In May, President Obama came out in support of gay marriage. And while it’s a big step for the LGBT community, not everyone is quite so supportive (remember that recent legislation in North Carolina?). That’s why the Healthy Development Lab at Rutgers University in Camden has been studying diversity in adult relationships for nearly a decade now.

For the most recent study, the university is seeking gay male couples to better understand how men’s same-sex partners influence their health, especially their eating behaviors.

Very little research, says Rutgers, has examined men and their same-sex partners in relation to health, nutrition and well being. The study lasts two hours – and couples get paid $100.

“Participants in our research routinely say that the experience is fun, interesting and provides an opportunity to learn more about their partners,” says Hanna Garrity, a spokesperson for the study.

If you or a gay male couple you know are interested, click here to apply for the study. Or email the lab directly: RUHealthyLab@gmail.com

FDA gives green light to OraQuick in-home HIV test

Health regulators on Tuesday said they approved OraSure Technologies Inc’s in-home test for HIV, making it the first over-the-counter, self-administered test for the virus that causes AIDS.

The Food and Drug Administration gave its green light to the OraQuick In-Home HIV Test, which within 20 to 40 minutes provides results from an oral fluid sample taken by swabbing the upper and lower gums inside the mouth.

The company said the test — already approved for use by trained technicians — will be available starting in October at more than 30,000 retailers and online. The price will be set closer to the launch date, it said.

The FDA cautioned that a positive result does not mean an individual is definitely infected with HIV, but rather that additional testing should be done in a medical setting to confirm the result.

About 1.2 million people in the United States are living with HIV infection, but one in five are not aware of it, according to estimates from the Centers for Disease Control and Prevention. About 50,000 new people are infected with HIV each year, often from people who may not know they have the virus, the FDA said.

“Knowing your status is an important factor in the effort to prevent the spread of HIV,” said Dr. Karen Midthun, director of the FDA’s Center for Biologics Evaluation and Research. “The availability of a home-use HIV test kit provides another option for individuals to get tested so that they can seek medical care, if appropriate.”

An FDA advisory committee of outside experts voted unanimously in favor of the test in May, saying its ability to prevent new HIV infections and link people to medical care and social services outweighed the risk of false results.

Clinical trials for the test showed it was accurate 92 percent of the time in diagnosing people who had HIV — meaning one out of every 12 test results would be a false negative.

False negatives are of particular concern because they could lead HIV-positive individuals to take fewer precautions, raising the danger that they will engage in unprotected sex.

The test accurately gave a negative result for those without HIV in 99.98 percent of cases, meaning there would be only one false positive result out of every 5,000 tests.

“We set out with a clear purpose – to dramatically impact the number of people getting tested for HIV nationwide,” Douglas Michels, OraSure’s chief executive, said in a statement.

“Today’s FDA approval of OraQuick brings us much closer to accomplishing that goal.”

(Reuters) – (By Bill Berkrot and Anna Yukhananov; Reporting by Bill Berkrot in New York and Anna Yukhananov in Washington; Editing by Maureen Bavdek, Jim Marshall and John Wallace)

CDC trying free HIV tests in drugstores

ATLANTA (AP) _ Getting an AIDS test at the drugstore could become as  common as a flu shot or blood pressure check, if a new pilot program takes off.

The $1.2 million program will offer the free rapid HIV tests at pharmacies and in-store clinics in 24 cities and rural communities, the Centers for Disease Control and Prevention announced Tuesday.

“We believe we can reach more people by making testing more accessible and reduce the stigma associated with HIV,” Dr. Kevin Fenton, who oversees the agency’s HIV prevention programs, said in a statement.

The tests are already available at seven places, including Washington, D.C., Oakland, California, and an Indian health service clinic in Montana. The CDC will soon pick 17 more locations.

The HIV test is a swab inside the mouth; it takes about 20 minutes for a preliminary result. The test maker says it’s correct 99  percent of the time. If the test is positive for the AIDS virus, pharmacy employees will refer customers to a local health department or other health care providers for a lab blood test to confirm the results, counseling and treatment. The workers are expected to deliver the news face-to-face and give customers privacy, the CDC said.

An estimated 1.1 million Americans are infected with HIV, but as many as 20 percent of them don’t know they carry the virus, according to the CDC. It can take a decade or more for an infection to cause symptoms and illness.

Since 2006, the CDC has recommended that all Americans ages 13 to 64  get tested at least once, not just those considered at highest risk: gay men and intravenous drug users. But fewer than half of adults   younger than 65 have been tested, according to the agency’s most recent statistics.

It’s important to know about infection not only for treating the condition but also to take steps to prevent spreading it to others. An HIV diagnosis used to be a death sentence, but medications now allow those infected to live longer and healthier lives.

On special occasions, health organizations have sent workers to some  drugstores to offer HIV testing. This week, Walgreens, the  nation’s  largest chain of pharmacies, is teaming with health departments and AIDS groups to offer free tests in 20 cities.

But in that program, health professionals conduct the tests and deliver the news. The CDC program aims to train pharmacy staff to test and deliver the results themselves.

“I’m excited. It’s such a new and novel thing for us,” said  Sarah  Freedman, who manages a Walgreens in Washington, D.C., that is participating in the pilot program.

At her pharmacy, prominent signs advertise the test, which is then done in a private room. The pharmacy has also taken steps to let a   customer discreetly request the test, putting out stacks of special test request cards (they look like business cards) at George Washington University and nearby businesses. Anyone seeking a test can simply hand the card to the clerk, she said.

Only three or four customers have gone through with a test in the first few weeks.

“We get a lot of questions,” she said. “Usually they get the information and they go and sit on it and think about it.”

The drugstores are expected to keep the test confidential.  Pharmacy workers are to refer customers with positive tests to counseling and other services.

When the project ends next summer, CDC officials will analyze what worked well and what didn’t, said Paul Weidle, the epidemiologist who is heading up the project.

The program carries both promise and potential pitfalls, said Julie Davids, a longtime advocate who now works for the AIDS Foundation of Chicago.

More testing is a plus, she said. And even if they don’t get a free test, signs in the drugstores may prompt people to get tested at a doctor’s office or clinic where they feel more comfortable, said Davids.

But Davids said pharmacies more used to handling cholesterol screenings might have difficulty responding to patients who learn in a drugstore they’re HIV-positive.

“A person may freeze up and fall apart later,” or get emotional on the spot and even talk about suicide, she said.

In addition to Freedman’s store, a second Walgreens in Washington is  offering the test, as well as branches in Chicago and Lithonia, Georgia. The other sites are East Pines Pharmacy in Riverdale, Maryland, Mike’s Pharmacy in Oakland, California and a federal Indian Health Service location in Billings, Montana.

Each location will get enough tests to check 200 to 300 people.  Made  by OraSure Technologies Inc., the $17.50 test is the only government-approved rapid HIV test that uses saliva. Other rapid tests on the market analyze a finger-prick blood sample. The tests are used   routinely in doctor’s offices, hospitals and clinics.

The OraSure swab test’s stick-like testing device is used to wipe the inside of the mouth, then it is put in a solution, said company spokesman Ron Ticho. If two lines appear, that indicates a positive test.

The company is seeking government approval to sell it over-the-counter for home testing. A decision is expected later this year.

The test is sold in about 40 countries, including Mexico, Italy, South Korea and South Africa. Ticho said he is not aware of another country where pharmacies routinely offer the testing.