PrEP and Beyound: HIV/AIDS & Black, Gay Men

From ebony.com

By Terrence Chappell

HIV PrEP and Black gay menLast month, a new study conducted by the Kaiser Permanente Medical Center in San Francisco found that 100% of study participants taking the HIV prevention pill Truvada as a pre-exposure prohylaxis (PrEP) remained infection-free when engaging in sex with high-risk partners.

While the new study is a tremendous step in the right direction in the fight against HIV and AIDS, Black men who have sex with men (MSM) are still significantly over represented in new HIV infections. According to the Centers for Disease Control (CDC), African Americans are the group that’s most affected by HIV, and the rate of new HIV infection is eight times higher for African Americans than Whites.

Advocate, an LGBT media outlet, reports that although gay men are 40 times more likely to contract HIV than the general population, that number launches to a whooping 72 times more likely among Black, gay men. If not treated properly, HIV can lead to AIDS. In 2013, of the estimated 14,611 gay and bisexual men diagnosed with AIDS, 40% were Blacks/African Americans; 32% were Whites, and 23% were Hispanic/Latinos according to the CDC.

Simply put, long-term PrEP  needs to reach the community’s most at-risk people. Howard Brown Health Center in Chicago, one of the nation’s largest LGBTQ health services organizations, recognizes the gap for Black MSM.

“Howard Brown Health Center (HBHC) is committed to providing PrEP access, navigation and counseling services to help HIV negative people stay negative,”  said Kristin Keglovitz, Howard Brown’s Chief Operations Officer. “This is particularly true for Black men who have sex with men, a population that experiences disproportionate rates of HIV infection and barriers to access quality healthcare services.”

There’s no ONE reason why cases of HIV infection are skyrocketing among Black men who sleep with men. It’s a holistic mix of stigma, access, and lack of awareness that form the perfect storm.

Stigma doesn’t always have to be attributed to family and friends. Healthcare-related stigmas often lead to mistrust and medical visit gaps. The American Journal of Public Health published an article in its February 2015 issue titled: “The role of stigma and medical mistrust in the routine healthcare engagement of Black men who have sex with men.” The piece focused on a study that sampled 544 Black MSM attending a community event. Of the 544 participants, 29% reported experiencing racial or sexual orientation discrimination from their healthcare providers, and 48% reported an overall mistrust of medical establishments.

 

University of Pittsburgh launching study to determine ways to promote health among aging gay and bisexual men

From NewsMedical.net

Dr Ron Stall at the University of Pittsburgh Grad School of Public Health

Dr Ron Stall at the University of Pittsburgh Grad School of Public Health

As the U.S. reaches an important milestone this year in the fight against HIV with more than half the people living with the virus older than age 50, the University of Pittsburgh Graduate School of Public Health is launching a study to determine ways to promote health among aging gay and bisexual men, who make up about two-thirds of the people aging with HIV.

In an effort to create strategies for use in public health outreach nationwide, the research team will be taking an innovative approach to the study by looking for protective factors – called “resiliencies” – that are helping keep some men with HIV healthy and could be extended to other men, rather than simply fixing health problems as they arise. This research is funded with a three-year, $2.1 million grant from the National Institutes of Health (NIH).

“We celebrate that medications now exist to enable people with HIV to live well into old age,” said study principal investigator Ron Stall, Ph.D., M.P.H., director of the Center for LGBT Health Research at Pitt Public Health. “But we also need to recognize that the health complications that come with aging – both mental and physical – are compounded when you’re living with HIV. It is critical that we develop research-based programs to support HIV-positive people as they age.”

Read the full article.

People with HIV are at higher risk of several types of cancer, large study finds

From aidsmap.com

People living with HIV remain at risk of AIDS-defining cancers in the era of effective antiretroviral therapy, and also have higher rates of several non-AIDS cancers than the general population, including lung, anal and liver cancer, according to findings from a study of more than 86,000 HIV-positive people published in the October 6 Annals of Internal Medicine.

Since the advent of effective combination antiretroviral therapy (ART) in the mid-1990s, rates of the three AIDS-defining cancers – Kaposi sarcoma, non-Hodgkin lymphoma and cervical cancer – have fallen among people with HIV. These cancers are caused by opportunistic viruses that can take hold when the immune system is damaged and CD4 T-cell counts are low, though human papillomavirus (HPV) also causes cervical and anal cancer in otherwise healthy people.

Most studies, however, have found that HIV-positive people have a higher overall risk for other non-AIDS-related cancers compared to HIV-negative populations, although data have been inconsistent about specific cancer types. In fact, cancer rates among people with HIV have risen over time as they live long enough to develop malignancies.

Michael Silverberg of Kaiser Permanente Northern California and fellow investigators evaluated trends in cumulative incidence of common cancer types by HIV status among participants in the large North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

Read the full article.

National Latino AIDS Awareness Day

National Latino AIDS Awarness DayOctober 15 is National Latino AIDS Awareness Day. Coordinated by the Latino Commission on AIDS, this day encourages Latino  communities to take action against HIV. This year’s theme,You and I Will Defeat AIDS (Tu y Yo Vamos a Derrotar al SIDA), is a call to action to work together to end the spread of HIV. It asks each of us to learn and share the facts about HIV, get tested, and stay in medical care if we are living with HIV.

And for good reason.

The Centers for Disease Control and Prevention (CDC) released the results of a recent study that confirms Latinos are diagnosed with HIV at a rate three times that of whites.

The report was featured in a recent issue of the CDC’s Morbidity and Mortality Weekly Report. Based on data from 2008 to 2013 on HIV diagnoses in the U.S. (and six “U.S. dependent areas” including Puerto Rico), the CDC concluded that although HIV infection rates went down for adult and adolescent Latinos overall, they increased three percent among Latino males who have sex with men. The rate of diagnosis—18.7 per 100,000—was nearly three times that of whites (6.6 per 100,000).

To find out more about National Latino AIDS Awarness Day, go to aids.gov. You can find free HIV testing near  you by searching by zip code at gettested.cdc.gov (Espanol)

Grindr, Scruff profiles now advertising use of PrEP

profiles advertise PrEPFrom the Advocate.com

Guys on Grindr and Scruff — two of the most popular gay hookup apps — recently started seeing profiles advertising the use of pre-exposure prophylaxis, or PrEP, which the Centers for Disease Control and Prevention last year recommended for gay and bisexual men at substantial risk for contracting HIV.

Jason Marchant, chief product officer of Scruff and one of the app’s founding partners, tells The Advocate he’s been on PrEP for two years and has listed it on his Scruff profile for over a year and a half. Marchant’s username is “Jason Scruff [PrEP].” Such is the way many Scruff users advertise their PrEP usage; including it in their usernames or in their written profile descriptions. But Scruff is about to make it easier to advertise PrEP adherence or find other users.

“Scruff 5, which will be launching on iOS devices in the next few weeks, will have two new profile metadata fields,” Marchant says. “One of them is sexual practices like top, bottom, versatile, oral, fetish, no sex, stuff like that. The second one is for safer sex practices like condoms, PrEP, and treatment as prevention.”

Read the full article.

To find out more about PrEP, check out the PrEP page on this Website.

‘Undetectable’ a new identity for gay men diagnosed with HIV

From aidsmap.com….
status: UNDETECTABLE

Achieving an undetectable viral load is a key milestone in the period after diagnosis with HIV, qualitative interviews with Canadian gay men suggest. Men incorporated knowledge of their own undetectable status into their identities as HIV-positive gay men and their sexual decision making, according to a study published in the August issue of AIDS Education and Prevention. Being undetectable helped many men feel ‘responsible’ and ‘normal’.

The findings come from in-depth, qualitative interviews with 25 gay men diagnosed with HIV in British Columbia, Canada between 2009 and 2012. All had acquired HIV less than a year before their diagnosis and half had been diagnosed with acute (very recent) infection. Up to four interviews were done, in order to see how experiences changed during the year after diagnosis.

Interviewees typically reported a period of sexual abstinence immediately after being diagnosed with HIV. During this period of adjustment, many men had no sex drive. Avoiding HIV transmission was a major concern for many, including this man:

“First of all, I killed my sex life. I was like, you know, I don’t want to infect anyone, I don’t want to take the risk and I don’t want to disclose, so the way of not doing is just not having sex.”

When participants did start to have sex again, they found themselves in an altered sexual landscape, facing new scenarios, challenges and possibilities. Faced with the difficulty of talking about having HIV with new partners, some sought out other HIV-positive men. Others avoided anal sex, even with condoms.

Learning that one’s viral load was undetectable could open up new possibilities:

“I didn’t play around when I was not sure… if I was undetectable or not. I didn’t play. They [sexual partners] would be open to it, but I didn’t want… Personally I didn’t feel comfortable, so I didn’t play until I was undetectable.”

Read the full article.

Awareness of treatment’s impact on transmission is transforming the lives of couples of mixed HIV status

From aidsmap.com

A greater understanding of the impact of HIV treatment on prevention is changing the experience of being in a relationship with a partner of a different HIV status, according to a qualitative Australian study published last week in the Sociology of Health and Illness. A biomedical intervention appears to be having unexpected effects – loosening the association of serodiscordant relationships with ‘risk’ and helping couples to experience their relationships as normal and safe.

Asha Persson of the University of New South Wales reports that people’s views about treatment as prevention have changed significantly in recent years. She previously researched the topic in 2009, soon after the ‘Swiss Statement’ was issued. At that time, people in a relationship with a partner of a different HIV status often expressed scepticism or uncertainty about the idea that HIV treatment could make a person non-infectious. They did not always see the relevance of the information to their own lives.

But in her more recent interviews, conducted in 2013 and 2014, couples readily discussed the implications of having an undetectable viral load. HIV treatment appears to be transforming the social and sexual lives of people living with HIV and their partners.

The research specifically focuses on so-called ‘serodiscordant couples’, in other words those in which one person has HIV and the other does not. The public health literature on serodiscordant relationships typically focuses on the risk of HIV transmission and tends to see such a relationship as inherently problematic. In contrast, Persson found that her interviewees wanted to stress how normal and positive their relationships were, with HIV being seen as ‘no big deal’.

Read the full article on aidsmap.com.