CDC’s Act Against AIDS initiative recently launched Prescribe HIV Prevention, a new initiative for healthcare providers that focuses on HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). The target audience includes primary care providers, infectious disease and HIV specialists, nurses, and public health practitioners.
PrEP is a way for people who are HIV-negative but at high risk for getting the virus to prevent HIV infection by taking a pill every day. PrEP is highly effective when taken as prescribed. PEP is the use of antiretroviral drugs after a single high-risk event to prevent HIV. It must be started within 72 hours of a possible exposure.
Prescribe HIV Prevention educates providers and patients about these biomedical prevention tools and encourages providers to consider PrEP and PEP for patients at high risk for HIV. It includes resources such as a guide for discussing sexual health with patients, brochures and posters to educate patients about PrEP and PEP, continuing medical education programs, and a medication guide for patients.
An online self-help intervention is effective in the treatment of mild to moderate depressive symptoms in people with HIV, according to a randomized clinical trial conducted in the Netherlands and published in the September issue of The Lancet HIV.
The trial compared the outcomes in a group who received the online self-help intervention and a control group. The internet-based intervention, available in Dutch and English, consisted of a cognitive behavioral therapy program called “Living Positive with HIV” and developed from a self-help booklet that had previously proved effective in decreasing depressive symptoms. Participants also received minimal telephone coaching by a Masters student in psychology. The control group received the telephone coaching and could access the online intervention after the trial was completed.
Sanne van Leunen and colleagues randomly assigned 188 eligible participants to the intervention (97) or the control group (91) in 2015. Depression was assessed at baseline, Month 2, Month 5 and Month 8 (the control group did not take the last assessment).
As detailed below, results show that more participants in the intervention group than in the control group demonstrated significant change in their symptoms and that this effect was maintained for six months. Anxiety symptoms were also decreased. No adverse events were reported, the rate of satisfaction with the intervention was high, and most participants reported that they would recommend “Living Positive with HIV” to others.
[A]ccording to US research published in Sociology of Health & Illness. A series of focus groups conducted in New York City showed that some men regarded PrEP users as irresponsible, naïve, vectors of disease and a social problem. In contrast, other men articulated PrEP as a beneficial new option for preventing the spread of HIV, and also had a nuanced view about the effectiveness of condom-based prevention campaigns and the epidemiology of sexually transmitted infections (STIs) among gay and bisexual men.
“By framing PrEP use as enabling gay and bisexual men to violate subcultural norms of sexual etiquette espoused in previous HIV prevention efforts, claims makers were able to present PrEP users as social problem villains,” write the authors. “Countering claims makers’ framing PrEP as a social problem, some men constructed PrEP as a helpful prevention tool in the fight against the HIV epidemic within gay an bisexual communities. Much of their discourse was couched within a harm reduction model in which PrEP medication is framed as significantly reducing the harm associated with engaging in risky sexual behavior.”
The use of emtricitabine/tenofovir (Truvada) as PrEP was approved in the US in 2012. Studies have shown that, with good adherence, this treatment can reduce the risk of infection with HIV by over 90%.
Read the full article.
Post-exposure prophylaxis (PEP) involves taking of Anti-Retroviral Therapy (ART) drugs after potential exposure to HIV infection. This is an emergency HIV treatment usually received within 72 hours after the possible exposure. This should be confused as a cure for HIV but rather a form of preventing infection. It is, in fact, a short course of ARV drugs to stop the exposure to HIV from progressing into a life-threatening condition.
Some facts about PEP:
- Taking PEP can result in an array of side effects including fatigue and nausea, but it is advisable not to stop taking the medication, instead consult your healthcare provider.
- The emergency treatment should be started as soon as possible to guarantee its effectiveness. That means, it should be less 72 hours after exposure to the virus.
- PEP is prescribed by your doctor to be taken daily at the same time for up to 4 weeks. This is according to the World Health Organization’s guideline on PEP use.
Read the full article.
Get more information about PEP from the Centers for Disease Control and Prevention (CDC).
From LGBTQ Nation…
In an interview with the Los Angeles Blade about the new study, lead author Phillip Hammack, a professor at the University of California, Santa Cruz, debunked the notion.
“Our data don’t support the idea that we can attribute the rise in STIs to PrEP use, at least not in a direct manner. I personally don’t think that’s what’s happening,” said Hammack.
Instead, Hammack points at the rise of dating apps like Grindr, and a decrease in fear towards contracting HIV, as more likely causes.
“I would speculate it has more to do with a culture shift about sex,” said Hammack. “More people are having sex today. We’re in sort of a quiet sexual revolution when it comes to new identities, new labels, and sexual behavior.”
On the down side, the study also showed that only 4% of men who have sex with men are using PrEP. What’s more, many gay and bisexual men aged 18-25 aren’t getting annual HIV tests. 25% of men who have sex with men in that age range have never gotten an HIV test.
“I worry especially about younger men who didn’t grow up with the concerns of HIV that men of older generations did,” said Hammack in the William Institute press release on the study. “The low rate of HIV testing probably reflects a degree of complacency and cultural amnesia about AIDS.”
Read the full article.