New study supports more frequent HIV screening among high-risk young men who have sex with men

From medicalexpress.com

A new study has found that HIV screening every three months compared to annually will improve clinical outcomes and be cost-effective among high-risk young men who have sex with men (YMSM) in the United States. The report, led by researchers at the Massachusetts General Hospital (MGH), is being published online in Clinical Infectious Diseases.

two young men“Young men who have sex with men account for one in five new HIV infections in the United States. Yet, more than half of young men who have sex with men and who are living with HIV don’t even know that they have it,” says Anne Neilan, MD, MPH, investigator in the MGH Division of Infectious Diseases and the Medical Practice Evaluation Center, who led the study.

“With so many youth with HIV being unaware of their status, this is an area where there are opportunities not only to improve care for individual youth but also to curb the HIV epidemic in the U.S. Despite these numbers, the Centers for Disease Control and Prevention previously determined that there was insufficient youth-specific evidence to warrant changing their 2006 recommendation of an annual HIV screening among men who have sex with men.”

Read the full article.

Sex and COVID-19

It may seem obvious that if a person is infected with COVID-19, they risk infecting others during sex. But people still have a lot of questions. Here’s an excerpt on the topic form the Mayo Clinic Website:

The virus spreads by respiratory droplets released when someone with the virus coughs, sneezes or talks. These droplets can be inhaled or land in the mouth or nose of a person nearby. Coming into contact with a person’s spit through kissing or other sexual activities could expose you to the virus. People who have COVID-19 could also spread respiratory droplets onto their skin and personal belongings. A sexual partner could get the virus by touching these surfaces and then touching his or her mouth, nose or eyes. In addition, the COVID-19 virus can spread through contact with feces. It’s possible that you could get the COVID-19 virus from sexual activities that expose you to fecal matter.

There is currently no evidence that the COVID-19 virus is transmitted through semen or vaginal fluids, but the virus has been detected in the semen of people who have or are recovering from the virus. Further research is needed to determine if the COVID-19 virus could be transmitted sexually.

Since some people who have COVID-19 show no symptoms, it’s important to keep distance between yourself and others if the COVID-19 virus is spreading in your community. This includes avoiding sexual contact with anybody who doesn’t live with you. If you or your partner isn’t feeling well or think you might have COVID-19, don’t kiss or have sex with each other until you’re both feeling better. Also, if you or your partner is at higher risk of serious illness with COVID-19 due to an existing chronic condition, you might want to avoid sex.

In case that wasn’t clear, The National Coalition of STD Directors (NCSD), in partnership with National Alliance of State and Territorial AIDS Directors (NASTAD), released a frequently asked questions resource regarding sex and COVID-19. In short, if you’re in the same room with someone who has the virus, you can get infected–sex or no sex.

If you have questions about getting tested, talk to your doctor or health care provider. You can also find testing in your area via a Google search. In Pennsylvania, call the Health Department at 1-877-PA-HEALTH (1-877-724-3258).

Rutgers study finds earlier sexual experiences for gay youth of color

LGBTQ Latino and Black youth have their first sexual experiences at earlier ages than LGBT white youth, according to researchers from the Rutgers School of Public Health.

[…] The study, “Age of Sexual Debut among Young Gay-identified Sexual Minority Men: The P18 Cohort Study,” was published in the Journal of Sex Research July 1. It found that the average age of sexual debut for same-sex male sexual encounters was 14.5 years. Some 19% of participants said that their first such experience was before the age of 13. The survey included 600 people; of those, 424 were involved in the analytic study.

Halkitis said that the gap between minority and white people was not very big — but that it points to larger inequalities between the social groups. The study states that lower ages of sexual debut are connected to higher rates of HIV infection and drug use.

“I never meant to make it about race — it’s probably about socioeconomic context,” Halkitis said. “It’s not like 10 years later the white guys are showing up. It’s that, one, lower [socioeconomic status] connect with worse health outcomes and, two, that’s because people of lower [socioeconomic status] have less access, which leads to greater stressors in life, and Black and Brown men are experiencing racial stressors, and people who have stressors tend to engage in risky activities at higher rates.”

LGBT-friendly primary care improves STD screening rates

From medicalxpress.com

Bruce W. Furness, M.D., M.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues developed and evaluated a quality improvement initiative (Transforming Primary Care for LGBT People) to enhance the capacity of 10 federally qualified health centers (FQHCs; 123 clinical sites in nine states) to provide culturally affirming care.

The researchers found that FQHCs reported increases in culturally affirming practices, including collecting patient pronoun information (42.9 percent increase) and identifying LGBT patient liaisons (300.0 percent increase). Based on  and  (SOGI) from  among nine FQHCs, SOGI documentation increased from 13.5 to 50.8 percent of patients. Screening of LGBT patients increased from 22.3 to 34.6 percent for syphilis, from 25.3 to 44.1 percent for chlamydia and gonorrhea, and from 14.8 to 30.5 percent for HIV among the eight FQHCs reporting the number of LGBT patients.

“FQHCs participating in this initiative reported improved capacity to provide culturally affirming care and targeted screening for LGBT patients,” the authors write.

Read the full article.

Age of sexual debut among young gay-identified sexual minority men

From MedicalExpress.com...

Young gay sexual minority men—especially Black and Latino youth—have their first sexual experiences at younger ages, emphasizing a need for comprehensive and inclusive sex education, according to Rutgers researchers.

The study, published in the Journal of Sex Research, examined consensual sex behaviors to better understand same-sex sexual debut, or the age at which people first engage in sexual behaviors.two young men

The researchers, part of the Rutgers School of Public Health’s Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), found that 19 percent of participants had their first sexual experience before the age of 13.

The researchers also found that same-sex sexual encounters first happen, on average, at 14.5 years, with Hispanic/Latinx and Black non-Hispanic participants reporting a younger age for their first time performing  or engaging in , compared to their peers.

Earlier age of sexual debut among sexual minority men is associated with a range of sexual and health risk behaviors, including increased likelihood of condomless sex; tobacco, alcohol, and other substance use; psychological distress; suicidality; and earlier age of HIV diagnosis.

[…] “As many schools are forced to redesign their classrooms and curricula to accommodate socially distanced or remote learning for COVID-19, this may be the perfect time to consider implementing comprehensive sex education programming to provide age-appropriate sexual health education for people of all genders and sexual orientations,” said Caleb LoSchiavo, doctoral student at the Rutgers School of Public Health and co-author.

Read the full article.

Alternative PrEP injection, dosed every other month, beats daily PrEP pill

From thebodypro.com

Taken every 2 months, the long-acting injectable drug cabotegravir (CAB-LA) prevented more HIV infections than daily oral pre-exposure prophylaxis (PrEP) with tenofovir/emtricitabine (TDF/FTC), according to newly announced results from a major Phase 3 study. The results were released originally in May due to the overwhelmingly positive data on CAB-LA for PrEP, but researchers presented their final data in early July at the 23rd International AIDS Conference (AIDS 2020).

The data show that the experimental drug is superior to the current standard-of-care PrEP regien, which may open the door for a new biomedical HIV prevention option aimed at those who would prefer a shot six times a year over taking a daily pill.

“The HPTN 083 results demonstrating the superiority of CAB to TDF/FTC have the potential to transform the landscape of HIV prevention for cisgender MSM and transgender women,” said HPTN 083 protocol chair Raphael J. Landovitz, M.D. “We know that some people have difficulty with or prefer not to take pills, and an injectable product such as long-acting CAB [cabotegravir] could be a very important option for them. We want to thank the study participants and research staff, as this study would not have been possible without their dedication and commitment.”

Read the full article.

The history of HIV/AIDS in the U.S.

From the Body.com

The history of HIV/AIDS is a long and complicated one. There are many conflicting details in its story, and each life touched by the virus has a complicated and beautiful story of their own. In this synopsis, we have tried our best to highlight the most crucial parts of the story of HIV in America, understanding that this is a near-impossible task. HIV stands out from many diseases, because today we are still without a cure—but also, perhaps more importantly, because the AIDS pandemic is now embedded into the histories and cultures of queer people, people of color, creative communities, and dozens of fringe and subculture groups; AIDS has become part of our own personal histories.

AIDS quilt closeup

[…] Out of the fear, hate, stigma, shame, and death, came the seeds of legendary and prolific AIDS activism. Some of the earliest activism led to the creation of Gay Men’s Health Crisis (GMHC) in 1982. Founded by writer Larry Kramer and a small group of his friends and other volunteers, GMHC began to organize and raise money for research, and started the first AIDS hotline. The group received over 100 calls in the first night alone. Other community agencies began to pop up in Los Angeles, New York, and across the country.

Read the full article. 

 

 

The dudes who won’t wear masks

From the Atlantic

Americans are figuring out how to live with a deadly new virus now, just as gay men did in the early years of AIDS. Abstinence from sex wasn’t sustainable, and condoms became a ticket to greater sexual freedom. Likewise, Americans can’t abstain from human interaction forever, and widespread masking may be a ticket to more social and economic freedom. But trying to shame people into wearing condoms didn’t work—and it won’t work for masks either.

man wearing a mask The public-health messaging around masks during the coronavirus pandemic has been muddled and confusing. The federal government recommended against face coverings for the public in March, with some public-health officials positing that they may even cause more harm than good. But a growing body of science, including evidence that people can transmit the virus when they don’t have symptoms, indicates that masks are an important tool for mitigating coronavirus transmission, especially in combination with physical distancing, hand hygiene, and other preventive strategies. Indeed, public-health concerns may justify mask mandates in some settings, including indoor spaces where many people gather for extended periods of time. But mandates have major downsides: Any enforcement is likely to disproportionately affect communities that are already marginalized, and some Americans—including some elected leaders in states facing serious coronavirus outbreaks—believe that requiring people to wear masks is an infringement on civil liberties. In practice, if Americans are going to mask up, public-health officials will have to cajole, not compel.

Read the full article.

Health Alert: HHS rule encourages discrimination and endangers LGBTQ health

A message from the Gay and Lesbian Medical Association

Earlier today the Department of Health and Human Services released a final rule that eliminates federal regulations ensuring nondiscrimination in healthcare for transgender people and LGB people, people who are pregnant or seeking an abortion, those who require healthcare services in a language other than English, and other marginalized communities. In its announcement, HHS noted it was “restoring the rule of law” by interpreting sex discrimination “according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.”

GLMA President Scott Nass, MD, MPA, issued the following statement in response:

“It is unconscionable that the Administration would take this action to encourage and promote discrimination during a pandemic that is already severely impacting vulnerable communities, including LGBTQ people. The fear of discrimination can have very real health consequences, especially in a public health crisis. These discriminatory measures are not only cruel, they also undermine public health and will assuredly result in poorer health outcomes for LGBTQ people.

“The rule stands in contradiction to prevailing medical science regarding transgender health and the consensus of all the leading health professional associations who have consistently opposed this measure. Healthcare providers in fact are united by the evidence in their support for nondiscrimination protections in healthcare for transgender and LGBQ people.

Why are Hispanic/Latino Men 4 Times More Likely to Get HIV Than White Men?

From EdgeMediaNetwork.com

Amid the coronavirus pandemic, the hope and promise for a healthier tomorrow might feel reminiscent of another virus — one that ravaged the LGBTQ community in the 1980s and beyond. But in the years since HIV transmission was at its height, has HIV/AIDS started to feel like a bygone disease despite a death toll that has soared over 32 million people worldwide? In the United States, it depends on who you ask. And if you’re part of the Latinx community, the answer is complicated.

Toward the end of 2019, The New York Times trumpeted a promising headline: “New York Says End of AIDS Epidemic Is Near.” The optimistic article sourced the Center for Disease Control (CDC)’s 2010-2016 findings, that rates of infection among gay and bisexual men have remained stable, and that, per Governor Andrew Cuomo, New York is on track to end the AIDS epidemic in the state by the end of 2020.

But while most demographics have experienced a trend-setting decrease in infection rates, the CDC noted that for Hispanic/Latino men, “the annual number of HIV infections in 2016, compared with 2010, increased,” and that during those years, the infection rates for this demographic were “4.3 times that for white males.”

With extensive and varied work, healthcare advocates and community leaders are spearheading efforts across the country to tackle HIV prevention and awareness for the Latinx community. But for many, it’s still an uphill battle.

“I will say I’m proud to be there for them,” says Danny Ochoa of his community. A gay man living with HIV, Ochoa is a Prevention Intervention Specialist in the Community Health Department at Gay Men’s Health Crisis (GMHC). A leader in HIV/AIDS prevention, care and advocacy, GMHC’s mission has evolved since its 1982 founding to recognize the importance of inclusion and diversity and has now become a haven for the urban queer Latinx populations. This resource can be just as vital as hospitals and medical centers.

Read the full article.

STD rates likely skyrocketing in US as fewer people get tested during pandemic

From businessinsider.com

decorative imageAs clinics and health departments across the country have shuttered during the coronavirus pandemic, the nation’s roughly 2,200 disease detectives, the so-called “contact tracers” of infectious disease outbreaks, have been re-deployed to track where cases of COVID-19 — the disease caused by the novel coronavirus — are spreading, to try to stop those outbreaks in their tracks. It’s a necessary shift, but one that may have serious, long-term impacts for the country’s sexual health, and for President Trump’s year-and-a-half-old plan to “eliminate” HIV from the US by 2030.

[…] According to a recent NCSD survey of HIV and STD disease tracers around the country, 83% are forgoing their usual field visits as a result of this pandemic. Two-thirds of the country’s clinics (66%) have also reported decreases in health screenings and testing due to COVID-19.

Read the article.

How AIDS Remained an Unspoken—But Deadly—Epidemic for Years

From History.com

By the end of 1984, AIDS had already ravaged the United States for a few years, affecting at least 7,700 people and killing more than 3,500. Scientists had identified the cause of AIDS—HIV—and the U.S. Centers for Disease Control and Prevention (CDC) identified all of its major transmission routes.Marchers on a Gay Pride parade through New York City

Marchers on a Gay Pride parade through New York City carry a banner which reads ‘A.I.D.S.: We need research, not hysteria!’, June 1983.
Barbara Alper/Getty ImagesYet, U.S. leaders had remained largely silent and unresponsive to the health emergency. And it wasn’t until September 1985, four years after the crisis began, that President Ronald Reagan first publicly mentioned AIDS.

But by then, AIDS was already a full-blown epidemic.

HIV originated in 1920 in Kinshasa, Democratic Republic of Congo. It spread to Haiti and the Caribbean before jumping to New York City around 1970 and California within the decade.

Health officials first became aware of AIDS in the summer of 1981. Young and otherwise healthy gay men in Los Angeles and New York began getting sick and dying of unusual illnesses normally associated with people with weakened immune systems.

It didn’t take long for fear of the “gay plague” to spread quickly among the gay community. Beyond the mortal danger from the disease, they also dealt with potentially being “outed” as homosexual if they had AIDS or an illness resembling it.

In fall 1982, the CDC described the disease as AIDS for the first time. Despite the growing cases and a new name, news outlets struggled with the disease, or at least how to cover it—some even shied away from giving it too much attention. Though the New York Times initially reported on the mysterious illnesses in July 1981, it would take almost two years before the prestigious paper gave AIDS front-page space on May 25, 1983. By that time, almost 600 people had died from it.

David W. Dunlap, a reporter in the Metro section at the time, told the New York Times Style Magazine: “There were strong messages that you got that were not written on any whiteboard. You knew to avoid it. It was a self-reinforcing edict: Don’t write about queers.”

Read the full article on History.

 

STD testing rates, service receipt among HIV-positive MSM remain low

From the American Journal of Managed Care

decorative imageThe CDC recommends regular testing for bacterial sexually transmitted diseases (STDs) among all sexually active gay, bisexual, and other men who have sex with men (MSM) because they have a higher risk of infection. Chief among these STDs are gonorrhea, chlamydia, syphilis, and hepatitis C virus (HCV). Those most at risk also should be receiving recommended STD counseling services.

“Having an STD (like gonorrhea) makes it easier to get HIV or give it to others, so it’s important that you get tested to protect your health and the health of your partner,” states the CDC.

Despite these guidelines, there has been a constant uptick in STDs over the past decade, particularly among HIV-positive MSM, even though they are receiving care for their HIV, according to the authors who investigated the receipt of STD testing and associated services among these individuals and published their results online today in Annals of Internal Medicine.

The primary outcome of their study was to determine both deficiencies in bacterial STD testing and what risky behaviors result in these deficiencies among HIV-positive MSM—especially because having an STD increases the risk of transmitting HIV.

Read the full article.

Pandemic sparks concerns about surging STD, HIV rates

The pandemic that has upended life in the U.S. could lead to increased STD rates and setbacks in the fight against HIV as public health resources are shifted to the coronavirus response.

Access to STD and HIV testing and treatment services are dwindling as local health departments shuffle staff to respond to COVID-19 and clinics reduce hours or close altogether and cancel outreach programs.

“We are seeing a complete disruption to STD prevention here in the United States,” said David Harvey, executive director of the National Coalition of STD Directors (NCSD). “We expect to experience even higher STD rates as a result.”

Read the full article.

Second Open Letter on COVID-19 Focuses on Nondiscrimination, Data Collection and Economic Harm for LGBTQ Communities

From the Gay and Lesbian Medical Association

On April 21, 2020, GLMA, Whitman-Walker Health, the National LGBT Cancer Network, the National Queer Asian Pacific Islander Alliance, the New York Transgender Advocacy Group, and SAGE issued a second open letter to public health officials, healthcare institutions and government leaders on the impact of COVID-19 on LGBTQ communities. The letter, joined by 170 organizations, called for action to protect LGBTQ patients from discrimination and to include sexual orientation and gender identity in data collection efforts related to the pandemic. The letter also called for action to address the economic harm to LGBTQ communities from the pandemic.

To read the full second open letter and list of signatories, click here.

The letter released on April 21 is a follow-up to an open letter signed by more than 150 organizations issued by the six coordinating organizations on March 11, 2020. Information on the first letter is available here.

Important COVID-19 Resources:

What you need to know about managing HIV during the COVID-19 outbreak

From Parade.com

Decorative imageDuring the coronavirus pandemic, people with HIV fall into the “underlying conditions” group that may need to be more careful about their health. As states give shelter-in-place orders and move through the toughest weeks ahead in the outbreak, those with HIV should take a few extra precautions to plan ahead and remain safe.

Overall, people with HIV should know that they aren’t more likely to contract COVID-19 than others, the World Health Organization says. At this time, it is unknown whether those with HIV face a greater risk of infection or more serious complications.

“While there’s not yet a lot of evidence here, COVID-19 does not appear to affect people with HIV differently than other people,” says Stephen Lee, executive director of NASTAD, formerly known as the National Alliance of State and Territorial AIDS Directors.

Until more data from the cases in China and the U.S. can be analyzed, those living with HIV should be “extra vigilant,” he says, especially those who have advanced HIV, are older, or have poorly controlled HIV. Those with additional chronic diseases, such as diabetes or heart or lung disease, should be careful as well.

“Stay home as much as you can, keep a safe distance, and wash your hands often,” Lee says.

[…]

Researchers haven’t been able to study much about the correlations between HIV and COVID-19. At the same time, those living with HIV should follow CDC guidelines for those with underlying health conditions, says Jonathan Mermin, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

Read the full article on Parade.com.

How does COVID-19 impact LGBTQ2 communities?

From Xtra.com

As the COVID-19 pandemic threatens the health of people and of economies worldwide, many in the global LGBTQ2 decorative imagecommunity sense a particular vulnerability to the pandemic’s immediate and downstream effects. In response, many are coordinating efforts to care for their own communities, often modeling their strategies on lessons learned from HIV/AIDS advocacy.

“One of the things I’m very concerned about is the social safety net,” says Charles Stephens, the director of The Counter Narrative Project, a Black gay men’s advocacy organization based in Atlanta, Georgia. Indeed, systematic employment discrimination could make the potential economic and health-related fallout of COVID-19 a greater threat to queer communities.

 

Read the full article.

Challenging HIV Stigma

From Sean Strub, POZ Magazine’s founder…

Biomedical advances against HIV since the dawn of the epidemic have been nothing short of astonishing. An almost always fatal disease is now, for those with the privilege of access to treatment, a manageable chronic illness, treated with a single daily pill. A person who acquires HIV today has every reason to expect to live a normal life span.

Sean Strub
POZ Magazine’s founder, Sean Strub

Yet with such astonishing success in treatment, why is HIV stigma worse today than ever before? Why do so many long-term survivors, including many who were exceptionally open about their HIV-positive status for years, find they must now keep it a secret, sometimes going deeply into closets they thought they had left for good years ago?

Many people—especially those who do not have HIV—find these questions startling. That’s because they remember the days when one had to wear a spacesuit to visit a person with AIDS in a hospital or was afraid to eat in a restaurant with gay waiters or refused to touch a person they thought might have the virus.

Read the full article.

Health Alert: LGBT people may be at higher risk from COVID-19

From the Bay Area Reporter

More than 100 organizations sent an open letter to medical groups and the news media stating that LGBT people are at greater risk from the novel coronavirus due to other social and medical issues that affect the LGBT community.

Scout, who goes by one name, is a bisexual and trans man who is the deputy director of the National LGBT Cancer Network. That organization took the initiative on drafting the letter, which was released March 11, and gathering co-signers.

Scout is the deputy director of the National LGBT Cancer Network

Local organizations that signed the letter include Equality California, Horizons Foundation, National Center for Lesbian Rights, the San Francisco LGBT Community Center, and the Transgender Law Center.

The letter highlights three issues that may put LGBTs at greater risk during the COVID-19 epidemic: higher tobacco use than among the general population, higher rates of cancer and HIV-infection, and instances of discrimination on account of sexual orientation and gender identity (COVID-19 is the respiratory disease caused by the novel coronavirus.)

“We’re really concerned because we know that whenever there’s a health issue, the pre-loaded issues in our community create an issue for us,” Scout, a Ph.D., said in a phone interview with the Bay Area Reporter March 16. “We have more social isolation, more smoking. But we know how to offset that. As coronavirus expands so fast, we wanted to let the public health community know we can take steps to avoid another health disparity.”

Read the full article on the Bay Area Reporter Website.

Young men unaware of risks of HPV infection and need for HPV vaccination

From Eurekalert.com

Young sexual minority men — including those who are gay, bisexual, queer or straight-identified men who have sex with men — do not fully understand their risk for human papillomavirus (HPV) due to a lack of information from health care providers, according to Rutgers researchers.

Doctors need to expand communication on risks and the importance of vaccination, Rutgers researchers say

A Rutgers study published in the Journal of Community Health, examined what young sexual minority men — a high-risk and high-need population — know about HPV and the HPV vaccine and how health care providers communicate information about the virus and vaccine.

About 79 million Americans are infected with HPV, with about 14 million becoming newly infected each year, according to the Centers for Disease Control and Prevention. As a sexually transmitted infection, HPV can lead to several types of cancer, including anal and penile cancer, and is particularly concerning for sexual minority men due to the high prevalence of HIV and smoking in this community and the low HPV vaccination rates overall among men.

“Particularly in light of the decades-long focus on gay men’s health care as HIV care, there is a missed opportunity for HPV prevention in the community,” said study co-author Caleb LoSchiavo, a doctoral student at the Rutgers School of Public Health.

Read the full article.