One size doesn’t fit all when it comes to products for preventing HIV from anal sex

From medicalXpresss.com

Conducted by the National Institutes of Health (NIH)-funded Microbicide Trials Network (MTN), DESIRE focused on potential delivery methods for rectal microbicides—topical products being developed and tested to reduce a person’s risk of acquiring HIV and other sexually transmitted infections from anal sex. MTN researchers are particularly interested in on-demand options—used around the time of sex—and behaviorally congruent options that deliver anti-HIV drugs via products people may already be using as part of their sex routine.

closeup of man in jean from behind

“DESIRE stands out as a unique study because we took a step back and said, ‘Let’s figure out the modality without automatically pairing it with a drug’,” explained José A. Bauermeister, Ph.D., M.P.H., study protocol chair and Albert M. Greenfield Professor of Human Relations at the University of Pennsylvania. “It gave us the ability to manipulate the delivery method without having to worry about how reactions to a particular drug might confound the results. We also had people trying out these methods in their own lives, and only then asked them to weigh the attributes of each.” As such, he said, participants weren’t making choices based on theoretical concepts, but instead using real experiences to guide their preferences.

Read the full article.

Get a free HIV self-test kit delivered to your home

The Pennsylvania Department of Health, in partnership with the Pennsylvania Expanded HIV Testing Initiative (PEHTI) and the HIV Prevention and Care Project (HPCP), has introduced HIV Self-Testing (HST) for individuals who reside in Pennsylvania (excluding Philadelphia County). The goal of the getmyHIVtest.com program is to help people get tested who wouldn’t otherwise go to their doctor or to a testing clinic.  

Tests are available from the website getmyhivtest.com. Individuals are asked to read the information on the website and answer a few questions in order to receive an FDA-approved, OraQuick home HIV test kit mailed to their provided address. Support for clients who request and administer the HIV self-test is available through OraQuick and the HPCP, as noted on the website.   

Individuals who reside in Philadelphia County should visit PhillyKeepOnLoving.com to order the HIV Self-test kit and for additional information about testing from the Philadelphia Department of Public Health.   

If you have any questions, please send an email to info@getmyHIVtest.com.  

National Black HIV/AIDS Awareness Day Puts Focus on Need to Address Equity and Drivers of HIV Disparities in U.S.

From HIV.gov

By: Harold J. Phillips, MRP, Senior HIV Advisor and Chief Operating Officer for Ending the HIV Epidemic: A Plan for America, Office of Infectious Disease and HIV/AIDS Policy, U.S. Department of Health and Human Services.

Keith Mumma/Kalamazoo College

This year’s National Black HIV/AIDS Awareness Day (NBHAAD) observance comes amidst a national dialogue on systemic racism and calls for a greater focus on equity in all our work. We should use this opportunity to examine and address historic inequities experienced by Black Americans. For the HIV community, this means working to understand and address the circumstances that put people at risk for HIV or that create barriers to HIV care and treatment.

Black Americans continue to be disproportionately affected by HIV compared to other racial/ethnic groups. According to CDC data,

  • Black Americans represent 13% of the U.S. population, but 41% of people with HIV in the U.S. in 2018.
  • 42% of new HIV infections in 2018 were among Black Americans.
  • Among the estimated 161,800 people in the U.S. with undiagnosed HIV, 42% (67,800) are Black. That means that nearly one in seven Black Americans with HIV are unaware of their HIV status and are not receiving the care they need to stay healthy and prevent transmission to others.

Fewer Black Americans in HIV care are virally suppressed: In 2018, 60% of Blacks, 64% of Latinos, and 71% of whites with diagnosed HIV were virally suppressed.

The recently released HIV National Strategic Plan (HIV Plan) makes clear the disproportionate impact of HIV among Black Americans, and includes Black women, transgender women, people who inject drugs, and Black gay, bisexual, and other men who have sex with men among its designated priority populations. The HIV Plan notes that focusing efforts on priority populations will reduce HIV-related disparities, which is essential to the nation’s effort to end the HIV epidemic by 2030.

Read the full article.

How the COVID-19 pandemic is affecting another epidemic among teens: STDs | Expert Opinion

2020 marks the fifth consecutive year of increasing rates of gonorrhea, chlamydia and syphilis in the U.S.

From The Philadelphia Inquirer

While the eyes of the nation are on the coronavirus pandemic, another threat to public health has been steadily growing in the United States. We’ve been battling rising rates of sexually transmitted infections (STI) for the last several years. In fact, 2020 marks the fifth consecutive year of increasing rates of gonorrhea, chlamydia and syphilis in the U.S., due in part to significant funding cuts to more than 50% of the nation’s public health STI programs. And now the COVID-19 pandemic has placed an even greater burden on our strained public health system and supply chains, shifting focus from one major public health issue to another.

virus and bacteria images

We can’t risk losing one critical resource that will be essential to ending the STI epidemic — the availability of free and confidential STI testing for adolescents. Prior to the pandemic, national public health efforts were scaling up to improve STI and HIV testing, and quickly link youth to prevention services.  Rapid identification and treatment of STIs not only has public health benefits in terms of lowering transmission, but when left untreated, STIs increase the risk of infertility, severe pelvic infection, chronic pelvic pain, ectopic pregnancy and HIV transmission.

While accounting for 25% of the population, adolescents and young adults comprise over 50% of STIs in the U.S. each year. Black, Latinx, and LGBT youth face the greatest burden of infections and risk of complications. Fortunately, significant advances have been made over the last several decades to improve rates of STI and HIV testing among adolescents and young adults. The American Academy of Pediatrics now recommends HIV screening by the age of 16-18 years for all youth regardless of their sexual activity.

Read the full article.

Transmission of HIV through oral sex is rare — here’s how to reduce your risk

From insider.com

HIV does not reproduce outside a human host and cannot be transmitted through saliva, tears, or sweat. It is a common misconception that sharing dishes, shaking hands, or hugging can transmit HIV, says Anne M. Neilan, MD, MPH, Infectious Disease Physician at Massachusetts General Hospital.

Generally, it’s unlikely that you will contract HIV from oral sex. However, there are some circumstances in which this could happen, though uncommon. This article will discuss the likelihood of getting HIV through oral sex and how to avoid contracting or transmitting it.

“The likelihood of acquiring HIV from oral sex is far lower than vaginal or anal sex,” says Neilan. The risk is so low that scientists have not established a conclusive statistic, but a 1999 study estimates a 0.04% risk among male sexual partners. 

Saliva contains secretory leukocyte protease inhibitors that inactivate the virus. Because of this HIV inhibitor, the virus reproduces less than it would in the blood cells. 

Although the risk is low, unprotected oral sex still carries the risk of transmitting HIV, as well as sexually transmitted infections (STI). “Protection against HIV does not mean protection against all sexually transmitted infections,” says Neilan.

A person without HIV may contract the virus by giving or receiving any type of oral sex to or from a partner with HIV. Some risk factors increase the likelihood of contracting HIV through oral sex, which include:

The risk of HIV from oral sex may be minimal, but it’s still important to know how to avoid contracting and transmitting the virus.

Using dental dams, male and female condoms during oral sex reduces the likelihood of contracting HIV, but you must use them correctly, says Neilan. Refraining from oral sex when risk factors are present, and avoiding seminal or vaginal fluids in the mouth also lessen the risk, but does not completely eliminate it.

STIs like gonorrhea or syphilis can cause sores on the mucous membrane, increasing the chances of getting or transmitting HIV, so get tested regularly and seek treatment if needed. 

Read the full story.

CDC 2018 report: Black/African American gay and bi men still have the highest rates of new HIV infections.

From the Centers for Disease Control and Prevention

In 2018, 37,968 people received an HIV diagnosis in the United States (US) and dependent areas. From 2014 to 2018, HIV diagnoses decreased 7% among adults and adolescents. However, annual diagnoses have increased among some groups.

Info graphic showing Black / African American men still have the highest rates of H I V infection as of 2018 according to the latest C D C report
click to enlarge graph

Gay and bisexual men are the population most affected by HIV, with Black/African American, Hispanic/Latino gay and bi men having the highest rates of new infections.

The number of new HIV diagnoses was highest among people aged 25 to 34.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated)HIV Surveillance Report 2020;31.

HRC is mailing sex positive kits as part of its “My Body” HIV campaign to celebrate Black and Latino LGBT people

From Poz.com

“Embrace your body and your sexuality. Taking precautions against HIV doesn’t mean you should be ashamed of your sexuality or not enjoy sex—you can love your body and stay safe.”

Find out how you can get your box of goodies…

That’s the opening message of “My Body,” a new HIV awareness and education campaign by the Human Rights Campaign (HRC), a national LGBT advocacy group. Recognizing that nearly a quarter of young queer adults lack proper evidence-based sex education about HIV, the campaign is geared to empowering Black and Latino LGBT people between ages 16 and 35.

You can learn more about the boxes in the video and request one at HRC.im/MyBody.

Read the full article on Poz.com.

Latino Gay/Bi men’s health rally to focus on U=U during COVID-19

From Poz.com

Spearheaded by the Hispanic Health Network, this year’s rally includes two panel discussions. “HIV Stigma and COVID-19” takes place at 1 p.m. ET Monday, November 9. According to the rally’s website, “panelists will share and discuss information about the importance of U=U in the times of COVID-19, how U=U is used to combat stigma and barriers to reach an undetectable viral load. They will also discuss how COVID-19 has impacted Latinx Gay/Bi Men’s Communities and HIV-related stigma connected to U=U. During this panel, speakers will explore the role of religion to interrupt stigma.”

U=U stands for Undetectable Equals Untransmittable, which refers to the fact that people living with HIV who maintain a suppressed viral load cannot transmit HIV via sex, even when condoms are not used.

The second virtual panel, “Strengthening of the Latinx Gay/Bi Men’s Communities,” is scheduled for 1 p.m. ET, Tuesday, November 10. “The panelists will discuss racism colorism, machismo and heteronormativity in Hispanic/Latinx communities,” according to the website. “Panelists will also touch upon how to address these issues through diversity acceptance. Panelists will talk about the impact of Black Lives Matter on the Hispanic/Latinx communities and the importance of developing leadership to strengthen communities for a healthier future.”

You can register for both events and read speaker bios on the Rally 2020 site.

9 FAQs for when your partner has HIV

From Everyday Health

If you’re in a new relationship with someone who has HIV or you’ve recently found out that your longtime partner is HIV positive, you may be experiencing a whirlwind of emotions — possibly fear, sadness, or even anger, depending on the context. You may be concerned that you’ll get HIV from your partner or wonder how being with an HIV-positive person will affect your relationship or daily life.

As you begin to emotionally adjust to your situation, it’s important to get the facts about being with a partner who has HIV. Certain fears about having an HIV-positive partner may be outdated, but there may also be precautions you weren’t aware of that you could take to avoid HIV

Here are some questions you may have if your partner has HIV, and answers from leading experts on the virus.

The 2021 Health Insurance Marketplace® is open for business!

Cross-posted from Healthcare.gov blog

You have until December 15 to apply for new 2021 health insurance, or renew, change, or update your 2020 health plan for 2021. Coverage starts January 1, 2021.

Important: If you miss the deadline, the only way you’ll be eligible to enroll in or change your health plan for 2021 is if you qualify for a Special Enrollment Period.

How to start or update an application online

  • If you’re new to HealthCare.gov, create an account.
  • If you already have an account, just log in to start or update an application.
  • If you have questions or need help with your application, you can connect with someone on the phone. Call Center Representatives are available most days (except certain holidays) to support your enrollment needs.

See other ways to apply.

Meet the queer artists changing the way we think about owning our sexual health

From Queerty.com

So it’s no surprise that James, like thousands of others, has turned to OraQuick’s in-home HIV test as a key part of their sexual health toolkit. James Falciano is a champion of their queer community, something that is reflected in their art, activism, and everyday life.

It’s the simplest way to get accurate, fast results without waiting in line at the clinic or doctor’s office – if you can even get one these days. In as little as 20 minutes, in the privacy of your own home, you obtain your results, along with access to 24/7 support.

It’s the way to take control of your own sexual health and to own your own sex life.

James and two other fabulous queer artists, Preston Nelson and Kitsch Harris, are partnering with OraQuick to encourage HIV self-testing.

Here are samples of their art to explore along with conversations about their work (and read more at Queerty.com).

  • James Falciano

Switching HIV treatment to delstrigo is safe and effective

From Poz. com

People with HIV who switch from a stable antiretroviral (ARV) regimen to Delstrigo (doravirine/tenofovir disoproxil fumarate/lamivudine) had a high rate of full suppression of the virus at the three-year mark in a large Phase III clinical trial.

Princy Kumar, MD, of Georgetown University, presented findings from the open-label, randomized, active-controlled, noninferiority DRIVE-SHIFT trial at the virtual HIV Drug Therapy Glasgow meeting.

Delstrigo contains the relatively new non-nucleoside reverse transcriptase inhibitor (NNRTI) Pifeltro (doravirine), which, like Delstrigo, was approved in September 2019.

Read the full article.

The single biggest risk factor for gay, bi men becoming HIV-positive

From the Advocate.com
Of all those who became HIV-positive, over a third (36 percent) were persistent meth users. Men aged 36-45 reported the most meth use, and those living in Western states had the highest incidence of the drug.

Persistent meth use is the biggest factor for seroconversion, researchers stated, followed by Black ethnicity and a syphilis diagnosis.

Researchers detailed the correlation between meth and HIV.

“Methamphetamine exacerbates HIV risk via increasing sexual libido while simultaneously reducing inhibitions,” the authors stated, according to AIDSMap. “Our findings highlight the need to address methamphetamine use and its associated risks among sexual and gender minorities, the likes of which may also serve to help end the HIV epidemic.”

Read the full article.

Has the COVID-19 pandemic marked the end of casual sex?

From Boston Magazine online

by 

Not long after the virus first hit, I was in a committed relationship, so casual sex wasn’t really an issue. When the relationship ended, though, I realized the impact of the disease on my sex life. Sleeping with random guys was off the table. Even making out with someone at a bar seemed risky. I felt ripped off. I’d been faithful, but he’d cheated, and after kicking him out of our apartment and getting tested (and, I believe, paying extra to expedite the lab results), I wanted to cut loose. I’ve always thought that beyond it being consensual and not involving minors or dire physical harm, there are no moral imperatives connected to sex, and because being a “gay man” means being at least partially defined by your sexuality, I believe it’s a gay man’s birthright and prerogative to exercise that sexuality freely.

This was the late ’80s. Not 10 years earlier, bathhouses and tricking were accepted and celebrated parts of gay life. In 1978, at the hormonally supercharged age of 13, I visited my uncle in San Francisco and had to hide my titillation walking down Polk Street, with all the leather-clad men who looked like Tom of Finland had drawn them. I secretly purchased a steamy memoir about hedonistic gay sex in Paris nightclubs, and snuck over to a convenience store on the other side of town to buy copies of Blueboy and Mandate magazines. Then, not long after, HIV slammed the door shut on all of that, delivering a sharp slap in the face to a horny twentysomething. Now, a possible death sentence came along with getting physically intimate with a stranger. It was unspeakably unfair, and frightening.

Fast-forward to today, and here we are again, it seems. Although I’m now happily married, I was pleased to know that casual sex was beginning to steam up in recent years, thanks to pre-exposure prophylaxis and hookup apps such as Grindr, allowing sex parties and cruising the dunes of P-town to once again become possibilities. But then the novel coronavirus came roaring in. As self-isolation became the new normal, I was reminded of my experiences as a young man during the dark days of the HIV/AIDS crisis, and I sympathized with my uncoupled friends who were suddenly saddled with unsought chastity belts, their libidos on lockdown. Not to make light of it, but among its many horrors, COVID-19 has turned out to be a total cock block. Once again, the idea of physical contact is married to mortal danger, making me wonder whether and how COVID-19 has affected singles’ sexual behavior. Are we headed right toward another pandemic-induced Victorian era?

Read the full article.

14 Things I Wish Queer Men Were Taught in Sex Ed By Zachary Zane

From Pride.com (By Zachary Zane)…

Oh, sex ed. A decade later, and the only thing I remember “learning” from it is “wear a condom.” I honestly don’t think I could tell you another single bit of information they “taught” me except for that men have a vas deferens, which is somewhere in the penis. (Testicles, maybe?)

Imagine how nice it would have been if they actually taught us something useful! Imagine if instead of scaring us and making us fear our own sexuality, sex ed courses taught us how to embrace and explore our sexuality safely! Can you imagine??

So here are 14 things I wish sex ed courses taught me! (And all queer men and queer folks, for that matter. Screw it—everyone can benefit from this!)

Health screening for gay men on PrEP falling behind recommended standards

From aidsmap.com

Levels of sexual health screening among gay men taking PrEP fall well below recommended levels, investigators from the United States report in the online edition of Clinical Infectious Diseases.  Rates of testing for sexually transmitted infections (STIs) in the rectum and throat – which can be asymptomatic – were especially low, so too testing coverage in south-eastern US states which have an especially high burden of HIV and STI infections among gay and other men who have sex with men.

“Consistency of STI screening at PrEP care visits was lower than recommended, especially for rectal and pharyngeal infections that are mostly asymptomatic,” write the authors. “Our findings also highlight the regional variation in gaps between recommendations and PrEP clinical practice overall, and raise concerns about whether comprehensive PrEP care as currently practiced would be effective for STI control.”

Tenofovir-based PrEP is highly effective at preventing infection with HIV but the treatment provides no protection against STIs. Pre-existing research shows elevated STI rates among PrEP-using gay men, probably the result of increased surveillance and sexual risk behaviour. The Centers for Disease Control and Prevention (CDC) therefore recommends that gay men taking PrEP should have comprehensive check-ups for bacterial STIs every three to six months. These sexual health screens should include tests for chlamydia, gonorrhoea and syphilis, with swabs or samples taken from the urethra, throat and rectum.

Read the full article.

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.