Stop blaming PrEP for the increase in STI rates

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.

Opinion: Why don’t more Americans use PrEP?

From the New York Times

Truvada was approved by the Food and Drug Administration in 2012. But over six years later, the United States is failing miserably in expanding its use. Less than 10 percent of the 1.2 million Americans who might benefit from PrEP are actually getting it. The major reason is quite clear: pricing. With a list price over $20,000 a year, Truvada, the only PrEP drug available in the United States, is simply too expensive to become the public health tool it should be.

[…] The disparities in PrEP access are astounding: Its use in black and Hispanic populations is a small fraction of that among whites. In the South, where a majority of H.I.V. infections occur, use is half what it is in the Northeast. Women use PrEP at drastically lower rates than men, and while there’s no national data on PrEP and transgender Americans, it’s almost certainly underused. The issue of PrEP access has become an issue of privilege.

The ability of PrEP to greatly reduce new H.I.V. infections is no longer in question. In New South Wales, Australia, a program providing free access to PrEP led to a drop in H.I.V. diagnoses in the most vulnerable communities by a third in just six months, one of the fastest declines recorded since the global AIDS crisis began.

Read the full article on New York Times online.

Opinion: We need to talk about how Grindr is affecting gay men’s mental health

I’m a gay psychiatrist. Here’s why I went on Grindr to survey men.

When I open the Grindr app on my smartphone, I see there’s a 26-year-old man with tanned abs just 200 feet away. He’s called “looking4now,” and his profile explains that he wants sex at his place as soon as possible.

Scrolling down, I find 100 similar profiles within a one-mile radius of my apartment in Boston. I can filter them by body type, sexual position (top, bottom, or versatile), and HIV status.

As a gay psychiatrist who studies gender and sexuality, I’m thrilled with the huge strides we’ve made over the past decade to bring gay relationships into the mainstream. The Supreme Court ruled that same-sex marriage is a constitutional right. Today in Boston, two men can walk down the street holding hands without consequence.

But I’m worried by the rise of the underground digital bathhouse. Apps like Grindr, with 3 million daily active users, and others like Scruff and Jack’d, are designed to help gay men solicit sex, often anonymously, online. I am all for sexual liberation, but I can’t stop wondering if these apps also have a negative effect on gay men’s mental health.

Since there’s little published research on the men using Grindr, I decided to conduct an informal survey and ask men why they’re on the app so much and how it’s affecting their relationships and mental health. I created a profile identifying myself as a medical writer looking to talk to men about their experiences. I received about 50 responses (including propositions).

It’s a small sample size, but enough to give us some clues about how Grindr is affecting gay men. And it doesn’t look good.

Read the full article on Vox.

Erie County Health Department: A little-known prevention tool can help reduce infection

From Lisa Szymanski, R.N. public health nurse with the Erie County Department of Health (via goErie.com)…

On the heels of World AIDS Day, I can think of no better time to talk about HIV prevention.

HIV is no longer the death sentence it once was. Today, people infected with the virus are living healthier and longer lives; there are well over 300 people living with HIV in Erie County alone.

But HIV can still have serious health consequences.

A little-known HIV prevention tool is available. We call it PrEP, or pre-exposure prophylaxis.

PrEP helps HIV-negative adults greatly reduce their risk of infection. It consists of a medication, Truvada, taken once a day.

If used as prescribed, the U. S. Centers for Disease Control and Prevention states that daily PrEP reduces the risk of getting HIV from sex by more than 90 percent or higher if combined with other risk-reducing behaviors. Among people who inject drugs, it reduces the risk by more than 70 percent.

The CDC is recommending PrEP for people who are HIV-negative and diagnosed with a sexually transmitted disease in the past six months. It is also recommended for those who have an HIV-positive sexual partner, heterosexual men and women who do not regularly use condoms during sex with partners of unknown HIV status, and gay or bisexual men unless in a mutually monogamous relationship with a partner who recently tested HIV-negative.

PrEP is also recommended for people who have injected drugs and have shared needles or been in drug treatment in the past six months.

You must take an HIV test before beginning PrEP and every three months while you’re taking it. There are several health-care providers in the Erie area who are now prescribing PrEP to their patients.

The cost of PrEP is covered by many health insurance plans, and a commercial medication assistance program provides free PrEP to people with limited income and no insurance to cover PrEP care.

Talk with your doctor or health-care provider to determine if PrEP is right for you. For more information, you may contact the Erie County Department of Health.

Gay guys: you’re douching wrong

From voice.com

…you don’t truly need to clean out before riding the baloney pony all night long. It all comes down to anatomy. As Dr. Goldstein told me, stool resides in the sigmoid colon, the part of the large intestine closest to the rectum and anus. There, you’ll find a muscle that keeps poo from going into the rectum and through the anus until you’re actually ready to, you know, poo. That means there shouldn’t be any stool where the top’s dick is going, unless your top is hung like Jon Hamm times Justin Theroux.

You’re probably about to say, “Yeah, but when I douche all kinds of poo comes out.” You’re not wrong. The thing about enemas and irrigation devices is that they were made for people with actual constipation issues, not bottoms. When we douche, the force of water propelled into the colon goes past the area that actually needs to be clean for sex, up into the sigmoid colon. That fills the feces up there with water, and then washes it all out, which is the point of the enema in the first place. An enema cleans out way more than you need to for sex, making your butthole even dirtier in the process. And many people do this repeatedly, until the water comes out clear. That’s like draining a whole pool just to get a few leaves out when you could be using a skimmer instead. (Though it’s possible for a dick to enter the sigmoid colon depending on one’s individual anatomy, it’s not common.)

Read the full article.

Six top experts resigned from Trump’s HIV/AIDS advisory panel

From the Huffingtonpost.com

Scott Schoettes, Counsel and HIV Project Director at the pioneering LGBTQ legal group Lambda Legal, resigned late last week from the Presidential Advisory Council on HIV/AIDS (PACHA), along with five other council members, in protest of Donald Trump’s polices ― or lack of polices ― to combat the HIV epidemic.

On Friday, Schoettes lambasted Trump as callous, a president who “simply does not care,” laying out the reasons for the resignations in a piece on Newsweek.com:

As advocates for people living with HIV, we have dedicated our lives to combating this disease and no longer feel we can do so effectively within the confines of an advisory body to a president who simply does not care. The Trump Administration has no strategy to address the on-going HIV/AIDS epidemic, seeks zero input from experts to formulate HIV policy, and—most concerning—pushes legislation that will harm people living with HIV and halt or reverse important gains made in the fight against this disease.

PACHA, created in 1995 during the Clinton administration, advises the Secretary of Health & Human Services, who is now Tom Price, the former Georgia GOP congressman with an abominable anti-LGBTQ voting record. In 2013, Price, on a conference call of far-right activists, responded to a question about the “medical health impact” of the “homosexual agenda” by stating that “the consequences of activity that has been seen as outside the norm are real and must be explored completely and in their entirety prior to moving forward with any social legislation that would alter things.”

Price is now spearheading Trump’s and the GOP’s efforts to repeal the Affordable Care Act and replace it with Trumpcare, which the Congressional Budget Office estimated would cause 23 million people to lose health care within ten years. This would harm hundreds of thousands of people with HIV across the country as well as many more HIV-negative gay and bisexual men and transgender women at risk who need insurance for pre-exposure prophylaxis (PrEP), the drug therapy to prevent HIV infection. And any advances to stem the epidemic could be dramatically halted or reversed.

One of the most ominous signs of Price’s and the Trump administration’s lack of concern about HIV is that the website for the Office of AIDS Policy was taken down shortly after Trump took office and has not been replaced ― another reason cited by the six members of PACHA who resigned.

Read the article here.

 

 

Canandian HIV activists: Your Nostalgia Is Killing Me

From thebody.com

[Chevalier and Bradley-Perrin’s] piece, titled “Your Nostalgia is Killing Me,” features that wry line, emphatically rendered in bright-yellow, drop-shadowed letters, against the backdrop of a computer-illustrated bedroom. Keith Haring and General Idea graphics serve as wallpaper; visual ephemera from the ’80s — ACT UP reproductions, Therese Frare’s famous photo of mourners at a patient’s bedside, promotional images for the films Philadelphia and Blue — are presented as teenybopper posters, plastered on the wall like pin-ups.

It was a bold comment on how romanticizing the past can obscure present priorities and impede real action. But not everyone read it that way. For many, especially those who had lived through those crisis years, the poster was a lightning rod. On social media, older activists attacked Ian and Vincent for what they perceived as undermining or dismissing the lived experience of survivors, calling them “stupid fucking brats” and accusing them, among other things, of committing “a little Oedipal murder.”

“It became really clear to me that there was this generational divide among people living with HIV, where younger people and older people interpreted the poster differently,” Ian says. He was struck, he notes, by how different generational experiences of HIV are from one another and he felt compelled to investigate that difference.

“It was personal, political, historical,” he continues. “That combination of factors is what my work is now, and what it has always been.”

The posterVIRUS clash was a particularly heated and visible example of Ian’s activist work, but it was far from his first foray into challenging the dominant paradigm. A lifelong critical thinker, Ian can trace the origins of his militant consciousness back to his time as a high school student in Oakville, Ontario, a well-heeled suburb of Toronto.

It was in his teens that the seeds of his current interest in the intersections of public health and marginalized communities were planted. In 2007, during Ian’s final year of high school, he began dating his first boyfriend, who was grappling with addiction and mental health issues and struggling to find ongoing care and treatment.

Through the lens of first love, Ian’s eyes were opened to the shortcomings in the Canadian healthcare system — the dearth of detox, addictions and recovery services, and the challenges of finding a therapist for someone struggling with serious mental health needs. In a time of crisis, the only option seemed to be to go to the emergency room. “I was watching the outer limits of what was possible in Canada for healthcare,” he says.

Read the full article.