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.  

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.

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.

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.

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.

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:

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.

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.

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.

Read the full article.

Health Alert: Get tested for HIV and other STIs

According to a CDC report, HIV continues to have a disproportionate impact on racial and ethnic minorities, gay and bisexual men, and other men who have sex with men. Yet, 15% of men who are infected with HIV don’t know it.
Also, according to CDC research, cases of gonorrhea, chlamydia and syphilis have risen for the fifth consecutive year.

Some STIs (including HIV) can go unnoticed since symptoms can be mistaken for minor health problems like a cold or sore throat. Some may have no symptoms at all. The only way to know if you’re infected is to get tested.

If you send us your zip code, we can help find local testing near you. Most are free. You can also ask us questions about basic sexual health, including PrEP. Send a message to m4mInformation@pitt.edu. We’re here to help

 

Health Alert: New drug-resistant STI spreading among men who have sex with men

Researchers at the University of Washington have identified a worrisome new bacterial cluster that’s growing in prevalence among men who have sex with men and is resistant to antibiotics.

The drug-resistant strains were identified in Seattle and Montreal, although researchers believe they’re common worldwide. Known as Campylobacter coli, the bacteria cause severe abdominal pain, bloody diarrhea, and fever and are estimated to affect about 1.3 million people in the United States annually. The journal Clinical Infectious Disease published the finding this month.

While the infection usually passes after a few days, it can pose a more serious threat to those with compromised immune systems.

Men who have sex with men are more prone to infection due to sexual practices like anal sex and rimming, according to the researchers. Transmission occurs when fecal matter enters another person’s body, and while it isn’t limited to any one population, gay men are more likely to experience drug-resistant infections because they’re more likely to have recieved antibiotics for similar infections in the past.

“The international spread of related isolates among MSM populations has been shown before for Shigella [another enteric pathogen], so it makes sense to see it in Campylobacter as well,” wrote the study’s lead author, Dr. Alex Greninger. “The global emergence of multidrug-resistant enteric pathogens in MSM poses an urgent public health challenge that may require new approaches for surveillance and prevention.”

Read more on Out Magazine online.

Most Americans have never been tested for HIV

From CNN

Most Americans have never been tested for HIV, the virus that attacks and weakens a person’s immune system.

The US Centers for Disease Control and Prevention is hoping to change that.
According to a new report, the agency found that fewer than 40% of people in the United States have been screened for HIV. It recommends that all people 13 to 64 be tested at least once.
Fifty jurisdictions across the country are responsible for more than half of all HIV diagnoses, yet only 35% of the people recommended for testing in those areas were screened in the previous year, the CDC says. And fewer than 30% of people across the country with the highest risk of acquiring HIV were tested in that period.
“Diagnosis and treatment are the first steps toward affording individuals living with HIV a normal life expectancy,” CDC Director Dr. Robert Redfield said in a statement. “As we encourage those at risk for HIV to seek care, we need to meet them in their journey. This means clearing the path of stigma, finding more comfortable ways of delivering health services, as well as learning from individuals already in treatment so the journey becomes easier for others who follow.”

1 in 5 new HIV diagnoses are among Latinx gay and bi men

From pridesource.com

According to the CDC, one in five new HIV diagnoses in 2017 in the U.S. were among Latinx gay and bisexual men. While HIV rates are stable, or falling in other groups, they rose by 12 percent among these men from 2012-2016. Eighty-four percent of the increase among Latinx gay and bisexual men was in Puerto Rico, Arizona, California, Florida, Illinois, New York, and Texas. By looking at different factors and health outcomes, the authors highlight four policy actions to heighten attention:

  • Strengthen governmental responses to HIV that focus on the unique prevention and care needs of Latinx gay and bisexual men
  • Address the social determinants of Latinx gay and bisexual men’s health.
  • Support immigrants and migrants, including when providing HIV services.
  • Cultivate and support emerging Latinx leaders.

“There is much that we are getting right in our national response to HIV, as exemplified by declining HIV diagnoses and increased HIV viral suppression, yet these outcomes are not being equally shared. By understanding the challenges facing Latinx communities and more strongly embracing Latinx gay and bisexual men, we can turn this around and reduce these disparities,” says Jeffrey S. Crowley, program director of Infectious Disease Initiatives at the O’Neill Institute for National and Global Health Law at Georgetown Law.

Read the full article.

April is STD awareness month: Good health means getting tested

If you are sexually active, getting tested for STDs is one of the most important things you can do to protect your health. Make sure you have an open and honest conversation about your sexual history and STD testing with your doctor and ask whether you should be tested for STDs. If you are not comfortable talking with your regular health care provider about STDs, there are many clinics that provide confidential and free or low-cost testing.

Below is a brief overview of STD testing recommendations. STD screening information for healthcare providers can be found here.

  • All adults and adolescents from ages 13 to 64 should be tested at least once for HIV.
  • All sexually active women younger than 25 years should be tested for gonorrhea and chlamydia every year. Women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STD should also be tested for gonorrhea and chlamydia every year.
  • All pregnant women should be tested for syphilis, HIV, and hepatitis B starting early in pregnancy. At-risk pregnant women should also be tested for chlamydia and gonorrhea starting early in pregnancy. Testing should be repeated as needed to protect the health of mothers and their infants.
  • All sexually active gay and bisexual men should be tested at least once a year for syphilis, chlamydia, and gonorrhea. Those who have multiple or anonymous partners should be tested more frequently for STDs (i.e., at 3- to 6-month intervals).
  • Sexually active gay and bisexual men may benefit from more frequent HIV testing (e.g., every 3 to 6 months).
  • Anyone who has unsafe sex or shares injection drug equipment should get tested for HIV at least once a year.

You can quickly find a place to be tested for STDs by entering your zip code at gettested.cdc.gov.

New STDs emerging

From the New York Daily News

The first worrisome pathogen is Neisseria meningitides, a bacteria that “can cause invasive meningitis, a potentially deadly infection of the brain and spinal cord’s protective membranes,” the health website Mosaic informs us. “More commonly, it’s gaining a reputation as a cause of urogenital infections.”

N meningitides resides in the back of the nose and throat of between 5% and 10% of adults, the site said. There’s a chance people can transmit the bacteria via oral sex or deep kissing.

In 2015, Mosaic said, the bacterial strain mixed with the closely related N gonorrhoeae, which causes gonorrhea — a mutation that allowed the disease to spread more readily.

On the upside, vaccines are available that can protect against all five strains of the gonorrhea bacterium.

Second on the list is Mycoplasma genitalium, one of the world’s smallest bacteria. Between 1% and 2% of people are infected, most of them teens and young adults. Many times it doesn’t cause symptoms, but it can irritate the urethra and cervix, just as gonorrhea and chlamydia do. In women this can lead, like chlamydia, to pelvic inflammatory disease and its associated potential for infertility, miscarriage, premature birth and stillbirth.

While antibiotics exist that will eradicate it, resistant strains are developing, which means it could morph into a superbug.

Third on the list is Shigella flexneri, which one contracts from feces. Shigellosis is one of the bacteria causing dysentery, so is not exclusively contracted via sexual contact. But it might have found a new avenue in anal-oral sex, reported Medscape and the CDC. And given that it is becoming resistant to azithromycin, which also treats gonorrhea, the potential for a superbug is there.

Lymphogranuloma venereum (LGV) is number four on the emerging-STD list, caused by acute Chlamydia trachomatis strains. Its incidence is increasing in Europe and North America, especially among gay and bisexual men, Mosaic reports. A 2016 CDC report documented a cluster of cases among men having sex with men in Michigan. Its symptoms can be subtle, with a fast-disappearing lesion in the genital area, but they can also be even less noticeable, according to the CDC.

Historic Increase in Syphilis Infections

The Pennsylvania Department of Health is reporting an historic increase in the number of new Syphilis infections in the state.

The Health Department is asking anyone who fits the criteria listed here to have a Syphilis test…

  • A rash on the palms of the hands or on the soles of the feet, back, chest, or stomach
  • A lesion (red sore) in the genital, rectal, or oral area
  • Moist papules in the mouth
  • Sudden scalp alopecia (loss of hair)
  • Sudden loss of eyelashes and eyebrows
  • Swelling of the lymph nodes
  • A recent positive test for another STD such as gonorrhea, chlamydia, HIV or Hepatitis C

Send your zip code to m4mInformation@pitt.edu and we’ll send you locations for STD testing. Most are free.

Syphilis is a sexually transmitted infection. If it goes untreated, it can lead to serious health problems including paralysis, blindness, and dementia. However, Syphilis is 100% curable with simple antibiotics.

Syphilis is spread through direct contact with a Syphilis sore during vaginal, anal, or oral sex. You can get Syphilis and not have any symptoms so the only way to know for sure you’re not infected is to get tested.

Several locations around the state have free Syphilis testing. Click on this link to find free testing at a State Health Center near you.

To find out more about Syphilis, go to www.cdc.gov/std/syphilis/stdfact-syphilis.htm

 

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To find out more about Health Alerts, go to the Pitt Men’s Study Website.

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Pitt Men’s Study Health Alerts are presented by the Pitt Men’s Study and the HIV Prevention and Care Project at the University of Pittsburgh Graduate School of Public Health.

Health Alert: Post-Exposure Prophylaxis for HIV (not to be confused with PrEP)

From redorbit.com

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).

Health Alert: Rates of STDs climbed for the fourth consecutive year in the US

Rates of syphilis, gonorrhea and chlamydia have climbed for the fourth consecutive year in the United States, the Centers for Disease Control and Prevention (DCD) announced recently. Last year, nearly 2.3 million US cases of sexually transmitted diseases (STDs) were diagnosed, which is the highest number ever reported.

Chlamydia, which remained the most common, is easily transmitted during any form of sexual activity. If not treated, chlamydia can cause permanent damage to the reproductive system. In men, the infection can spread to the tube that carries sperm from the testicles, causing pain and fever.

If not treated, gonorrhea can cause severe and permanent health issues, including problems with the prostate and testicles in men or problems with pregnancy and infertility in women. Gonorrhea is also typically treated with antibiotics but the threat of antibiotic-resistant gonorrhea persists nationwide. 

Syphilis can affect the heart, nervous system and other organs if left untreated. Syphilis is most often transmitted through sexual contact and is 100 percent curable with antibiotics.

Gonorrhea and chlamydia can infect other sites of the body such as the rectum and the throat and diagnosis requires a swab of each site. A urine test alone is not sufficient to diagnose STDs of the throat and the rectum. Additionally, all of these infections can be transmitted through unprotected oral sex.

It is important to remember that even if you don’t have symptoms, you can still be infected. If you’re sexually active, you should get tested for a full range of STDs, including the ones listed here. Don’t be shy about asking your doctor for a full screening. If you need to find free, confidential testing in your area, you can check the PA Department of Health listing here.

Health Alerts are presented by the Pitt Men’s Study and the HIV Prevention and Care Project at the University of Pittsburgh, with funding from the State Department of Health.

Why STDs are on the rise in America

From the Economist online

Much of the increase in STDs has come from gay and bisexual men. Although a relatively small share of the population, they accounted for 81% of male syphilis cases in 2016, according to the Centres for Disease Control. As with heterosexuals, this seems to be because sex is now seen as less risky. That is due to the advent of PrEP, a prophylactic drug cocktail which gay men can take to nearly inoculate themselves from HIV. The reduced chances of catching HIV—along with the fact that a positive diagnosis is no longer a death sentence—seems to encourage men to drop their guard. A recent study of gay and bisexual men, published in the Lancet, a medical journal, found that as more began taking PrEP, rates of consistent condom usage dropped from 46% to 31%. Recent studies have shown that uptake of PrEP is strongly associated with increased rates of STD infection.

All this shows that changing sexual mores, and a reduced fear of the risks of unprotected sex, seem to be at fault—especially since the problem is not just limited to America. England experienced a 20% increase in syphilis diagnoses in 2017 and a 22% increase in those of gonorrhoea. Other countries in western Europe have seen ever worse outbreaks, sometimes exceeding 50%. Dwindling public spending on STD prevention—which in America has fallen by 40% in real terms since 2003—is not helping matters. Yet the chief methods of prevention, abstinence and condoms, are tried and true. Should these options seem too chaste or chaffing, then prospective partners ought to get an STD test (especially since most infections can be cleared up with a simple course of antibiotics). Verified testing is vital since verbal assurances, especially on the cusp of a liaison, can be misleading.

Read the full article.

Does PrEP use lead to higher STI rates among gay and bi men?

From POZ.com

Rates of new sexually transmitted infections (STIs) are much higher among men who have sex with men (MSM) taking Truvada (tenofovir disoproxil fumarate/emtricitabine) as pre-exposure prophylaxis (PrEP) than among other MSM. More research is needed, however, to determine whether starting PrEP leads to higher STI rates among MSM.

Publishing their findings in the journal AIDS, researchers conducted a meta-analysis of 18 studies of MSM in which new STI diagnoses were reported. Five of the studies included MSM given PrEP, and 14 were conducted with MSM who were not given PrEP. (One study, the PROUD study, included both a group given PrEP immediately and a group given PrEP on a deferred basis and thus fell into both the PrEP and the non-PrEP categories of studies.)

The researchers found that the rates of new diagnoses of STIs among MSM given PrEP were 25.3 times greater for gonorrhea, 11.2 times greater for chlamydia and 44.6 times greater for syphilis, compared with the rates among MSM not given PrEP. After repeating the analysis but excluding studies conducted before 1999, the researchers found that the results were similar.

Looking to parse apart the contributing factors to the higher rate of STI diagnoses among MSM given PrEP, the meta-analysis’s authors theorized that the regular STI testing that is part of taking PrEP might have led to a higher rate of STI detection. A greater number of sex partners and a higher rate of condomless sex among those given PrEP might also have contributed to their higher STI diagnosis rate.

The study is limited by the fact that, except in the case of PROUD, the researchers compared different populations of MSM from study to study. They also compared groups that tested for STIs at different frequencies and used different variations of STI tests. Additionally, the PrEP studies specifically sought out participants engaging in high-risk sexual behaviors, while the other studies might have had different criteria with regard to sexual risk taking. However, participants in many of the non-PrEP studies were indeed recruited based on some level of reported sexual risk taking.

 

Read the full article.