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.

virusChlamydia, 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.

Health Alert: Return of the AIDS epidemic

From voanews.com

Thirty-six million people currently live with AIDS, a disease that claimed the lives of nearly 1 million people last year. Experts predict that by 2030, 100 million people will have been infected with the HIV virus.

Despite the alarming numbers, there have been great strides in treatment. HIV is no longer a death sentence, and researchers say people receiving treatment for HIV are able to live normal lives and do not pose a risk to others when they are being treated proactively.

But success carries a price: complacency. Funding for AIDS research and treatment has declined, and in some places, so has government interest.

“When we talk to ministers of finance, they always say to me, ‘I thought HIV was over because I don’t see anybody dying,’” said Dr. Deborah Birx, a U.S. Global AIDS coordinator who oversees the President’s Emergency Plan for AIDS Relief (PEPFAR).

J. Stephen Morrison of the Center for Strategic and International Studies, said, “We’re not reaching goals.” He added, “There’s going to be a struggle to hold ground. … There’s a widening deficit of political will and financial capacity that we face some really daunting challenges in prevention.”

Dr. Chris Beyrer, with Johns Hopkins Medicine, predicted that things will get worse if governments and civilians continue their complacency.

“We are not done with AIDS,” he said. “It is much too early to declare victory, and the risks of a resurgent epidemic are real.”

Read the full article.

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.

High numbers of HIV-positive MSM not being tested for syphilis

From healio.com

Nearly one-third of sexually active HIV-positive men who have sex with men are not tested for syphilis at least annually, researchers reported in a recent study, calling the finding “concerning.”

Alex de Voux, PhDan Epidemiologist in the CDC’s Division of STD Prevention, and colleagues sought to examine the proportion of sexually active HIV-positive men who have sex with men (MSM) currently in care who were tested for syphilis in the past 3, 6 and 12 months by their HIV care provider.

A 2017 study showed that MSM accounted for more than 60% of syphilis cases nationwide in 2015. In that study, researchers determined that the rate of primary and secondary syphilis in the United States among MSM was 106 times that of men who have sex with women only.

In the current study, the authors noted that guidelines recommend that sexually active MSM, including HIV-positive MSM, be tested at least annually for syphilis, with testing every 3 to 6 months for MSM at elevated risk, and used this timeline to evaluate the group.

De Voux and colleagues used the most recent medical record and interview data collected by the Medical Monitoring Project, a population-based HIV surveillance system, from 2013 to 2014. The data showed that 71% of all sexually active HIV-positive MSM had at least one test for syphilis in the past 12 months. In the past 6 months, only 43% had been tested, and the number dropped to 22% in the past 3 months.

Researchers also examined the frequency of testing in MSM who reported risk factors, including having condomless sex and having sex with two or more partners.

Read the full article.

To find free syphilis testing near you, search by zip code on the CDC testing Website: gettested.cdc.gov

For more information about syphilis, its symptoms and treatment, click here.

Bisexual men have higher risk of heart disease

From Medical Daily

The research team analyzed data on 7,731 male participants between the ages of 20 to 59. They were divided into four groups based on their sexual identities: gay men, heterosexual men, bisexual men, and heterosexual men who have sex with men.

The two objectives of the study were to examine heart disease diagnoses among men of different sexual orientations and also measure their modifiable risk factors for heart disease.

While no correlation was found between sexual identities and heart disease diagnoses, bisexual men were found to have higher rates of several risk factors for heart disease compared to heterosexual men. These included mental distress, obesity, elevated blood pressure, etc.

The other three groups were found to have similar heart disease risk. The only difference observed in health behavior was that gay men reported lower binge drinking than straight men.

“Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of men and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in bisexual men,” said lead author Billy Caceres, an adjunct faculty member at Rory Meyers College of Nursing, New York University.

Read the full article.

Increasing Incidence of Syphilis in People With HIV

From Infectious Disease Adviser

The incidence rate of syphilis in people with HIV increased through 2015, according to new research published in Clinical Infectious Diseases.

Since 2000, the incidence of syphilis has increased among gay, bisexual, and other men who have sex with men (MSM) in the United States. This represents an ongoing sexual risk, and temporal trends and associated risk factors for newly diagnosed syphilis infections among people with HIV were therefore investigated.

Data from HIV Outpatient Study cohort participants visiting 10 clinics in the United States from 1999 to 2015 were analyzed. A total of 6888 participants with HIV were included, and 641 had one or more new syphilis diagnoses during a median follow period of 5.2 years. Participants were mostly male, age 31 to 50 years (78%), and the majority were MSM (56%).

Read the full article.