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. 

 

 

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.

A new campaign is calling for butt selfies

From hivplusmag.com…
By Zachary Zane

It shouldn’t be that hard to find a health care professional who’s up-to-date and sensitive to specific needs of the LGBTQ and HIV-positive communities. Yet, for many, it still is.

In some smaller suburbs, it’s nearly impossible to find a doctor who is knowledgeable about issues like PrEP, hormone replacement therapy, anal pap smears, and other queer health care requirements. In fact, most people living with HIV have to specifically see an infectious disease specialist when, in theory, their primary care physician should know how to help them achieve and sustain an undetectable viral load.

These days, HIV is a manageable condition, similar to diabetes. It shouldn’t be the responsibility of HIV-positive and/or queer people to find a doctor adept at treating them. That’s why the #WeNeedAButton campaign is putting the responsibility on doctor-patient matching sites.

I’ve teamed up with DatingPositives.com, a dating site for poz people, and Waxoh.com, its sex-positive digital magazine, to promote the effort. DatingPositives.com embraces those managing all STIs and takes their issues very seriously. Given that the LGBTQ community often overlaps with this community, the partnership was a perfect match — so to speak.

Together, we have a mission to improve our community’s health care experience and minimize stigmatization. Our simple solution? A single button to identify queer-friendly doctors.

Read the full article.

Post a selfie to help end HIV stigma

From plus online…

The campaign captures 24 hours in the lives of people affected by HIV stigma, which impacts everyone regardless of age, race, or status. The social media-driven campaign, now in its tenth year, is an opportunity for people to share a moment of their day and tell their story, while breaking down the barriers that stigma creates and raising awareness about HIV, as stated in a press release.

“Stigma can isolate and scare people,” said Positively Aware art director Rick Guasco, who created the campaign. “It can also prevent people from accessing care and treatment. A Day with HIV brings people together; it shows that we’re all affected by stigma, and that people living with HIV are just like everyone else.”

We encourage you to take a picture and post it to your social media with the hashtag #ADayWithHIV and include a caption that gives the time, location, and what inspired you to take the photo.

Images can also be uploaded to ADayWithHIV.com, where they will be considered for publication in a special section of the November/December issue of Positively Aware.

Check out some of last year’s photos

Care providers reluctant to explain *undetectable equals untransmittable* to patients

From Medscape

WASHINGTON, DC — HIV treatment that leads to viral suppression for at least 6 months is 100% effective in preventing the transmission of HIV, even in the absence of condoms or HIV prevention drugs, according to the Centers for Disease Control and Prevention. But not all care providers tell their patients that.

A survey in the Midwest showed that 22% of HIV physicians still don’t feel comfortable explaining to patients the science behind what is known in the community as U=U, or undetectable equals untransmittable.

And that number is even higher among the physician assistants, nurse practitioners, advanced practice nurses, and traditional registered nurses who serve people living with HIV, said Emily Petran, MPH, from the Minnesota site of the Midwest AIDS Training and Education Center (MATEC) in Minneapolis.

The survey — which was more of a needs assessment than a scientific survey — points to the need for education so that people with HIV have all the information they need to care for themselves and their partners, she said here at the United States Conference on AIDS 2019.

Continue reading

Living with HIV

From U.S. News and World Report

According to the Centers for Disease Control and Prevention, an estimated 1.1 million people in the United States are living with HIV. In 2017, 38,739 people received an HIV diagnosis, and when they first heard the word “positive,” many were thrust into feelings of anger, sadness, denial and fear.

“There are some people who suspect they are HIV-positive but go a very long time without testing, and then there are other people who test for whatever reason and turn out positive,” says Mallory Johnson, a clinical psychologist and professor at the University of California–San Francisco School of Medicine and co-director of the NIH-funded Center for AIDS Prevention Studies. “Those tend to be the extremes of the experience.” Disbelief and shock, Johnson says, are the most common responses.

Of those living with the virus in the U.S., about 14%, or 1 in 7, are unaware of their infection. HIV weakens the immune system by destroying cells meant to combat infection and disease; AIDS is the final stage of the infection, when the immune system has been severely damaged. Not all HIV-positive individuals will develop AIDS – antiretroviral therapies and other medications now allow people with the virus to live long, healthy lives.

Still, receiving a chronic diagnosis like HIV is likely to produce emotional distress. Here’s a look at the toll such a diagnosis takes, as well as how patients can tend to their psychological health.

Learning he was “undetectable” was a game changer

In 2012, Bruce Richman received news about his health that would set him on an unexpected path.

His doctor explained to him that he was “undetectable,” meaning that by adhering to his HIV antiretroviral therapy, the viral load in his blood was so low that it could no longer be detected.

Bruce Richman, founder of Prevention Access Campaign, is working to change the way the world views people living with HIV

This was a game changer for him. The news meant that Richman, who first found out he had HIV in 2003, would be unable to pass the virus on to any sexual partner.

“I found out nine years after my diagnosis that I can’t transmit the disease. My doctor told me and, here I am, a privileged white guy with a support system. I’m privileged with this information, and I started looking around and saw that nothing confirmed it was true,” Richman told Healthline. “I started doing research. There was no information out there to the general public that was clear and inclusive and accepted that this was true.”

Richman’s realization that this information, which could benefit thousands upon thousands of people living with HIV, rested mainly within medical circles — accessible to those with connections and privilege — awakened something within him.

Continue reading on Healthline.com.

Documentary 5B shows the real heroes of the AIDS epidemic

From People.com

This was a time when people weren’t even touching patients with HIV,” says Priyanka Chopra, a prominent supporter of the film on behalf of the AIDS charity RED, which will receive 30 percent of all box office proceeds. “They would lay in their soiled bedsheets for days where nobody would come and even enter their room to feed them. At that time, these nurses chose to not think about whether they would live or die and actually the nobility of the profession is what you see in this movie.”

The film, which received a four-minute standing ovation at the Cannes Film Festival last month, features the nurses of ward 5B at San Francisco General Hospital who didn’t allow societal ignorance, prejudice and fear curtail their drive to administer compassionate health care to patients who had otherwise been cast aside. These were patients who most health care professionals wouldn’t touch without wearing gloves, even a hazmat suit.

Read the full article.

 

How Pittsburgh is at the forefront of HIV awareness, prevention, and care

From the Pittsburgh City Paper…

On World AIDS Day in 2015, AIDS Free Pittsburgh launched as a collective initiative of healthcare institutions and community-based organizations to support those living with HIV/AIDS, and those in high-risk communities. Following the example of San Francisco and New York, the organization set three goals: to increase access to PrEP, to routinize and destigmatize HIV testing, and to put in place a rapid linkage to care for those diagnosed.

One of the major successes of these efforts has been the increased information about and access to PrEP. Dr. Ken Ho, chair of the PrEP subcommittee of AIDS Free Pittsburgh, says, “We’ve developed multiple programs to make PrEP more accessible in Pittsburgh.” He goes on, “My hope is that our efforts will translate to a continued decline in HIV infections.” These efforts have included putting together PrEP toolkits for providers, hosting informational happy hours for pharmacists, and multi-pronged advertising and media campaigns to chip away at the stigma associated with HIV.

Read the full article.

Healthcare providers should discuss U=U with all their HIV-positive patients

From aidsmap.com

Healthcare providers should inform all patients with HIV they cannot transmit HIV to a sexual partner when their viral load is undetectable, argue the authors of  a strongly worded comment in The Lancet HIV. The authors note that despite overwhelming scientific data supporting the undetectable = untransmittable (U=U) message, significant numbers of healthcare providers do not educate their patients about U=U when telling them their viral load is undetectable.

“Providers caring for patients with HIV should universally inform their patients about U=U as part of their routine care,” write Dr Sarah Calabrese of George Washington University and Professor Ken Mayer of the Harvard Medical School and Fenway Institute. “Conveying benefits and risks surrounding any treatment is fundamental to patients’ decision making, and this HIV treatment benefit should be no exception.”

Read the article on aidsmap.com.

Five ways to flip the script on HIV

From HIVplusmag.com

 

According to the Centers for Disease Control and Prevention’s 2017 HIV Surveillance Report, African-Americans represent 41 percent of new HIV diagnoses yet comprise only 12 percent of the U.S. population. In 2018, an article in Journal of Racial and Ethnic Health Disparities offered a five-point “action plan” for community leaders to address and reduce that disparity.

Be Immersive: Although the authors don’t go as far as suggesting all efforts must arise from black communities, they do note the need for work to be done in collaboration with those communities, and for answers to these challenges to be culturally relevant to African-Americans. (Pointing to an “unavailability of access to HIV healthcare and testing,” the researchers also call for “free or reduced-cost testing.”)

Be Nonjudgmental: The authors call for leaders and service providers to work to eliminate prejudices and unconscious biases that may interfere with HIV diagnoses and treatment. After all, they point out, some of the most-impacted populations are those who face stigma, including LGBTQ people, drug users, and those currently or formerly incarcerated. In particular, the researchers call out “cultural HIV/AIDS stigma” and “homo-negativity.”

Be Knowledgeable: The authors stress the importance of understanding “new approaches” to prevention and treatment—clearly referencing the recent consensus that undetectable equals untransmittable (U=U, which shows that once an HIV-positive person in treatment reaches viral suppression they are no longer at risk of transmitting the virus to a partner), and explicitly mentioning the use of pre-exposure prophylaxis (PrEP) as a highly effective barrier to transmission.

Be an Advocate: The authors want community leaders to become more vocal in calling attention to the epidemic and its impact on the black community. But that’s just the beginning. The action plan notes that much larger social issues must also be addressed in order to “eradicate secondary factors such as incarceration rates, poverty, STDs, and other factors that increase the chances of contracting HIV.” Essentially, they are calling for intersectional activism.

Be Innovative: The plan says to be “proactive and create solutions that evolve with the times and the changing needs of the affected populations.” Certainly, that includes new technologies and treatments, but the authors also point to innovative programs such as Many Men, Many Voices (3MV), aimed at black men who have sex with men who may or may not identify as gay or bi, in which small groups talk about cultural, social, and religious norms; sexual relationship dynamics; and how racism and homophobia influence HIV risk behaviors.

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.

State-level PrEP utilization data now available from AIDSVu

From HIV.gov

Since PrEP is one of the newer HIV prevention tools, understanding more about who is using it is important to better tailoring HIV prevention efforts at the national, state, and community levels. PrEP, or pre-exposure prophylaxis, is when people at high risk for HIV take HIV medicine daily to lower their chances of getting infected with HIV. AIDSVu has released the first-ever publicly available data and interactive maps of PrEP use by state from 2012 through 2016, stratified by sex and age.

The new maps from AIDSVu show more than 77,000 people were prescribed PrEP in 2016, with an average 73 percent increase year over year in persons using PrEP across the U.S. from 2012 – when the drug TDF/FTC was approved by the FDA for use as PrEP – to 2016. However, approximately 1.1 million people in the U.S. are at substantial risk for HIV exposure and could benefit from PrEP, according to analysis presented by the Centers for Disease Control and Prevention (CDC) at CROI 2018 earlier this year.

The data presented on AIDSVu reveal that the growth and distribution of PrEP use has been inconsistent across different sexes, age groups, and geographic regions. For example, the Southern U.S. accounted for more than half (52 percent) of all new HIV diagnoses in 2016 but represented only 30 percent of all PrEP users in 2016. That same year, women comprised 19 percent of all new HIV diagnoses but made up only seven percent of all PrEP users.

Read the full article.

Social isolation is dangerous for your health

From thebody.com

No one living with HIV/AIDS is immune from the impact of isolation. Numerous studies find that social isolation is a problem among the aging population in general, and especially among the elderly living with HIV. Younger persons are also affected. One study found that younger people living with HIV/AIDS experience more disconnectedness from family and friends than their older peers do. Researchers believe this is due to a combination of factors, including stigma, feeling blamed by others for their illness and younger people not identifying with the need to battle a chronic illness. It should also be noted that persons affected by HIV/AIDS, especially those who went through the 1980s and 1990s, can experience the same symptoms of trauma and isolation as people who are HIV-positive.

Read the full article.

February 7th is National Black HIV/AIDS Awareness Day

From the National Black HIV/AIDS Awareness Day Website

February 7, 2018 marks the 18th year for National Black HIV/AIDS Awareness Day (NBHAAD), a national HIV testing and treatment community mobilization initiative targeted at Blacks in the United States and the Diaspora.  NBHAAD was founded in 1999 as a national response to the growing HIV and AIDS epidemic in African American communities. The NBHAAD initiative leverages a national platform to educate, bring awareness, and mobilize the African American community. NBHAAD has four key focus areas which encourage people to:

  • Get Educated about HIV and AIDS;
  • Get Involved in community prevention efforts;
  • Get Tested to know their status; and
  • Get Treated to receive the continuum of care needed to live with HIV/AIDS.

For more information go to National HIV/AIDS Awareness Day online.  You can also find local testing resources by entering your zip code here.

Allies for Health + Wellbeing launches “I am an Ally” campaign with the support of Mayor Peduto and many prominent Pittsburghers

The campaign is designed to help raise the community’s awareness that what was the Pittsburgh AIDS Task Force is now Allies for Health + Wellbeing and that Allies provides integrated medical and behavioral health care, as well as supportive human services and community-based education for all those living with or at risk of HIV, viral hepatitis and sexually transmitted infections.

The “I am an Ally.” campaign will feature images on the back of Port Authority buses leaving the East Liberty garage starting February 1, 2018, and in other media outlets through April.

Allies of Allies for Health + Wellbeing featured in the campaign include:

  • Allies Board Member Linda Bucci and her husband, Chairman of MARC USA Tony Bucci
  • Medical Director of the Pitt Men’s Study, UPMC infectious disease doctor and Allies Board Member, Ken Ho, MD, MPH
  • Director of the Allegheny Health Department, Karen Hacker, MD MPH
  • Friends of Allies Richard Parsakian, Dr. Larry Leahy, John Van de Grift, Nancy Simpronio and Chuck Culbertson.
  • Allies for Health + Wellbeing LGBQTIA community advocates J Daniel Barlow and Dandy Hayes.

Join the Allies campaign by contacting Allies for Health + Wellbeing at 412-345-7456/info@alliespgh.org.

 

Trans men face heavy HIV burden

From the Washington Blade

HIV-positive transgender men in the United States have significant unmet social and health care needs, according to a study published in Research and Practice, AIDSmap reports. Approximately half were living in poverty and only 60 percent had sustained viral suppression.

“Many transgender men receiving HIV medical care in the United States face socioeconomic challenges and suboptimal health outcomes,” write the authors. “Although these transgender men had access to HIV medical care, many experienced poor health outcomes and unmet needs.”

Transgender people experience poorer health outcomes compared to cisgendered individuals, AIDSmap reports.

Little is known about characteristics and outcomes of HIV-positive transgender men (designated female at birth). A team of investigators therefore analyzed the records of patients who received HIV care in the United States between 2009-2014. Their aim was to characterize the sociodemographic and clinical characteristics of these patients, AIDSmap reports.

Overall, transgender men constituted 0.16 percent of all adults but 11 percent of transgender adults receiving HIV care in the United States. The majority (59 percent) were aged between 18-49 years and 40 percent identified as gay or bisexual. Although 42 percent had completed high school, almost half (47 percent) had an income below the national poverty level. A third were uninsured or relied on a Ryan White program for their health care. Over two-thirds (69 percent) had an unmet support need and a quarter were currently living with depression, AIDSmap report.

Read the full article.

Research: Lung cancer deaths higher among HIV+ smokers

According to the U.S. National AIDS Strategy report, about 1 in 5 American adults smoke. Among adults living with HIV, the number of people who smoke is 2 to 3 times greater. The report also states that smoking can cause health risks specifically for people who are living with HIV. For example, smokers with HIV are at higher risk (as compared to nonsmokers with HIV) of developing smoking-related cancers, bacterial pneumonia, COPD, heart disease, and oral candidiasis (thrush).

Furthermore, previous research found that HIV-positive smokers lose years of life to cigarettes as compared to nonsmokers with HIV.

If all of that wasn’t enough to convince gay and bi men with HIV to kick the habit, a new study published in The Journal of the American Medical Association narrows the range of research, focusing specifically on projected lung cancer deaths.

The researchers found that nearly 25 percent of people who adhere well to anti-HIV medications but continue to smoke will die from lung cancer. Among smokers who quit at age 40, only about 6 percent will die of lung cancer. The authors also found that people with HIV who take antiviral medicines but who also smoke are from 6 to 13 times more likely to die from lung cancer than from HIV/AIDS.

“Quitting smoking is one of the most important things that people with HIV can do to improve their health and live longer,” Travis Baggett, MD, MPH, of the MGH Division of General Internal Medicine and coauthor of the study, said in a recent press release. “Quitting will not only reduce their risk of lung cancer but also decrease their risk of many other diseases, such as heart attack, stroke and emphysema.”

To read a press release about the study, click here. To find out more about how you can quit smoking, click here and here.  For more information about Health Alerts, go to the Pitt Men’s Study Website at https://pittmensstudy.com/health-alerts/. To subscribe to the Pitt Men’s Study Health Alerts, send an email to rgy2@Pitt.edu, with the word subscribe in the subject line.

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

New injectable antiretroviral treatment proved to be as effective as standard oral therapy

From Science Daily

Antiretroviral therapy (ART) intramuscularly administered may have the same effectiveness as current oral treatments. This is the main conclusion of the Phase II clinical trial carried out by 50 centers around the world — 9 in Spain — to which the team of Dr. Daniel Podzamczer, principal investigator of the Bellvitge Biomedical Research Institute (IDIBELL) and Chief of the HIV and STD Unit of the Infectious Diseases Service of Bellvitge University hospital (HUB) has contributed. The results of the trial, published by the journal The Lancet, pave the way to the implantation of all-injectable antiretroviral therapies with a lower frequency of administration, which would imply a significant improvement of the quality of life of HIV patients.

Read the full article.