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.