Young people dying as stigma, misunderstanding prevent HIV treatment

From Canada’s CBC News

When Saskatoon man Ian Longman found out he had HIV, it was two years before he sought treatment. He thought the diagnosis meant certain death, and he didn’t know treatment was an option.

Ian Longman almost died because he didn’t know treatment for HIV was available

“I just started hating myself and hating other people and hating what they were saying about me and stuff like that,” said Longman.

“Because I heard that you die from it so I thought that I was dying.”

In the months leading up to his hospitalization, he’d been shunned by his loved ones, who didn’t know that HIV could only be transmitted by sharing certain bodily fluids and not, for example, by sharing a cup.

Lack of education, understanding

It’s a lack of awareness that Sanctum executive director Katelyn Roberts said is common in Saskatchewan, a province in which doctors are calling the spread of HIV an “epidemic.”

“We have people in Saskatchewan who are in their 20s and they’re dying,” she said.

“And they’re not dying because of the HIV per se, they’re dying because they haven’t engaged in health care and by the time we catch them and we get them into the appropriate setting, it’s too late.”

Read the full article.

Who we are… 

m4mHealthySex.org is a joint effort between the HIV Prevention and Care Project and the Pitt Men’s Study at the Graduate School of Public Health, University of Pittsburgh. Our goal is to provide up-to-date sexual health information for men who have sex with men. Click on the menu or the page links above to find testing and care resources, including information about PrEP.

You can also scroll down for the latest blog posts as part of our archive of sexual health information…

The new gay sexual revolution

From Advocate.com

Now there’s hope the younger generation may also experience worry-free sex lives — without the side effects of living with HIV. The use of the antiretroviral drug Truvada as pre-exposure prophylaxis, or PrEP (it’s the only medication approved for HIV prevention), has been shown to reduce the chance of HIV transmission to near zero. Since the medication was first approved as PrEP in 2012, only two verified cases of transmission have been documented among those who adhere to the daily schedule (a third, according to HIV expert Howard Grossman, could not be confirmed). New, longer-lasting PrEP injectables should reach market in the next few years. Studies suggest that on-demand PrEP (such as taking it before and after sexual activity) may also be effective.

“This is a revolution!” Gary Cohan, MD, who prescribes PrEP, told us in 2016. “This should be above the fold in The New York Times and on the cover of Time magazine. A pill to prevent HIV?”

Read the full article on Advocate.com.

Finding LGBT-friendly care  

 

Resources for finding LGBT-friendly care, support and useful information:

• The Human Rights Campaign releases an annual report, “Healthcare Equality Index,” with information on the policies and practices that health care facilities in the United States offer to LGBT patients and their families.

SAGE is a national social service agency dedicated to LGBT seniors, with a free and confidential LGBT Elder Hotline: 888-234-7243.

• The National Resource Center on LGBT Aging offers a wide range of health, policy and legal info on its site, where you can search for local resources by state.

  • The LGBT National Help Center is an online and call-in resource center for information, support and referrals. It includes an online peer-support chat group and a hotline you can call to speak with a volunteer peer counselor: 888-843-4564.

• The Gay and Lesbian Medical Association allows you to search for health care providers in your area.

CenterLink, the Community of LGBT Centers, has a locator where you can find the gay community center nearest to you or your loved one’s home.

• The Metropolitan Community Churches, an international Christian denomination, is particularly welcoming of LGBT people. A staff person at the nearest MCC might be able to recommend appropriate resources in your area.

  • Family Caregiver Alliance offers LGBT caregiving FAQs, as well as a section on “Legal Issues for LGBT Caregivers” and other useful legal resources.

• The U.S. Department of Veterans Affairs has information about its policies and military benefits for LGBT service members and veterans.

• The Centers for Disease Control and Prevention offers a range of info on LGBT health issues.

• The American Psychological Association includes some general information on transgender people and gender identity.

• The World Professional Association for Transgender Health has established standards of care for the treatment of gender identity disorders, and offers information on a spectrum of transgender issues, plus a provider search engine.

• The Transgender Law Center fights discrimination, helps transgender people find legal assistance and has updates on related legal news (with some focus on California).

Editor’s note: If you live in Allegheny County, you can find local health resources on our Website in a downloadable pdf file. 

More gay, bi men with HIV receiving care, disparities remain

From Reuters Health

Gay and bisexual men in the United States who are diagnosed with HIV are promptly receiving the necessary treatments more often than in the past, according to a new report from the Centers for Disease Control and Prevention (CDC).

Still, black gay and bisexual men are less likely than their white counterparts to receive antiretroviral therapy (ART) to keep the human immunodeficiency virus in check, the researchers found.

They write in the Journal of Infectious Diseases that one goal of the National HIV/AIDS Strategy was to get 85 percent of people to a healthcare facility within three months of being diagnosed with HIV by 2015. By 2020, the goal is to get 85 percent of people diagnosed with HIV to care within one month.

The study team previously published 2008 and 2011 results from the CDC’s National HIV Behavioral Surveillance, which includes data from 20 cities on adult HIV-positive men who have sex with men – a group at particular risk for HIV infection. The new study adds data from 2014.

Altogether, 1,144 men provided data in 2008, 1,338 in 2011 and 1,716 in 2014. The proportion of white men taking the survey fell 14 percentage points between 2008 and 2014, but the proportion of black men participating increased by 13 percentage points during the same period.

The average age of the men dropped over the study period, too. Insurance coverage increased from 75 percent in 2008 to 86 percent in 2014, which was the first year of coverage expansion under the Affordable Care Act.

In 2008, 79 percent of the men were seen at a healthcare facility within three months of their diagnosis. That measure – known as linkage to care – increased to 87 percent by 2014.

With the 2020 goal in mind, the researchers analyzed how many men were seen at a healthcare facility within one month of their HIV diagnosis. In 2014, 78 percent of men were linked to care within one month, which the researchers say suggests the 2020 goal is feasible.

When the researchers looked at how many of the men were receiving ART, they found the rate increased from 69 percent in 2008 to 88 percent in 2014.

People with insurance or with higher levels of education or income were more likely to be linked to care within a short amount of time and be on ART.

In all years, a higher percentage of ARV treatment was observed among whites, according to the researchers – and this disparity persisted in 2014. The proportion of white men on ART were 9 percentage points higher than the proportion of black men.

“We’re moving in the right direction, but the fact that the disparities are persisting in 2014 when we’ve had access to antiretroviral therapy for so long is troubling,” said Jennifer Kates, who is vice president and director of global health and HIV policy at the Kaiser Family Foundation in Washington, D.C.

The findings suggest black men are being linked to care at roughly the same rate as white men, but they’re not getting equal access to ART, said Kates, who wasn’t involved in the new study.

“There are some systemic issues on the healthcare system side – from providers to insurance – that this study wasn’t designed to look at,” she told Reuters Health.

Read the full article.

New HIV testing, treatment and prevention clinic opens in Washington

From the Observer Reporter in Washington County…

An HIV/AIDS medical clinic is operating in Washington, focusing not only on assisting people who are HIV positive, but testing for the virus and preventing those at high risk from contracting it.

Central Outreach Wellness Center South opened three months ago at 95 Leonard Ave., Washington. It is in Suite 203 in an office building adjacent to Washington Hospital, but it is not affiliated with the facility. For now, the center is open Wednesdays and Thursdays, or by appointment. Walk-ins are accepted.

Initial screenings for and treatment of sexually transmitted diseases is conducted at the clinic, and is covered by the state Department of Health. Central Outreach is filling a need in the Washington area, which did not have an STD clinic since one closed more than a year ago.

Nurse practitioner Carol Priest of Arden is running the office. She is assisted by Braden Bash, who has been trained as a physician assistant and is waiting to take his boards.

Nurse practitioner Carol Priest and physician assistant trainee Braden Bash oversee operations at Central Outreach Wellness Center South

“We hope to be open Monday through Friday by summer,” Priest said.

Stacy Lane, a physician and Washington & Jefferson College graduate, opened the clinic by appointment only in December. It is a “satellite” of the Central Outreach Wellness Center she launched two years ago – and still operates – on Pittsburgh’s North Shore, near the Andy Warhol Museum. She said there was an urgent need for the Washington facility.

“We noticed there were more than 50 people driving from West Virginia to the North Shore, and that wasn’t counting Washington and Canonsburg folks,” Lane said.

“There were no STD options in that area. There was a huge deficit.”

That deficit was underscored by the drug crisis that engulfed the region in recent times. “HIV can be transmitted by drug use,” Priest said.

A major weapon being used to combat HIV, Priest said, is a pill called PrEP, which stands for pre-exposure prophylaxis and has the brand name Truvada. It was used as a treatment for HIV, but is now used as a preventative for people who have been diagnosed as HIV negative and others who are at high risk of getting the virus. “These are people who use (intravenous) drugs and share needles, gay men not using condoms,” Lane said.

PrEP, according to results, has been a huge success.

“Of 200,000 people who were HIV negative and are on that pill, there have been only three cases of HIV,” Lane said.

Lane specializes in infectious diseases and was motivated to do so years ago. An uncle died from AIDS while she was in high school and pondering a medical career.

Read the full article.

AIDS United: Republicans’ American Health Care Act will “worsen treatment and care for people living with HIV”

Press release from AIDS United

AIDS United opposes the American Health Care Act as released by House Republicans on March 6th. The American Health Care Act would, if passed, strongly affect and potentially worsen treatment and care for people living with HIV and the provision of HIV prevention services for people at risk for infection. AIDS United works toward an end to the HIV epidemic by reaching outcomes described in the National HIV/AIDS Strategy and the many state-specific efforts to curb and finally end the epidemic. These outcomes include reducing HIV incidence, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities.

The American Health Care Act undermines these goals. The replacement of premium subsidies with refundable tax credits will hurt the ability of low income people, including people living with HIV, to afford up-front payment of health plan premiums. Under this system thousands of people will lose coverage. These people will then be subject to a 30 percent penalty in their future cost of coverage because of continuous coverage requirements. These same requirements will hurt people who lose their jobs and will also make it more difficult for people to change jobs or move across the country. The bill also places a higher cost burden on older Americans by allowing higher premium as people age. This will result in much higher costs and lower access to care for lower income people. Finally, the bill effectively repeals Medicaid expansion in under three years at the end of 2019. Such a repeal will result in a loss of health coverage for millions of Americans, including people living with HIV and other chronic conditions.

Read the full press release.