Category Archives: HIV Care

National Black HIV/AIDS Awareness Day Puts Focus on Need to Address Equity and Drivers of HIV Disparities in U.S.

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From HIV.gov…

By: Harold J. Phillips, MRP, Senior HIV Advisor and Chief Operating Officer for Ending the HIV Epidemic: A Plan for America, Office of Infectious Disease and HIV/AIDS Policy, U.S. Department of Health and Human Services.

This year’s National Black HIV/AIDS Awareness Day (NBHAAD) observance comes amidst a national dialogue on systemic racism and calls for a greater focus on equity in all our work. We should use this opportunity to examine and address historic inequities experienced by Black Americans. For the HIV community, this means working to understand and address the circumstances that put people at risk for HIV or that create barriers to HIV care and treatment.

Black Americans continue to be disproportionately affected by HIV compared to other racial/ethnic groups. According to CDC data,

  • Black Americans represent 13% of the U.S. population, but 41% of people with HIV in the U.S. in 2018.
  • 42% of new HIV infections in 2018 were among Black Americans.
  • Among the estimated 161,800 people in the U.S. with undiagnosed HIV, 42% (67,800) are Black. That means that nearly one in seven Black Americans with HIV are unaware of their HIV status and are not receiving the care they need to stay healthy and prevent transmission to others.

Fewer Black Americans in HIV care are virally suppressed: In 2018, 60% of Blacks, 64% of Latinos, and 71% of whites with diagnosed HIV were virally suppressed.

The recently released HIV National Strategic Plan (HIV Plan) makes clear the disproportionate impact of HIV among Black Americans, and includes Black women, transgender women, people who inject drugs, and Black gay, bisexual, and other men who have sex with men among its designated priority populations. The HIV Plan notes that focusing efforts on priority populations will reduce HIV-related disparities, which is essential to the nation’s effort to end the HIV epidemic by 2030.

Read the full article.

What you need to know about managing HIV during the COVID-19 outbreak

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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.

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

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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

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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

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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

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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

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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

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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.

State-level PrEP utilization data now available from AIDSVu

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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.

February 7th is National Black HIV/AIDS Awareness Day

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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

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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.

 

Young people dying as stigma, misunderstanding prevent HIV treatment

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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.

“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… 

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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…

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

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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.

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

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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.

NASTAD: People living with HIV on antiretroviral therapy (ART) do not transmit the virus

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From LGBTweekley.com…

nastad-300x195WASHINGTON, D.C. – NASTAD (National Alliance of State & Territorial AIDS Directors), a leading non-partisan non-profit association that represents public health officials who administer HIV and hepatitis programs in the U.S. and around the world, published a new statement affirming that durably virally suppressed people living with HIV on antiretroviral therapy (ART) do not sexually transmit the virus. The statement accelerates NASTAD’s longstanding work to end HIV and promote policies and public health practice grounded in science.

”The science is clear that people living with HIV with a sustained undetectable viral load do not transmit the virus to others. What’s also clear is that we have the tools to end the HIV epidemic and HIV-related stigma and make new infections a thing of the past. Today, we tackle a major part of this work by raising awareness about the latest science of HIV transmission risk,” remarked NASTAD Executive Director Murray Penner.

Read the full article.

LGBTs would be disproportionately affected by the repeal of the ACA

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Matt Baume writes in the Huffington Post:

If the ACA is repealed, as Republicans are trying to do, not only would 32 million people lose health care, according to the Congressional Budget Office, but LGBTs would be disproportionately affected. And “disproportionately affected” is a phrase which here means “get sick and die.” For example, HIV treatment can cost thousands of dollars per month. Insurance companies that don’t want to pay for that treatment could just refuse to cover all gay people on the basis that gay men are more likely to be HIV positive. Or they could raise monthly premiums just for gays. Or they could create a lifetime cap, so you pay into their system and then as soon as you need expensive treatment, they drop you. All this was legal until the ACA banned it.

MidAtlantic AIDS Education and Training Center hosts World AIDS Day 2016 conference

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nov_labg_worldaidsday2WHAT: To observe the 28th World AIDS Day, The MidAtlantic AIDS Education and Training Center (MAAETC), based at the University of Pittsburgh Graduate School of Public Health, will collaborate with UPMC and local HIV/AIDS clinics to host an all-day educational event. The World AIDS Day 2016 conference will bring together experts in the field of HIV to enable physicians, nurses and other HIV care providers to improve care. Experts will discuss prevention including PreP, aging and HIV, antiretroviral treatment, and substance use and HIV. To learn more or register, visit https://www.maaetc.org/events/view/8202.

WHY: Despite advances in HIV treatment, there continues to be an increase in HIV infections. This necessitates routine testing for everyone, to identify and link persons with HIV to care so that they can live longer lives. New treatment is available to prevent HIV infection, and concerns and issues are emerging among persons aging with HIV infection.
WHO: Introductions by Corey O’Connor, councilman, City of Pittsburgh, and Donald S. Burke, M.D., Dean, Pitt Public Health. Speakers include Rachel Levine, M.D., physician general, Commonwealth of Pennsylvania, Harold Wiesenfeld, M.D., M.P.H., Allegheny County Health Department, and Magee-Womens Hospital of UPMC, Donna Gallagher, Ph.D., M.S.N., ANP-BC, F.A.A.N., New England AIDS Education and Training Center, Ken Ho, M.D., M.P.H., medical director, Pitt Men’s Study, University of Pittsburgh School of Medicine, Antoine Douaihy, M.D., medical director, Addiction Medicine, University of Pittsburgh Department of Psychiatry
WHEN: 8:30 a.m. to 5:30 p.m., Thursday, Dec. 1
WHERE: University Club, 123 University Place, Pittsburgh, 15260
Note to Media: To cover this event, contact Allison Hydzik at 412-647-9975 or HydzikAM@upmc.edu.

$1 million renovation and expansion of the Pittsburgh AIDS Task Force

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From the Pittsburgh Trib Review…

A recently completed $1 million renovation and expansion of the Pittsburgh AIDS Task Force in East Liberty has made Sean DeYoung’s vision a reality.

The project, which took about a year to complete and included a medical clinic expansion, is a step toward PATF’s goal to transition to a fully integrated medical and social-service care organization for people with HIV.

“I’m a social worker, and that’s where the social work field is moving,” said DeYoung, the AIDS Task Force CEO who came aboard last year. “Research has shown that people who can receive all of their medical and social services in one place are much more likely to get the comprehensive level of care they need.”

The population served by PATF has unique challenges in addition to living with HIV/AIDS, DeYoung said.

“Ninety-eight percent of our client base is below the poverty line,” he said, “so they may also face housing challenges and job challenges, which is a huge problem. If you’re worried about getting evicted or not having a place to stay, you’re not going to be worried about taking your medication like you’re supposed to or coming to see your doctor when you need to.”

The renovated PATF center, unveiled at a ribbon-cutting last Tuesday, offers a food pantry, an on-site pharmacy, legal aid, programs for medical case management and federal housing assistance. It also offers an adherence program designed to help patients who struggle to remember to take their medications through personalized texts or phone calls.

Read the full article on the Trib Review online.