From the New York Times…

Grindr, the gay dating app, is an effective way to get gay black and Hispanic men to try home H.I.V. self-testing kits, according to a recent study.

The small study was confined to Los Angeles, and fewer than 400 test kits were distributed, but the idea has broader potential. Grindr is used by at least five million men in 192 countries, according to its developer.

In the United States, young gay black and Hispanic men are the groups most likely to be infected with H.I.V. and the least likely to be tested for it, because they often lack health insurance and fear being rejected by their families.

In some other countries, gay men may be harassed, jailed or even executed.

The study used banner ads on Grindr to offer free test kits. Recipients received a kit in the mail, a voucher that could be redeemed for a kit at a pharmacy, or a code that would produce a kit from a vending machine in the parking lot of the Los Angeles Gay and Lesbian Center.

The test requires no blood; a swab of the gums produces results in 20 minutes.

Of the 56 black and Hispanic men who requested kits and were willing to answer survey questions, 69 percent had not been tested in the last six months; medical experts recommend that gay men who do not always usecondoms get tested every three months.

Two men learned from the kits that they were infected.

Researchers at the medical schools of Indiana University and the University of California, Los Angeles, chose Grindr rather than other gay dating apps like Scruff and Jack’d “because it was the oldest and biggest,” said Dr. Jeffrey D. Klausner, an H.I.V. specialist at U.C.L.A.’s David Geffen School of Medicine and one of the authors of the paper published in Sexual Health.

The idea of using the app to encourage home testing is “ripe for expansion” to other cities, and possibly to other countries, Dr. Klausner said

From Johns Hopkins University…

Across countries and income levels, gay men continue to see disproportionately high rates of HIV infection, according to a new study from Johns Hopkins University’s Bloomberg School of Public Health. Though overall HIV rates have flattened in recent years and a diagnosis is no longer the death sentence it was once considered, researchers are concerned that the epidemic persists globally among men who have sex with men.

“It’s a tragic situation and it’s painful that the history of AIDS is looking like its future, but that’s actually where we are,” says study leader Chris Beyrer, a Bloomberg School professor and president of the International AIDS Society. “But the first step in taking on a problem is recognizing and articulating it, and we’ve really done that here.”

The findings, to be published July 9 in The Lancet, follow up on a 2012 call to action from the same group of researchers. Back then, they laid out anambitious framework to curtail HIV epidemics in gay men, setting targets for policy reform, funding, and improvement in HIV prevention and treatment—including expanded access to pre-exposure prophylaxis, or PrEP, a pill that has proved highly effective in reducing transmission among this population.

Read the full article.

From aidsmap.com…

Test-and-treat’ is unlikely to be an effective strategy to control the HIV epidemic in the United States without improvements in retention in care, investigators argue in the online edition of Clinical Infectious Diseases. A mathematical model suggested that without interventions to address poor levels of engagement in HIV care, there could be as many as 1.39 million new HIV infections in the US over the next 20 years, at a cost of $256 billion. Targeting testing and linkage would only prevent 21% of these new infections. But a package of interventions comprising testing, linkage and retention in care would prevent over half of the projected new infections, reduce AIDS-related mortality by almost two-thirds and be cost effective.

“To alter the course of the HIV epidemic in the United States, strategies of ‘test and treat’ alone may be insufficient; attention to the full continuum of care will be essential,” comment the authors.

United States guidelines recommend expanded HIV testing and antiretroviral therapy at any CD4 count as strategies to reduce rates of AIDS-related deaths and HIV transmissions. However, this approach may not be as effective as hoped. Recent research has shown that there is significant attrition at each stage of the HIV care continuum in the US. Up to a fifth of HIV-infected individuals are undiagnosed; 20% of recently diagnosed patients are not linked to care within 90 days; 54% of patients are not retained in care; only 30% of diagnosed patients have an undetectable viral load.

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From aidsmap.com…

Daily post-exposure prophylaxis (PEP) with single tablet emtricitabine/tenofovir/rilpivirine (Complera, Eviplera) has excellent completion rates and good side-effect and safety profiles, Australian investigators report in the online edition of Clinical Infectious Diseases.

The open-label, non-randomised study involved 100 men who have sex with men (MSM) requiring PEP after possible sexual exposure to HIV. Treatment lasted 28 days and was completed by 92% of participants. Side-effects were mild, the most common being nausea and tiredness. There were no serious adverse events.

Prompt PEP, after possible sexual or occupational exposure to HIV, can reduce the risk of infection. Guidelines recommend triple-drug therapy, ideally commenced within 72 hours of exposure. Failure of PEP has been linked to poor treatment adherence or the premature discontinuation of treatment. A recent analysis of 97 PEP studies found that only 57% of patients completed their four-week course of treatment.

The combination pill emtricitabine/tenofovir/rilpivirine provides well tolerated and easy-to-take once-daily HIV therapy. Though it must be taken with food, investigators from Australia hypothesised that the combination pill would provide convenient and safe PEP.

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