Latino and Black men less likely to use PrEP

Research says that men who have sex with other men make up 67% of new HIV infections. Then on top of that, 25 percent of Latino men who have sex with other men (MSM) will be infected with HIV in their lifetime. And, 50 percent of Black MSM will experience the same. That’s compared to 12.5 percent of white men. That said, men of color are less likely to use the HIV preventive drug pre-exposure prophylaxis or PrEP. Why is this?

A recently published study in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report tries to understand why this is happening. The study, led by Dafna Kanny of the CDC’s Division of HIV/AIDs Prevention looked through interviews with 4,000 men who took part in a 2017 HIV Behavioral Surveillance Survey.

As NBC writes, researchers believe the problem lies in accessibility issues to health care. Studies show health care providers are not prescribing Black and Latino men to PrEP. In addition, men of color are less aware of PrEP’s very existence. The CDC’s study found that 95% of white men, 87% of Latino men, and 43% of Black men are knowledgeable about PrEP. Then even worse, only 58% of white, 44% of Latino, and 43% of Black men said they discussed the preventative medication with a physician.

As Kanny told Reuters Health,“This type of research is critical to finding—and correcting — missed opportunities to offer PrEP to people at risk of HIV, particularly among African American and Latin gay and bisexual men.”

He said further: “It’s important for providers to take sexual histories of gay and bisexual men and to discuss PrEP as an option for HIV prevention with those who could potentially benefit from it,” said Kanny. “These discussions also help to destigmatize PrEP use, which is particularly important for increasing PrEP use among African American and bisexual men.”

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.

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Use of HIV prevention pill rising among men who have sex with men

From Reuters Health

A growing proportion of American men who have sex with men know they can take a daily pill to avoid infection with HIV and more of them are using it, a U.S. study suggests.

So-called HIV pre-exposure prophylaxis (PrEP) is highly protective against the virus that causes AIDS, but many people worldwide don’t get this pill because they aren’t aware of it, don’t think they need it, or because it’s unavailable or unaffordable. Efforts to raise awareness among one high-risk group – men who have sex with men – have been complicated because some of these men don’t identify as gay or bisexual and mistakenly think heterosexual people don’t need PrEP.

In 2014, the U.S. Centers for Disease Control and Prevention (CDC) launched an effort to get PrEP to all men who have sex with men who might benefit from the pill, not just gay and bisexual individuals. The current study looked at national health survey data to track changes in awareness and use of PrEP from 2014 to 2017 in 20 American cities.

Overall, there was “a significant increase in the percentage of gay and bisexual men at high risk for HIV who are using PrEP,” said Teresa Finlayson, lead author of the study and a researcher at the CDC in Atlanta.

Read the full article.

We won’t end the HIV epidemic until we help the most vulnerable

How do we reduce rates concentrated among black and Latino men who have sex with men? Or meet the needs of HIV-positive patients caught between insurance plans or places to live? To end the epidemic, we must start where we began — by focusing on those most affected, uniting advocacy efforts, pushing for a cross-sector response and focusing on the social determinants of health.

As someone who has spent the better part of my professional career as both an advocate and HIV public health expert, I’ve been reflecting on the decades-long fight for gay rights sparked by people who gathered together at Stonewall in 1969 to demand change for the LGBTQ+ community and put an end to years of discrimination. Not long after, the AIDS epidemic swept across the country, closely intertwining the movement for increased LGBTQ+ rights with the AIDS response. Gay rights groups were relentless in pushing for increased government attention and funding as thousands died from the disease. Activists organized “buyers clubs,” lobbied for faster FDA approval of promising drugs and countered the fear and discrimination people living with AIDS faced.

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Most Americans have never been tested for HIV

From CNN

Most Americans have never been tested for HIV, the virus that attacks and weakens a person’s immune system.

The US Centers for Disease Control and Prevention is hoping to change that.
According to a new report, the agency found that fewer than 40% of people in the United States have been screened for HIV. It recommends that all people 13 to 64 be tested at least once.
Fifty jurisdictions across the country are responsible for more than half of all HIV diagnoses, yet only 35% of the people recommended for testing in those areas were screened in the previous year, the CDC says. And fewer than 30% of people across the country with the highest risk of acquiring HIV were tested in that period.
“Diagnosis and treatment are the first steps toward affording individuals living with HIV a normal life expectancy,” CDC Director Dr. Robert Redfield said in a statement. “As we encourage those at risk for HIV to seek care, we need to meet them in their journey. This means clearing the path of stigma, finding more comfortable ways of delivering health services, as well as learning from individuals already in treatment so the journey becomes easier for others who follow.”

Researchers receive NIH grant to develop rapid, low cost HIV test

From eurekalert.org

Currently, there is no reliable technology that can detect HIV during the early stages of the infection or measure viral rebound in antiretroviral therapy in treated patients in resource constrained point-of-care settings. There is therefore, an urgent need to develop a rapid, disposable, automated, and low-cost HIV viral load assay to increase timely access to HIV care and to improve treatment outcomes.

WASEEM ASGHAR, PH.D., PRINCIPAL INVESTIGATOR

That’s exactly what a researcher from Florida Atlantic University’s College of Engineering and Computer Science is developing. He has teamed up with a researcher from FAU’s Schmidt College of Medicine to combine their expertise in microchip fabrication, microfluidics, surface functionalization, lensless imaging, and biosensing to create a reliable, rapid and inexpensive device for viral load quantification at point-of-care settings with limited resources.

They have received a $377,971 grant from the National Institutes of Health (NIH) to develop a disposable HIV-1 viral load microchip that can selectively capture HIV from whole blood/plasma. The technology is being developed to be highly sensitive to quantify clinically relevant viral load during acute phase and virus rebound as well as inexpensive (costing less than $1), and quick (results in less than 45 minutes). Moreover, this technology is highly stable, and does not require refrigeration or a regular electric supply to enable HIV viral load at point-of-care settings.

Read the full article.