Study: Combining PrEP with U=U yields incredible results

From HIVplusmag.com

When people use a combination of HIV prevention methods, researchers found there was a significant drop in HIV transmission.

Published in the academic journal HIV Medicine, the study found that using several methods such as taking PrEP, early HIV diagnosis from frequent testing, and proper antiretroviral treatment decreased transmission by 80 percent.

The research was evaluated at 56 Dean Street, which is a sexual health clinic and part of Chelsea and Westminster Hospital NHS Foundation Trust in London.

“We witnessed an 80% reduction in the number of HIV diagnoses between 2012 and 2017, following the introduction of a number of HIV prevention measures (PrEP introduction, early HIV diagnosis through frequent and facilitated access to HIV testing and timely ART used as treatment-as-prevention) were key to the success of this model,” lead author Nicolo Girometti, told Contagion. Girometti is also a consultant in HIV medicine at 56 Dean Street.

Read the full article.

Penn State and Pitt team up to create getmyHIVtest.com—free HIV test kits to anyone who resides in Pennsylvania, with a focus on minority/ethnic communities most at risk.

The Centers for Disease Control and Prevention (CDC) reports that some racial/ethnic groups are at higher risk for getting HIV than others.  

CDC data shows that Black/African American communities account for a higher proportion of new HIV infections as compared to other races and ethnicities. In 2018, Black/African Americans accounted for 13% of the US population but 42% of new HIV diagnoses.

Similarly, in the same 2018 report, the CDC notes adult and adolescent Hispanics/Latinos made up 27% of the 37,968 new HIV diagnoses in the United States.

Why? Because these communities are impacted by demographic factors such as discrimination, stigma, and institutionalized health disparities—all of which affect their risk for HIV.

So what can we do?  

People who know they’re infected can get into treatment and become HIV undetectable—which means the level of virus in the body is so low that it can’t be passed on to a sex partner. And people who know they’re not infected can take steps to prevent future infection by practicing safer sex (like using condoms) and taking the HIV prevention medication known as PrEP.

The first step, then, to preventing HIV is to get tested.

Men sitting together and smiling

The good news is that anyone who resides in Pennsylvania can now get a free HIV self-test kit delivered in the mail.

In early 2021, the Pennsylvania Expanded HIV Testing Initiative (at Penn State University) and the HIV Prevention and Care Project (at the University of Pittsburgh) began a joint program called getmyHIVtest.com.

“We created getmyHIVtest.com to make test kits available to anyone in the state who might be at risk for HIV,” explains Raymond Yeo, one of the project’s coordinators at the University of Pittsburgh. “Knowing your HIV status is key in the preventing HIV in our communities—especially those most at risk for new infections.” 

The website, www.getmyHIVtest.com, provides easy-to-follow instructions and online form where PA residents can order their free kit, which typically arrives—in an unmarked package—within five to ten business days. Recipients of the kit are asked to provide basic demographic information and to take a follow up survey as a means to improve the program in the months ahead.  

“This is a big development in the fight against HIV in Pennsylvania and we need all the input we can get,” added Yeo. “It’s unrealistic to think we can test everyone in the state so it’s important that we find ways to get our test kits into the hands of the people who need them the most.”  

Questions and comments about the getmyHIVtest.com program can be sent to info@getmyHIVtest.com. To order your HIV self-test kit, go to www.getmyHIVtest.com.

PrEP for beginners: What to know about the HIV-preventive drugs

From mensvariety.com

Truvada was the original PrEP drug. All of the trials and data about PrEP that you can find right now are about Truvada. It’s the tried and true option. Meanwhile, the Food and Drug Administration approved a second drug in 2019 from Gilead Sciences. As clinic trials showed, this second drug, called Descovy, is less toxic to the kidneys and bones than Truvada. That’s not to say that Truvada is toxic, but that the drug can possibly cause kidney problems or bone mineral density problems later on. As such, PrEP users have celebrated the arrival of Descovy. On top of that, it is MORE effective in preventing HIV. But, of course, it’s more expensive too.

Are you considering getting PrEP but need to know more basic info before you take the plunge? Are you concerned about your safe sex measures and want to know your options in protecting yourself from STIs like HIV? We decided it would be a good idea to write up a “basics” post and general guide for anyone wanting to know more about the HIV-preventive drug. If that sounds interesting to you, keep reading

One size doesn’t fit all when it comes to products for preventing HIV from anal sex

From medicalXpresss.com

Conducted by the National Institutes of Health (NIH)-funded Microbicide Trials Network (MTN), DESIRE focused on potential delivery methods for rectal microbicides—topical products being developed and tested to reduce a person’s risk of acquiring HIV and other sexually transmitted infections from anal sex. MTN researchers are particularly interested in on-demand options—used around the time of sex—and behaviorally congruent options that deliver anti-HIV drugs via products people may already be using as part of their sex routine.

“DESIRE stands out as a unique study because we took a step back and said, ‘Let’s figure out the modality without automatically pairing it with a drug’,” explained José A. Bauermeister, Ph.D., M.P.H., study protocol chair and Albert M. Greenfield Professor of Human Relations at the University of Pennsylvania. “It gave us the ability to manipulate the delivery method without having to worry about how reactions to a particular drug might confound the results. We also had people trying out these methods in their own lives, and only then asked them to weigh the attributes of each.” As such, he said, participants weren’t making choices based on theoretical concepts, but instead using real experiences to guide their preferences.

Read the full article.

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

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.

Transmission of HIV through oral sex is rare — here’s how to reduce your risk

From insider.com

HIV does not reproduce outside a human host and cannot be transmitted through saliva, tears, or sweat. It is a common misconception that sharing dishes, shaking hands, or hugging can transmit HIV, says Anne M. Neilan, MD, MPH, Infectious Disease Physician at Massachusetts General Hospital.

Generally, it’s unlikely that you will contract HIV from oral sex. However, there are some circumstances in which this could happen, though uncommon. This article will discuss the likelihood of getting HIV through oral sex and how to avoid contracting or transmitting it.

“The likelihood of acquiring HIV from oral sex is far lower than vaginal or anal sex,” says Neilan. The risk is so low that scientists have not established a conclusive statistic, but a 1999 study estimates a 0.04% risk among male sexual partners. 

Saliva contains secretory leukocyte protease inhibitors that inactivate the virus. Because of this HIV inhibitor, the virus reproduces less than it would in the blood cells. 

Although the risk is low, unprotected oral sex still carries the risk of transmitting HIV, as well as sexually transmitted infections (STI). “Protection against HIV does not mean protection against all sexually transmitted infections,” says Neilan.

A person without HIV may contract the virus by giving or receiving any type of oral sex to or from a partner with HIV. Some risk factors increase the likelihood of contracting HIV through oral sex, which include:

The risk of HIV from oral sex may be minimal, but it’s still important to know how to avoid contracting and transmitting the virus.

Using dental dams, male and female condoms during oral sex reduces the likelihood of contracting HIV, but you must use them correctly, says Neilan. Refraining from oral sex when risk factors are present, and avoiding seminal or vaginal fluids in the mouth also lessen the risk, but does not completely eliminate it.

STIs like gonorrhea or syphilis can cause sores on the mucous membrane, increasing the chances of getting or transmitting HIV, so get tested regularly and seek treatment if needed. 

Read the full story.

CDC 2018 report: Black/African American gay and bi men still have the highest rates of new HIV infections.

From the Centers for Disease Control and Prevention

In 2018, 37,968 people received an HIV diagnosis in the United States (US) and dependent areas. From 2014 to 2018, HIV diagnoses decreased 7% among adults and adolescents. However, annual diagnoses have increased among some groups.

Info graphic showing Black / African American men still have the highest rates of H I V infection as of 2018 according to the latest C D C report
click to enlarge graph

Gay and bisexual men are the population most affected by HIV, with Black/African American, Hispanic/Latino gay and bi men having the highest rates of new infections.

The number of new HIV diagnoses was highest among people aged 25 to 34.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated)HIV Surveillance Report 2020;31.

HRC is mailing sex positive kits as part of its “My Body” HIV campaign to celebrate Black and Latino LGBT people

From Poz.com

“Embrace your body and your sexuality. Taking precautions against HIV doesn’t mean you should be ashamed of your sexuality or not enjoy sex—you can love your body and stay safe.”

Find out how you can get your box of goodies…

That’s the opening message of “My Body,” a new HIV awareness and education campaign by the Human Rights Campaign (HRC), a national LGBT advocacy group. Recognizing that nearly a quarter of young queer adults lack proper evidence-based sex education about HIV, the campaign is geared to empowering Black and Latino LGBT people between ages 16 and 35.

You can learn more about the boxes in the video and request one at HRC.im/MyBody.

Read the full article on Poz.com.

Latino Gay/Bi men’s health rally to focus on U=U during COVID-19

From Poz.com

Spearheaded by the Hispanic Health Network, this year’s rally includes two panel discussions. “HIV Stigma and COVID-19” takes place at 1 p.m. ET Monday, November 9. According to the rally’s website, “panelists will share and discuss information about the importance of U=U in the times of COVID-19, how U=U is used to combat stigma and barriers to reach an undetectable viral load. They will also discuss how COVID-19 has impacted Latinx Gay/Bi Men’s Communities and HIV-related stigma connected to U=U. During this panel, speakers will explore the role of religion to interrupt stigma.”

U=U stands for Undetectable Equals Untransmittable, which refers to the fact that people living with HIV who maintain a suppressed viral load cannot transmit HIV via sex, even when condoms are not used.

The second virtual panel, “Strengthening of the Latinx Gay/Bi Men’s Communities,” is scheduled for 1 p.m. ET, Tuesday, November 10. “The panelists will discuss racism colorism, machismo and heteronormativity in Hispanic/Latinx communities,” according to the website. “Panelists will also touch upon how to address these issues through diversity acceptance. Panelists will talk about the impact of Black Lives Matter on the Hispanic/Latinx communities and the importance of developing leadership to strengthen communities for a healthier future.”

You can register for both events and read speaker bios on the Rally 2020 site.

9 FAQs for when your partner has HIV

From Everyday Health

If you’re in a new relationship with someone who has HIV or you’ve recently found out that your longtime partner is HIV positive, you may be experiencing a whirlwind of emotions — possibly fear, sadness, or even anger, depending on the context. You may be concerned that you’ll get HIV from your partner or wonder how being with an HIV-positive person will affect your relationship or daily life.

As you begin to emotionally adjust to your situation, it’s important to get the facts about being with a partner who has HIV. Certain fears about having an HIV-positive partner may be outdated, but there may also be precautions you weren’t aware of that you could take to avoid HIV

Here are some questions you may have if your partner has HIV, and answers from leading experts on the virus.

Meet the queer artists changing the way we think about owning our sexual health

From Queerty.com

So it’s no surprise that James, like thousands of others, has turned to OraQuick’s in-home HIV test as a key part of their sexual health toolkit. James Falciano is a champion of their queer community, something that is reflected in their art, activism, and everyday life.

It’s the simplest way to get accurate, fast results without waiting in line at the clinic or doctor’s office – if you can even get one these days. In as little as 20 minutes, in the privacy of your own home, you obtain your results, along with access to 24/7 support.

It’s the way to take control of your own sexual health and to own your own sex life.

James and two other fabulous queer artists, Preston Nelson and Kitsch Harris, are partnering with OraQuick to encourage HIV self-testing.

Here are samples of their art to explore along with conversations about their work (and read more at Queerty.com).

  • James Falciano

The single biggest risk factor for gay, bi men becoming HIV-positive

From the Advocate.com
Of all those who became HIV-positive, over a third (36 percent) were persistent meth users. Men aged 36-45 reported the most meth use, and those living in Western states had the highest incidence of the drug.

Persistent meth use is the biggest factor for seroconversion, researchers stated, followed by Black ethnicity and a syphilis diagnosis.

Researchers detailed the correlation between meth and HIV.

“Methamphetamine exacerbates HIV risk via increasing sexual libido while simultaneously reducing inhibitions,” the authors stated, according to AIDSMap. “Our findings highlight the need to address methamphetamine use and its associated risks among sexual and gender minorities, the likes of which may also serve to help end the HIV epidemic.”

Read the full article.

14 Things I Wish Queer Men Were Taught in Sex Ed By Zachary Zane

From Pride.com (By Zachary Zane)…

Oh, sex ed. A decade later, and the only thing I remember “learning” from it is “wear a condom.” I honestly don’t think I could tell you another single bit of information they “taught” me except for that men have a vas deferens, which is somewhere in the penis. (Testicles, maybe?)

Imagine how nice it would have been if they actually taught us something useful! Imagine if instead of scaring us and making us fear our own sexuality, sex ed courses taught us how to embrace and explore our sexuality safely! Can you imagine??

So here are 14 things I wish sex ed courses taught me! (And all queer men and queer folks, for that matter. Screw it—everyone can benefit from this!)

Health screening for gay men on PrEP falling behind recommended standards

From aidsmap.com

Levels of sexual health screening among gay men taking PrEP fall well below recommended levels, investigators from the United States report in the online edition of Clinical Infectious Diseases.  Rates of testing for sexually transmitted infections (STIs) in the rectum and throat – which can be asymptomatic – were especially low, so too testing coverage in south-eastern US states which have an especially high burden of HIV and STI infections among gay and other men who have sex with men.

“Consistency of STI screening at PrEP care visits was lower than recommended, especially for rectal and pharyngeal infections that are mostly asymptomatic,” write the authors. “Our findings also highlight the regional variation in gaps between recommendations and PrEP clinical practice overall, and raise concerns about whether comprehensive PrEP care as currently practiced would be effective for STI control.”

Tenofovir-based PrEP is highly effective at preventing infection with HIV but the treatment provides no protection against STIs. Pre-existing research shows elevated STI rates among PrEP-using gay men, probably the result of increased surveillance and sexual risk behaviour. The Centers for Disease Control and Prevention (CDC) therefore recommends that gay men taking PrEP should have comprehensive check-ups for bacterial STIs every three to six months. These sexual health screens should include tests for chlamydia, gonorrhoea and syphilis, with swabs or samples taken from the urethra, throat and rectum.

Read the full article.

New study supports more frequent HIV screening among high-risk young men who have sex with men

From medicalexpress.com

A new study has found that HIV screening every three months compared to annually will improve clinical outcomes and be cost-effective among high-risk young men who have sex with men (YMSM) in the United States. The report, led by researchers at the Massachusetts General Hospital (MGH), is being published online in Clinical Infectious Diseases.

“Young men who have sex with men account for one in five new HIV infections in the United States. Yet, more than half of young men who have sex with men and who are living with HIV don’t even know that they have it,” says Anne Neilan, MD, MPH, investigator in the MGH Division of Infectious Diseases and the Medical Practice Evaluation Center, who led the study.

“With so many youth with HIV being unaware of their status, this is an area where there are opportunities not only to improve care for individual youth but also to curb the HIV epidemic in the U.S. Despite these numbers, the Centers for Disease Control and Prevention previously determined that there was insufficient youth-specific evidence to warrant changing their 2006 recommendation of an annual HIV screening among men who have sex with men.”

Read the full article.

Alternative PrEP injection, dosed every other month, beats daily PrEP pill

From thebodypro.com

Taken every 2 months, the long-acting injectable drug cabotegravir (CAB-LA) prevented more HIV infections than daily oral pre-exposure prophylaxis (PrEP) with tenofovir/emtricitabine (TDF/FTC), according to newly announced results from a major Phase 3 study. The results were released originally in May due to the overwhelmingly positive data on CAB-LA for PrEP, but researchers presented their final data in early July at the 23rd International AIDS Conference (AIDS 2020).

The data show that the experimental drug is superior to the current standard-of-care PrEP regien, which may open the door for a new biomedical HIV prevention option aimed at those who would prefer a shot six times a year over taking a daily pill.

“The HPTN 083 results demonstrating the superiority of CAB to TDF/FTC have the potential to transform the landscape of HIV prevention for cisgender MSM and transgender women,” said HPTN 083 protocol chair Raphael J. Landovitz, M.D. “We know that some people have difficulty with or prefer not to take pills, and an injectable product such as long-acting CAB [cabotegravir] could be a very important option for them. We want to thank the study participants and research staff, as this study would not have been possible without their dedication and commitment.”

Read the full article.

Pandemic sparks concerns about surging STD, HIV rates

The pandemic that has upended life in the U.S. could lead to increased STD rates and setbacks in the fight against HIV as public health resources are shifted to the coronavirus response.

Access to STD and HIV testing and treatment services are dwindling as local health departments shuffle staff to respond to COVID-19 and clinics reduce hours or close altogether and cancel outreach programs.

“We are seeing a complete disruption to STD prevention here in the United States,” said David Harvey, executive director of the National Coalition of STD Directors (NCSD). “We expect to experience even higher STD rates as a result.”

Read the full article.

Bruce Richman: Meet the Man Behind U=U

From aidsplusmag.com….

Bruce Richman, the renowned activist and founder of the Prevention Access Campaign, the organization that launched the undetectable equals untransmittable (U=U) message, is on a return flight from Greece where he joined local advocates in sharing the news that when you’re living with HIV, on meds, and undetectable, it is impossible to transmit the virus to others.

For the last several years, Richman has united activists in efforts to end both the HIV epidemic and the stigma that many people living with HIV face. A growing network of health experts, professionals, teachers, siblings, spouses, parents, and friends have changed perspectives on what a positive diagnosis means. Through hard-hitting research and tenacious activism and lobbying, U=U has become a global consensus, recognized by the Centers for Disease Control and Prevention and numerous other agencies, doctors, and organizations around the world.

But despite the immense impact U=U has already had on the esteem, relationships, and overall wellness of those living with HIV (and the people who love them), the rest of the country’s general perception of HIV is still outdated. This is what drives Richman’s pursuit to change hearts and minds.

“U=U is my calling,” Richman, a lawyer-turned-activist, says. “It grabbed me by the gut and yanked me forward. I’ve never felt such a compulsion and clarity. I knew that undetectable equals untransmittable, but millions of people were suffering because they were not being told and people in positions of great influence to alleviate that suffering were sitting on their hands. I had no choice.”

Read the full article.

Studies firmly establish “undetectable equals untransmittable”

From NIH.gov

Extensive evidence from HIV prevention research studies has firmly established that “Undetectable Equals Untransmittable,” or U=U. This means that people living with HIV who achieve and maintain an undetectable viral load — the amount of virus in their blood — by taking antiretroviral therapy (ART) as prescribed do not sexually transmit HIV to others. The U.S. Centers for Disease Control and Prevention estimates this strategy is 100% effective against the sexual transmission of HIV.

Now, a new study of nearly 112,000 men who have sex with men in the United States has found increasing acceptance of the U=U message in this population. Overall, 54% of HIV-negative participants and 84% of participants with HIV correctly identified U=U as accurate. The study was supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Study results were published online in the Journal of Acquired Immune Deficiency Syndromes.

“U=U has been validated repeatedly by numerous studies as a safe and effective means of preventing the sexual transmission of HIV,” said Anthony S. Fauci, M.D., NIAID Director. “The increased understanding and acceptance of U=U is encouraging because HIV treatment as prevention is a foundation of efforts to end the epidemic in the United States and around the world. This public health message has the power to reduce stigma, protect the health of people living with HIV and prevent sexual transmission of HIV to others.”

Read the full article.

Health Alert: Get tested for HIV and other STIs

According to a CDC report, HIV continues to have a disproportionate impact on racial and ethnic minorities, gay and bisexual men, and other men who have sex with men. Yet, 15% of men who are infected with HIV don’t know it.
Also, according to CDC research, cases of gonorrhea, chlamydia and syphilis have risen for the fifth consecutive year.

Some STIs (including HIV) can go unnoticed since symptoms can be mistaken for minor health problems like a cold or sore throat. Some may have no symptoms at all. The only way to know if you’re infected is to get tested.

If you send us your zip code, we can help find local testing near you. Most are free. You can also ask us questions about basic sexual health, including PrEP. Send a message to m4mInformation@pitt.edu. We’re here to help