Category Archives: HIV Prevention

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

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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

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From the Hill…

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

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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”

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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

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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. 

 

Latino and Black men less likely to use PrEP

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From Instinct Magazine online…

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

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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…

Most Americans have never been tested for HIV

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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

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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.

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.

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.

Rectal douching may increase odds of contracting HIV and other STIs

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From HIVplusmag.com..

According to a study published in the journal Sexually Transmitted Infections, rectal douching might increase the odds of contracting HIV and other STIs — including hepatitis, chlamydia, and gonorrhea.

Researchers state that douching before sex can damage the lining of the rectum, which leads to an increased risk of transmission due to indirect entry into the bloodstream.

Rectal douching is a common practice among gay and bisexual men who prefer the “bottom” role in sex. It’s widely used in an effort cleanse the rectum before having anal sex. According to researchers, nearly half of men who have sex with men engage in the practice.

In this particular study, researchers examined 28 studies involving 21,570 MSM — 46 percent were in the U.S., 35 percent were in Europe, and the rest were in South America, Asia, and Africa, reports NAM AIDS Map. All of the studies were published between 1982 and 2018.

Twenty of the studies were particularly focused on the association between douching and HIV transmission. They found that men who practiced rectal douching were nearly three times as likely to contract HIV.

Read more.

AIDS Education Month: Philadelphia FIGHT looks to raise awareness, combat the virus

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From kywnewsradio.radio.com…

June is AIDS Education Month, and Philadelphia FIGHT has organized a number of events designed to prevent HIV and get folks tested. “People are not going in to get treatment. People still lack access to care,” said Tashina Okorie the director of community health training alliance for Philadelphia FIGHT. She says, while many believe that the AIDS epidemic is over, there is a lack of education and a plethora of stigma.

So the goal of AIDS Education Month, Okorie says, is to dispel myths and provide details on testing, prevention and access to health care. “Access to prep and access to just medication, so you can take care of your health,” she said.

On Tuesday, hundreds will attend the HIV Prevention and Education Summit at the Pennsylvania Convention Center, which will feature dozens of workshops. “Around HIV prevention, around hepatitis C treatment, around behavioral health matters,” she explained. Later in the month there’s a community cookout and workshop on how to teach others about HIV.

Read the full article.

1 in 5 new HIV diagnoses are among Latinx gay and bi men

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From pridesource.com…

According to the CDC, one in five new HIV diagnoses in 2017 in the U.S. were among Latinx gay and bisexual men. While HIV rates are stable, or falling in other groups, they rose by 12 percent among these men from 2012-2016. Eighty-four percent of the increase among Latinx gay and bisexual men was in Puerto Rico, Arizona, California, Florida, Illinois, New York, and Texas. By looking at different factors and health outcomes, the authors highlight four policy actions to heighten attention:

  • Strengthen governmental responses to HIV that focus on the unique prevention and care needs of Latinx gay and bisexual men
  • Address the social determinants of Latinx gay and bisexual men’s health.
  • Support immigrants and migrants, including when providing HIV services.
  • Cultivate and support emerging Latinx leaders.

“There is much that we are getting right in our national response to HIV, as exemplified by declining HIV diagnoses and increased HIV viral suppression, yet these outcomes are not being equally shared. By understanding the challenges facing Latinx communities and more strongly embracing Latinx gay and bisexual men, we can turn this around and reduce these disparities,” says Jeffrey S. Crowley, program director of Infectious Disease Initiatives at the O’Neill Institute for National and Global Health Law at Georgetown Law.

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.

Black and African American LGBTQ Youth Report

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From the Human Rights Campaign…

In 2017, the Human Rights Campaign Foundation partnered with researchers at the University of Connecticut to conduct a groundbreaking survey of over 12,000 LGBTQ youth and capture their experiences in their families, schools, social circles and communities. More than 1,600 Black and African American LGBTQ youth responded to the survey.

This resource presents data collected from these youth, shedding light on their challenges and triumphs encountered while navigating multiple, intersecting identities. This report utilizes the full sample (any respondent who answered more than 10 percent of the survey) and provides more detail than is captured in the 2018 Youth Report.

Find out more.

AIDS Resource Alliance offers education, support, prevention services in State College

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From centredaily.com…

Though HIV is treatable today, the challenges of navigating the health care system can be stressful for anyone, let alone an individual living with a chronic illness. AIDS Resource Alliance utilizes a team of case managers who are trained to help their clients with insurance, housing, treatment and other issues that impact the lives of persons living with HIV. Twice-monthly support groups give clients a chance to share their experiences and struggles within a safe space where judgment and stigma are not allowed.

AIDS Resource Alliance also provides prevention services to the communities they serve. HIV and STI testing are available free of charge during office hours, as are condoms and other harm reduction materials. Each testing client is also provided with risk-reduction education, and general education services are available to local agencies and organizations who want their members to learn more about HIV and sexual health.

Much has changed since the earliest days of the epidemic, and the staff at AIDS Resource are preparing for the future with programming that addresses the new landscape of HIV in America. PrEP, the daily medication that can prevent HIV infection, is prescribed free in the Williamsport offices, as are the required testing and physical examinations necessary to continue the medication (the cost of the drug is the responsibility of the patient, but the AIDS Resource team can assist the client in applying for programs that assist in covering the cost of the drug.) As the population of people living with HIV enters their 60s and beyond, support group and other focused social activities enable clients to maintain positive social connections. Counseling services are provided free of charge to clients who request them.

Find out more.

Health Alert: 10% of HIV cases in gay/bi men linked to gonorrhea and chlamydia infection

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From Gaystarnews.com…

One in ten new cases of HIV in gay and bisexual men are linked to gonorrhea and chlamydia infection. That’s the conclusion of a modelling study highlighted by the NCSD (National Coalition of STD Directors) in the US.

The journal, Sexually Transmitted Diseases, published the research this week. Both sexually transmitted infections can increase the risk of HIV transmission taking place: a fact known for some time.

However, with rates of both gonorrhea and chlamydia rising in the US, health experts are concerned how this may impact public health advances in tackling HIV.

Between 2013-2017, the US saw a 22% increase in chlamydia. Gonorrhea diagnosis shot up by 67%. By comparison, there has been a 13% drop in HIV diagnosis over the last eight years.

The precise extent to which chlamydia and gonorrhea increase HIV transmission is unknown. Other biological factors may also play an influence. For this reason, parts of the ‘modelling’ study relied on estimates.

However, researchers from Emory University and the Centers for Disease Control and Prevention (CDC) in Atlanta say their findings should be used by those working in public health to address the issue of STIs and HIV transmission.

Read the full article.

Overwhelming evidence shows HIV undetectable = untransmittable

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From Gay Star News…

HIV positive people with an undetectable viral load cannot sexually transmit HIV. That’s the unequivocal conclusion from one of the leading health agencies in the US.

Researchers from the National Institute of Allergy and Infectious Diseases (NIAID) undertook a review of recent research. Their conclusion is simple: Undetectable = Untransmittable (U=U). It’s the same message now backed by over 300 health agencies all around the world.

The results of the NIAID review were published yesterday in the Journal of the American Medical Association (JAMA). One of the reports co-authors is NIAID Director, Dr Anthony Fauci. He is widely regarded as one of the world’s leading HIV experts.

In a statement, NIAID called evidence for Undetectable = Untransmittable ‘overwhelming’. Not only does getting those diagnosed with HIV on to Antiretroviral Therapy (ART) ensure their long term health. But it also significantly reduces HIV transmission rates. This is because those with the virus suppressed in their body cannot pass it on.

The authors pointed to research that looked at over 77,000 examples of condomless sex between serodiscordant male couples. One half of the couple had HIV and the other did not. There was not a single transmission of the virus from the HIV positive person to the negative person.

Read the full article.

HIV infections among black gay men taking PrEP, probably due to poor adherence

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From aidsmap.com …

Awareness and use of HIV pre-exposure prophylaxis (PrEP) among black gay, bisexual and other men who have sex with men (MSM) in the United States increased significantly between 2014 and 2017, according to research published in the 1 November edition of the Journal of Acquired Immune Deficiency Syndromes. The study also showed that PrEP was reaching individuals with high levels of sexual risk, sexually transmitted infections (STIs) and substance use, the very individuals most in need of this highly effective form of HIV prevention.

However, HIV prevalence was significantly higher among PrEP users compared to individuals who were not on PrEP. The investigators stress this does not show PrEP failure but is likely due to factors such as poor medication adherence and lack of engagement with healthcare providers.

“It is imperative to recognize that our findings reflect challenges to maintain proper usage of PrEP rather than biological failure of PrEP to protect against HIV,” write the authors. “HIV infections that have occurred among PrEP users are the result of suboptimal levels of drug concentrations because of challenges in adhering to PrEP medical regimens.”

Black MSM account for the largest proportion of new HIV infections in the US. If current epidemiological trends continue, 60% of black MSM will be HIV positive by the age of 40. Tackling the HIV epidemic among black MSM is therefore an urgent public health priority.

Read the full article.