Gay men syphilis rates over 100x greater than straight men

From medpagetoday.com

The first state-specific analysis of syphilis among men who have sex with men (MSM) shows they have dramatically higher incidence than men whose only sexual partners are female, the CDC is reporting.

Data from 2015, analyzed with a new methodology, show that the incidence of primary and secondary syphilis among MSM was 309.0 cases per 100,000 people, compared with 2.9 per 100,000 among men who reported sex with women only, according to Alex de Voux, PhD, of the CDC’s epidemic intelligence service, and colleagues at the CDC and Emory University in Atlanta.

The disparity was even more marked when the rate among MSM was compared with the 1.8 cases per 100,000 population seen among women, the researchers reported in the April 7 issue of Morbidity and Mortality Weekly Report.

County-by-county data from the U.S. Census Bureau’s American Community Survey included the number of households with a male head-of-household and a male partner, De Voux and colleagues reported, and that information could be used to estimate the MSM population per county.

For the syphilis analysis, the researchers used data from the 44 states that had information on the sex of partners in at least 70% of reported cases. Those states accounted for 83.4% of all 23,872 reported cases in 2015, De Voux and colleagues reported.

State-specific incidence rates among MSM ranged from 73.1 per 100,000 population in Alaska to 748.3 in North Carolina, the investigators found. Syphilis incidence among MSM was highest in the South and West and four of the five states with the highest rates among MSM — Louisiana, Mississippi, North Carolina, South Carolina, and New Mexico — were in the South.

The overall syphilis among MSM was 167.5 times the rate among women, with state-specific rate ratios ranging from 63.7 in Louisiana to 2,140.3 in Hawaii, De Voux and colleagues reported.

Interestingly, the highest overall syphilis rate in the U.S., seen in 1946, was 70.9 cases per 100,000 population — a rate exceeded by the lowest state-specific rate among MSM in 2015: the 73.1 cases per 100,000 observed in Alaska.

The researchers cautioned that the data are based on 44 states and might not reflect the nation as a whole. Similarly, the estimates rely on the American Community Survey data; under-reporting of same-sex households would skew the outcome.

As well, they noted, the analysis did not include cases in which the sex of partners was unknown and if MSM are less likely than other men to report the sex of their partners, the findings might under-estimate the rate of disease among MSM.

Finally, De Voux and colleagues cautioned, not all cases of syphilis are diagnosed and reported.

Campus environment tied to sexual assault risk for LGBT people

From Reuters.com

College students in the U.S. who say their campus is welcoming to lesbian, gay, bisexual and transgender people are less likely to be victims of sexual assaults at school, a new study suggests.

The researchers found that students who perceived their campus as an inclusive environment for LGBT people were significantly less likely to be the victims of sexual assault. “I believe this study provides proof of concept for how environment may influence sexual assault violence,” said lead author Robert Coulter, a researcher at the University of Pittsburgh Graduate School of Public Health. Coulter and colleagues write in the Journal of Interpersonal Violence that sexual assault affects 2 to 15 percent of U.S. undergraduates.

In earlier research, they found that certain groups are more at risk of sexual assault than others. For example, women and transgender people in general are at greater risk of sexual assault than non-transgender men.

To see whether campus environment is tied to the risk of sexual assault, the researchers analyzed survey data collected in 2010 from 1,925 undergraduates who were LGBT or questioning their sexual orientation. Overall, 5.2 percent reported that they had been sexually assaulted on campus.

Read the full article.

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

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.

Professor Matt G. Mutchler examines HIV prevention with focus on communication among young Black gay and bisexual men

From csudhnews.com

Professor of sociology Matt G. Mutchler’s research over the past 20 years into HIV prevention and treatment issues, especially within the African American community, has garnered him more than 15 external research awards and respect as an expert in the field. In addition to serving as a faculty member at California State University, Dominguez Hills, he is currently a visiting professor with the Center for AIDS Prevention and Study at University of California, San Francisco, and director of community-based research with AIDS Project Los Angeles.

Mutchler’s more recent work addresses sexual communication among African-American gay and bisexual males and their close friends, and other sexual health issues related to gay men. He also investigates HIV treatment adherence programs.

Mutchler brings his expertise in community-based research to the CSUDH’s Urban Community Research Center (UCRC), where he serves as director. The multi-disciplinary, sociology-based applied research center focuses on the needs, problems and solutions that arise in urban areas. The center also offers CSUDH students hand-on research experience as they collaborate with CSUDH faculty, and a number of governmental, community-based, and university/research institutions, such as AIDS Project Los Angeles (APLA), Charles R. Drew University, Spectrum, REACH LA, and the RAND Corporation.

Mutchler recently shared insights about his studies and findings, the challenges and rewards of conducting his research within the African American community, and his latest work.

Read the interview with Professor Mutchler on csudhnews.com.

 

Six things you need to know for National Black HIV/AIDS Awareness Day

From thebody.com

National Black HIV/AIDS Awareness Day, observed every year on February 7, is a good time to remind the general public of the racial disparities in HIV infection that persist in the United States. Year after year, African-Americans continue to shoulder the heaviest burden of HIV.

Greg Millett (Credit: amfAR, The Foundation for AIDS Research)

Greg Millett (Credit: amfAR, The Foundation for AIDS Research)

“If you don’t have access to healthcare and you’re HIV-positive, you’re less likely to be on medication or virally suppressed, and therefore more likely to transmit HIV,” said amfAR vice president and director of public policy Greg Millett. “We also have to do a better job of reducing HIV stigma because it keeps people from being tested for HIV, and it keeps people who are HIV-positive from seeking care because they’re afraid they’ll be discriminated against. And that is what continues to fuel the epidemic.”

According to Millett, to effectively address the racial disparities in the HIV/AIDS epidemic in the U.S., we need to continue raising awareness about how HIV disproportionately affects the black community, urge our policymakers to prioritize HIV prevention and treatment resources to the hardest hit communities, such as black gay men, and improve care for HIV-positive black women and injecting drug users.

Discrimination, stigma, poverty, and lack of access to healthcare contribute to the disproportionate burden of HIV among black Americans. This is most notably the case in regions with large black populations like the American South where approximately half of the nation’s new HIV infections occur, with black Americans accounting for nearly 80 percent of them. In general, African-Americans are less likely than whites to have private health insurance.

Read the full article.

LGBTs would be disproportionately affected by the repeal of the ACA

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.

Gay men headed for an STD epidemic?

From Slate.com

Earlier this month, Poz magazine’s Benjamin Ryan drew attention to a concerning new study out of Northern California’s health system: Using data gathered from July 2012 through June 2015, researchers found that, among a cohort consisting mostly of same-sex–attracted men on the HIV-prevention regimen PrEP, “quarterly rates of rectal gonorrhea and urethral chlamydia increased steadily and about doubled after one year.” In other words, guys on the fantastically effective pill-a-day Truvada program were avoiding HIV infection—there were no new transmissions for regimen-adherent patients over the study period, in fact—but they seemed to be getting other sexually transmitted diseases relatively often.

Read the full article.