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

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.

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.

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.”

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

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.

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

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.

New CDC initiative educates providers about PrEP and PEP

From HIV.gov

CDC’s Act Against AIDS initiative recently launched Prescribe HIV Prevention, a new initiative for healthcare providers that focuses on HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). The target audience includes primary care providers, infectious disease and HIV specialists, nurses, and public health practitioners.

PrEP is a way for people who are HIV-negative but at high risk for getting the virus to prevent HIV infection by taking a pill every day. PrEP is highly effective when taken as prescribed. PEP is the use of antiretroviral drugs after a single high-risk event to prevent HIV. It must be started within 72 hours of a possible exposure.

Prescribe HIV Prevention educates providers and patients about these biomedical prevention tools and encourages providers to consider PrEP and PEP for patients at high risk for HIV. It includes resources such as a guide for discussing sexual health with patients, brochures and posters to educate patients about PrEP and PEP, continuing medical education programs, and a medication guide for patients.

PrEP regarded as a social problem by some gay and bisexual men

From aidsmap.com

[A]ccording to US research published in Sociology of Health & Illness. A series of focus groups conducted in New York City showed that some men regarded PrEP users as irresponsible, naïve, vectors of disease and a social problem. In contrast, other men articulated PrEP as a beneficial new option for preventing the spread of HIV, and also had a nuanced view about the effectiveness of condom-based prevention campaigns and the epidemiology of sexually transmitted infections (STIs) among gay and bisexual men.

“By framing PrEP use as enabling gay and bisexual men to violate subcultural norms of sexual etiquette espoused in previous HIV prevention efforts, claims makers were able to present PrEP users as social problem villains,” write the authors. “Countering claims makers’ framing PrEP as a social problem, some men constructed PrEP as a helpful prevention tool in the fight against the HIV epidemic within gay an bisexual communities. Much of their discourse was couched within a harm reduction model in which PrEP medication is framed as significantly reducing the harm associated with engaging in risky sexual behavior.”

The use of emtricitabine/tenofovir (Truvada) as PrEP was approved in the US in 2012. Studies have shown that, with good adherence, this treatment can reduce the risk of infection with HIV by over 90%.

Read the full article.

State-level PrEP utilization data now available from AIDSVu

From HIV.gov

Since PrEP is one of the newer HIV prevention tools, understanding more about who is using it is important to better tailoring HIV prevention efforts at the national, state, and community levels. PrEP, or pre-exposure prophylaxis, is when people at high risk for HIV take HIV medicine daily to lower their chances of getting infected with HIV. AIDSVu has released the first-ever publicly available data and interactive maps of PrEP use by state from 2012 through 2016, stratified by sex and age.

The new maps from AIDSVu show more than 77,000 people were prescribed PrEP in 2016, with an average 73 percent increase year over year in persons using PrEP across the U.S. from 2012 – when the drug TDF/FTC was approved by the FDA for use as PrEP – to 2016. However, approximately 1.1 million people in the U.S. are at substantial risk for HIV exposure and could benefit from PrEP, according to analysis presented by the Centers for Disease Control and Prevention (CDC) at CROI 2018 earlier this year.

The data presented on AIDSVu reveal that the growth and distribution of PrEP use has been inconsistent across different sexes, age groups, and geographic regions. For example, the Southern U.S. accounted for more than half (52 percent) of all new HIV diagnoses in 2016 but represented only 30 percent of all PrEP users in 2016. That same year, women comprised 19 percent of all new HIV diagnoses but made up only seven percent of all PrEP users.

Read the full article.

Many at-risk men still don’t take HIV prevention pill

From The Associated Press…

From gritty neighborhoods in New York and Los Angeles to clinics in Kenya and Brazil, health workers are trying to popularize a pill that has proven highly effective in preventing HIV but which — in their view — remains woefully underused.

Marketed in the United States as Truvada, and sometimes available abroad in generic versions, the pill has been shown to reduce the risk of getting HIV from sex by more than 90 percent if taken daily. Yet worldwide, only about a dozen countries have aggressive, government-backed programs to promote the pill. In the U.S., there are problems related to Truvada’s high cost, lingering skepticism among some doctors and low usage rates among black gays and bisexuals who have the highest rates of HIV infection.

“Truvada works,” said James Krellenstein, a New York-based activist. “We have to start thinking of it not as a luxury but as an essential public health component of this nation’s response to HIV.”

A few large U.S. cities are promoting Truvada, often with sexually charged ads. In New York, “Bare It All” was among the slogans urging gay men to consult their doctors. The Los Angeles LGBT Center — using what it called “raw, real language” — launched a campaign to increase use among young Latino and black gay men and transgender women.

“We’ve got the tools to not only end the fear of HIV, but to end it as an epidemic,” said the center’s chief of staff, Darrel Cummings. “Those at risk have to know about the tools, though, and they need honest information about them.”

In New York, roughly 30 percent of gay and bisexual men are using Truvada now, up dramatically from a few years ago, according to Dr. Demetre Daskalakis, a deputy commissioner of the city’s health department.

However, Daskalakis said use among young black and Hispanic men — who account for a majority of new HIV diagnoses — lags behind. To address that, the city is making Truvada readily available in some clinics in or near heavily black and Hispanic neighborhoods.

Read the full article on Newsday.com.

Erie County Health Department: A little-known prevention tool can help reduce infection

From Lisa Szymanski, R.N. public health nurse with the Erie County Department of Health (via goErie.com)…

On the heels of World AIDS Day, I can think of no better time to talk about HIV prevention.

HIV is no longer the death sentence it once was. Today, people infected with the virus are living healthier and longer lives; there are well over 300 people living with HIV in Erie County alone.

But HIV can still have serious health consequences.

A little-known HIV prevention tool is available. We call it PrEP, or pre-exposure prophylaxis.

PrEP helps HIV-negative adults greatly reduce their risk of infection. It consists of a medication, Truvada, taken once a day.

If used as prescribed, the U. S. Centers for Disease Control and Prevention states that daily PrEP reduces the risk of getting HIV from sex by more than 90 percent or higher if combined with other risk-reducing behaviors. Among people who inject drugs, it reduces the risk by more than 70 percent.

The CDC is recommending PrEP for people who are HIV-negative and diagnosed with a sexually transmitted disease in the past six months. It is also recommended for those who have an HIV-positive sexual partner, heterosexual men and women who do not regularly use condoms during sex with partners of unknown HIV status, and gay or bisexual men unless in a mutually monogamous relationship with a partner who recently tested HIV-negative.

PrEP is also recommended for people who have injected drugs and have shared needles or been in drug treatment in the past six months.

You must take an HIV test before beginning PrEP and every three months while you’re taking it. There are several health-care providers in the Erie area who are now prescribing PrEP to their patients.

The cost of PrEP is covered by many health insurance plans, and a commercial medication assistance program provides free PrEP to people with limited income and no insurance to cover PrEP care.

Talk with your doctor or health-care provider to determine if PrEP is right for you. For more information, you may contact the Erie County Department of Health.

Does PrEP use lead to higher STI rates among gay and bi men?

From POZ.com

Rates of new sexually transmitted infections (STIs) are much higher among men who have sex with men (MSM) taking Truvada (tenofovir disoproxil fumarate/emtricitabine) as pre-exposure prophylaxis (PrEP) than among other MSM. More research is needed, however, to determine whether starting PrEP leads to higher STI rates among MSM.

Publishing their findings in the journal AIDS, researchers conducted a meta-analysis of 18 studies of MSM in which new STI diagnoses were reported. Five of the studies included MSM given PrEP, and 14 were conducted with MSM who were not given PrEP. (One study, the PROUD study, included both a group given PrEP immediately and a group given PrEP on a deferred basis and thus fell into both the PrEP and the non-PrEP categories of studies.)

The researchers found that the rates of new diagnoses of STIs among MSM given PrEP were 25.3 times greater for gonorrhea, 11.2 times greater for chlamydia and 44.6 times greater for syphilis, compared with the rates among MSM not given PrEP. After repeating the analysis but excluding studies conducted before 1999, the researchers found that the results were similar.

Looking to parse apart the contributing factors to the higher rate of STI diagnoses among MSM given PrEP, the meta-analysis’s authors theorized that the regular STI testing that is part of taking PrEP might have led to a higher rate of STI detection. A greater number of sex partners and a higher rate of condomless sex among those given PrEP might also have contributed to their higher STI diagnosis rate.

The study is limited by the fact that, except in the case of PROUD, the researchers compared different populations of MSM from study to study. They also compared groups that tested for STIs at different frequencies and used different variations of STI tests. Additionally, the PrEP studies specifically sought out participants engaging in high-risk sexual behaviors, while the other studies might have had different criteria with regard to sexual risk taking. However, participants in many of the non-PrEP studies were indeed recruited based on some level of reported sexual risk taking.

 

Read the full article.

 

Can new ‘Smart PrEP Pills’ increase adherence for HIV-prevention medication among young people?

From the Daily Herald online…

How does the smart PrEP work?

“The pill Truvada — the only PrEP drug approved by the Food and Drug Administration — has a sensor tablet encapsulated over it, so that when the pill is swallowed, the sensor tablet comes in contact with gastric fluid in the stomach and creates an electrical signal,” explained Dr. Gregory Huhn, CCHHS’ Associate Professor of Infectious Diseases and principal investigator of the trial. “The electrical signal is less than the frequency of a heartbeat, so nobody is going to feel it. But it transmits a signal in real-time that the pill has been ingested.”

By having a record of when the pill has been taken that goes to both the patient and his or her doctors or providers, the providers can reach out to patients who haven’t been taking the pills as directed and find out if there are any issues they can help resolve-like medication side effects a patient might be having or that they’ve run out of medication, Brothers said.

PrEP is supposed to be taken once a day.

Read the full article.

New online tool finds providers of HIV Pre-Exposure Prophylaxis (PrEP) in the US

PrEP Locator is a national directory of providers of HIV Pre-Exposure Prophylaxis (PrEP) in the US. PrEP Locator seeks to provide patients access to a national, integrated service including both public and private practice providers. An open source tool, PrEP Locator data and map-based widget are easily accessible via API.

logoThe Locator seeks to serve as a common repository for information regarding providers and clinics that prescribe PrEP. The Locator is an open source tool for those who are managing existing directories to share their resources in a common format, so that patients can access a national, integrated PrEP provider location service that includes both public and private practice PrEP providers. Data will be made accessible with open source tools to facilitate patient access through existing organizational websites and mobile apps.

PrEP Locator is presented by Emory University, in partnership with M•A•C AIDS Fund. The project is led by Dr. Aaron Siegler, Research Assistant Professor of Epidemiology at Emory University’s Rollins School of Public Health. The project is guided by a coalition of partners with expertise in the field of HIV prevention: PleasePrEPMe.org, Greater Than AIDS represented by the Kaiser Family Foundation, National Alliance of State & Territorial AIDS Directors (NASTAD).

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.

Carnegie Mellon University recruiting HIV-negative individuals at risk of getting HIV

carnegiemellonuniversity_wordmarkSocial scientists at Carnegie Mellon University are recruiting HIV-negative individuals who are at risk of contracting HIV for one-hour interviews about their daily lives, their view on their personal HIV risk, and their thoughts about the costs, risks and benefits of taking PrEP.

You are eligible to participate if you:

Are HIV negative and between the ages of 18-60, AND;

* Have had sex without a condom in the last 6 months, OR
* Have been diagnosed with a sexually transmitted infection within the last 6 months, OR
* Use a needle to inject drugs

All participants will receive $50 cash.

This study is sponsored by the Center for Inclusion Health at Allegheny Health Network

For more information or to schedule an interview, contact: 

The PrEP Study
Phone: 412-336-8993
Email:CMUPrEPstudy@gmail.com

Optimal Care Checklist available for men who have sex with men

for men onlyWhether you are gay, bisexual or any man who has sex with other men (MSM), there are certain health issues that are important for you to talk about with your doctor. This brochure entitled Your Sexual Health, published by the National Coalition of STD Directors and the National Alliance of State & Territorial AIDS Directors, is designed to help you get important health care specific to the wellbeing of gay and bi men.

Issues such as Pre-Exposure Prophylactics (PrEP), rising STD rates in the community, getting vaccinated for Hepatitis A & B and for Human Papillomavirus (HPV) are just a few of the topics you might want to discuss with your health care provider. Your Sexual Health can help you break the ice. Being informed is an important first step in protecting yourself and your community.