The new gay sexual revolution

From Advocate.com

Now there’s hope the younger generation may also experience worry-free sex lives — without the side effects of living with HIV. The use of the antiretroviral drug Truvada as pre-exposure prophylaxis, or PrEP (it’s the only medication approved for HIV prevention), has been shown to reduce the chance of HIV transmission to near zero. Since the medication was first approved as PrEP in 2012, only two verified cases of transmission have been documented among those who adhere to the daily schedule (a third, according to HIV expert Howard Grossman, could not be confirmed). New, longer-lasting PrEP injectables should reach market in the next few years. Studies suggest that on-demand PrEP (such as taking it before and after sexual activity) may also be effective.

“This is a revolution!” Gary Cohan, MD, who prescribes PrEP, told us in 2016. “This should be above the fold in The New York Times and on the cover of Time magazine. A pill to prevent HIV?”

Read the full article on Advocate.com.

New HIV testing, treatment and prevention clinic opens in Washington

From the Observer Reporter in Washington County…

An HIV/AIDS medical clinic is operating in Washington, focusing not only on assisting people who are HIV positive, but testing for the virus and preventing those at high risk from contracting it.

Central Outreach Wellness Center South opened three months ago at 95 Leonard Ave., Washington. It is in Suite 203 in an office building adjacent to Washington Hospital, but it is not affiliated with the facility. For now, the center is open Wednesdays and Thursdays, or by appointment. Walk-ins are accepted.

Initial screenings for and treatment of sexually transmitted diseases is conducted at the clinic, and is covered by the state Department of Health. Central Outreach is filling a need in the Washington area, which did not have an STD clinic since one closed more than a year ago.

Nurse practitioner Carol Priest of Arden is running the office. She is assisted by Braden Bash, who has been trained as a physician assistant and is waiting to take his boards.

Nurse practitioner Carol Priest and physician assistant trainee Braden Bash oversee operations at Central Outreach Wellness Center South

“We hope to be open Monday through Friday by summer,” Priest said.

Stacy Lane, a physician and Washington & Jefferson College graduate, opened the clinic by appointment only in December. It is a “satellite” of the Central Outreach Wellness Center she launched two years ago – and still operates – on Pittsburgh’s North Shore, near the Andy Warhol Museum. She said there was an urgent need for the Washington facility.

“We noticed there were more than 50 people driving from West Virginia to the North Shore, and that wasn’t counting Washington and Canonsburg folks,” Lane said.

“There were no STD options in that area. There was a huge deficit.”

That deficit was underscored by the drug crisis that engulfed the region in recent times. “HIV can be transmitted by drug use,” Priest said.

A major weapon being used to combat HIV, Priest said, is a pill called PrEP, which stands for pre-exposure prophylaxis and has the brand name Truvada. It was used as a treatment for HIV, but is now used as a preventative for people who have been diagnosed as HIV negative and others who are at high risk of getting the virus. “These are people who use (intravenous) drugs and share needles, gay men not using condoms,” Lane said.

PrEP, according to results, has been a huge success.

“Of 200,000 people who were HIV negative and are on that pill, there have been only three cases of HIV,” Lane said.

Lane specializes in infectious diseases and was motivated to do so years ago. An uncle died from AIDS while she was in high school and pondering a medical career.

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.

Pittsburgh AIDS Task Force adds PrEP to its efforts in fighting HIV

From the Pittsburgh AIDS Task Force

As part of our new medical services, PATF is excited to now offer Pre-Exposure Prophylaxis (PrEP), a powerful new tool in the fight to halt the spread of HIV! PrEP involves taking a daily medication, called Truvada, and is over 90 percent effective at reducing the risk of HIV transmission for HIV-negative individuals.
logoExpanding access to PrEP is a main component of the national HIV strategy, which has a goal of eliminating new HIV infections. Despite best efforts at HIV prevention, including encouraging condom use, the number of new HIV infections per year in Pittsburgh and the surrounding area has remained stable in the last few years. PrEP empowers individuals with a critical new method to help prevent HIV and is an especially important tool for those who are disproportionately affected by the virus including men who have sex with men and transgender women.
While any medical doctor is able to prescribe PrEP, many are unaware of the regimen or are uncomfortable prescribing it. Furthermore, many individuals may not be comfortable discussing HIV risk factors, like sexual practice or drug use, with primary care physicians. We’re proud to now be part of a small group of clinics and practitioners in Pittsburgh who regularly offer PrEP and who provide a stigma-free zone to discuss HIV risk factors openly and honestly.
PATF’s PrEP for Wellness program takes a holistic approach to sexual health care. Individuals who enroll in the program come into PATF every three months for HIV and STI testing and have a clinical check up every six months. Trained Health Advocates lead clients through the process, answer questions, and help devise strategies to adhere to the medication.
Individuals in our PrEP program are also able to use PATF’s pharmacy, which delivers medications directly to clients at their home or location of their choosing. Though side effects from Truvada are rare and are generally very mild, pharmacy staff is available on-call to answer any questions related to the medication, drug interactions or side effects.
Most insurance covers PrEP, and our pharmacy is specially trained to help with drug assistance programs, including those that cover co-pays and deductibles. Assistance is also available for those without insurance.
For more information on our PrEP for Wellness program, visit patf.org/prep or call 412-248-0550.

Why aren’t HIV prevention pills going to the people who need them?

From Rolling Stone online

When Truvada was introduced four years ago as a way to prevent HIV, public health leaders didn’t welcome the drug with open arms. The head of the AIDS Healthcare Foundation panned the once-daily pill as a “party drug.” Other health officials claimed that taking Truvada would cause a wave of wild unprotected sex. Even members of the LGBTQ community parroted the criticism, with one gay journalist (regretfully) labeling some users “Truvada whores.”

But the last four years has seen a shift in attitude. More andgetting-prep-to-people-who-need-it more Americans are embracing pre-exposure prophylaxis (PrEP), the HIV prevention method that requires a daily dose of Truvada to reduce viral risk. And more and more prescriptions are being written for the antiretroviral drug. While PrEP is growing in popularity, a new study out of the University of California released last month suggests that the populations most at risk of HIV infection are not the ones benefitting from the prevention strategy.

In a survey of gay and bisexual men in California, only a handful of participants reported having taken PrEP. PrEP use was highest among young white men, at 13.9 percent. For young Latino men, that figure was cut by more than half, while young black men represented less than 10 percent of people who started PrEP.

“This is not reflective of the HIV epidemic at all,” says Shannon Weber, founder of Please PrEP Me, an online directory of over 230 clinics in California that provide PrEP. “It is reflective about access, and where and how people are getting that information.”

Read the full article.