PrEP use up 35% among gay and bi men at risk

From NBC News

Thirty-five percent of gay and bisexual men at high risk of HIV infection were using PrEP, or pre-exposure prophylaxis, the daily pill that prevents HIV infection, in 2017, according to data released Thursday by the Centers for Disease Control and Prevention. In 2014, just 6 percent of these men used PrEP.

However, despite the nearly 500 percent jump in PrEP use among men who have sex with men, the CDC notes “PrEP use remains too low, especially among gay and bisexual men of color.”

The study was presented Thursday in Seattle at the 2019 Conference on Retroviruses and Opportunistic Infections, a major annual HIV/AIDS conference, and was based on more than 8,000 interviews in 20 American cities.

Read the full article.

Study shows high HIV prevalence in Black, gay men taking PrEP

From thevitalvoice.com

Black men who engage in sex with men have a 1 in 2 chance of getting HIV in their lifetime, according to the National Institutes of Health. This is unconscionable when a drug called PrEP (a once-a-day pill that prevents HIV) exists. However, as recently published in the Journal of AIDS, black men who have sex with men on PrEP had a higher incidence of HIV than those not on PrEP, due to poor adherence to the drug. The study suggests that PrEP alone is not enough to stop the spread of HIV. The study does not, however, challenge the efficacy of PrEP itself but rather the uptake of the surrounding preventative package including behavioral risk reduction support, STI treatment, and medication adherence counseling.

Two health technology startups, UrSure and Healthvana, have separately made enormous strides in reducing HIV. UrSure improves adherence to HIV medications with diagnostic tests, while Healthvana’s platform/app is being used by clinics and their 250,000 patients who are at high-risk for HIV or are HIV positive. Collaboratively, the two startups are now working to build the most technologically innovative PrEP programs in the 48 counties in the U.S. with the highest prevalence of HIV, as identified last week by HHS Secretary Azar.

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.

Experts debate if HIV prevention pill contributes to rise in other STDs

Prevention program manager Adam Weaver talks about sexually transmitted diseases in the testing room at Palmetto Community Care in North Charleston

From postandcourier.com

The STD explosion has led to a debate over a possible connection since the introduction of the HIV prevention pill.

PrEP is not a cure for HIV, and it also is not 100 percent effective, but, taken as directed at the same time once a day, it comes pretty close — up to 99 percent successful in preventing HIV, according to Palmetto Community Care, formerly Lowcountry AIDS Services, in North Charleston.

The drumbeat of safe sex practices hasn’t changed among health officials. Abstinence, using condoms and being in a monogamous relationship are still the best ways to help prevent STD infections.

But the naked truth is people don’t always follow that advice.

“After they start taking PrEP, we don’t see a great shift in risk behavior,” said Aaron O’Brien with Roper Hospital’s Ryan White Wellness Center.

Aaron O’Brien, quality and development manager of Roper Hospital’s Ryan White Wellness Center.

He puts condom users into two groups: those who use them regularly and those who don’t, and, based on his talks with patients, that doesn’t change much once they start taking the pill.

Adam Weaver, prevention program manager at Palmetto Community Care, agrees with O’Brien.

“What we are finding is that the people we are putting on PrEP aren’t changing their condom use,” he said.

They also don’t believe PrEP’s introduction, in and of itself, contributed to the explosion in STDs.

They say it has more to do with better reporting since people taking PrEP must check in with their doctor or provider every three months or so for regular testing.

Read the full article.

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.