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

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

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 strikes Black gay men more, despite safer behaviors

Young black gay men are 16 times more likely to have HIV than whites, even though they have fewer partners, have less unsafe sex, and get tested for HIV more often, a new study shows.

“Our study illuminates how HIV disparities emerge from complex social and sexual networks and inequalities in access to medical care for those who are HIV-positive,” said senior study author Brian Mustanski. He is director of the Northwestern Institute for Sexual and Gender Minority Health and Wellbeing at Northwestern University’s Feinberg School of Medicine in Chicago.

“Their social and sexual networks are more dense and interconnected, which from an infectious disease standpoint makes infections transmitted more efficiently through the group,” Mustanski explained in a university news release.

“That, coupled with the higher HIV prevalence in the population, means any sexual act has a higher chance of HIV transmission,” he added.

If this trend continues, 1 out of every 2 black gay men will become infected with HIV at some point in life, compared to 1 in 5 Hispanic gay men and 1 in 11 white gay men, according to the U.S. Centers for Disease Control and Prevention.

In the study, researchers analyzed data from more than 1,000 gay men, aged 16 to 29, in Chicago.

Among their other findings: black gay men were less likely to have close relationships with their sexual partners, more likely to have hazardous marijuana use, and more likely to have experienced more stigma, trauma and childhood sexual abuse. White gay men were more likely to have alcohol problems.

The study was published Dec. 4 in the Journal of Acquired Immunodeficiency Syndromes.

For more information, check out the U.S. Centers for Disease Control and Prevention.

Internet-based intervention effective in the treatment of depression in people living with HIV

From aidsmap.com

An online self-help intervention is effective in the treatment of mild to moderate depressive symptoms in people with HIV, according to a randomized clinical trial conducted in the Netherlands and published in the September issue of The Lancet HIV.

The trial compared the outcomes in a group who received the online self-help intervention and a control group. The internet-based intervention, available in Dutch and English, consisted of a cognitive behavioral therapy program called “Living Positive with HIV” and developed from a self-help booklet that had previously proved effective in decreasing depressive symptoms. Participants also received minimal telephone coaching by a Masters student in psychology. The control group received the telephone coaching and could access the online intervention after the trial was completed.

Sanne van Leunen and colleagues randomly assigned 188 eligible participants to the intervention (97) or the control group (91) in 2015. Depression was assessed at baseline, Month 2, Month 5 and Month 8 (the control group did not take the last assessment).

As detailed below, results show that more participants in the intervention group than in the control group demonstrated significant change in their symptoms and that this effect was maintained for six months. Anxiety symptoms were also decreased. No adverse events were reported, the rate of satisfaction with the intervention was high, and most participants reported that they would recommend “Living Positive with HIV” to others.

Stop blaming PrEP for the increase in STI rates

From LGBTQ Nation

In an interview with the Los Angeles Blade about the new study, lead author Phillip Hammack, a professor at the University of California, Santa Cruz, debunked the notion.

“Our data don’t support the idea that we can attribute the rise in STIs to PrEP use, at least not in a direct manner. I personally don’t think that’s what’s happening,” said Hammack.

Instead, Hammack points at the rise of dating apps like Grindr, and a decrease in fear towards contracting HIV, as more likely causes.

“I would speculate it has more to do with a culture shift about sex,” said Hammack. “More people are having sex today. We’re in sort of a quiet sexual revolution when it comes to new identities, new labels, and sexual behavior.”

On the down side, the study also showed that only 4% of men who have sex with men are using PrEP. What’s more, many gay and bisexual men aged 18-25 aren’t getting annual HIV tests. 25% of men who have sex with men in that age range have never gotten an HIV test.

“I worry especially about younger men who didn’t grow up with the concerns of HIV that men of older generations did,” said Hammack in the William Institute press release on the study. “The low rate of HIV testing probably reflects a degree of complacency and cultural amnesia about AIDS.”

Read the full article.

Gay teens at least twice as likely to use illegal drugs, study suggests

From NBC News online

Lesbian, gay, bisexual and questioning (LGBQ) teens are at least twice as likely as their heterosexual peers to use illegal drugs like cocaine, ecstasy, heroin and methamphetamines, a U.S. study suggests. Previous research suggests that stressors related to being closeted or coming out and being rejected by family or friends could contribute to an increased risk of substance use among sexual minority teens, senior study author John Ayers of San Diego State University in California said.

For the new study, researchers looked at data from roughly 14,703 high school students who had been surveyed about their lifetime and prior-month use of 15 different substances, including illegal drugs as well as tobacco, alcohol and prescription drugs that weren’t given to them by a physician.

LGBQ youth were more than three times more likely to try heroin or methamphetamines at least once, and more than twice as likely to try ecstasy or cocaine, the study also found.

Stressors faced by LGBQ teens, such as stigma and isolation, “may make drugs foolishly appear attractive as a coping mechanism,” Ayers said by email. “Even experimentation with these harder drugs can derail a teen’s future,” he said.

The vast majority of teens didn’t use illegal drugs, regardless of sexual orientation, researchers report in the American Journal of Public Health.

Read the full article on NBC News.

Why STDs are on the rise in America

From the Economist online

Much of the increase in STDs has come from gay and bisexual men. Although a relatively small share of the population, they accounted for 81% of male syphilis cases in 2016, according to the Centres for Disease Control. As with heterosexuals, this seems to be because sex is now seen as less risky. That is due to the advent of PrEP, a prophylactic drug cocktail which gay men can take to nearly inoculate themselves from HIV. The reduced chances of catching HIV—along with the fact that a positive diagnosis is no longer a death sentence—seems to encourage men to drop their guard. A recent study of gay and bisexual men, published in the Lancet, a medical journal, found that as more began taking PrEP, rates of consistent condom usage dropped from 46% to 31%. Recent studies have shown that uptake of PrEP is strongly associated with increased rates of STD infection.

All this shows that changing sexual mores, and a reduced fear of the risks of unprotected sex, seem to be at fault—especially since the problem is not just limited to America. England experienced a 20% increase in syphilis diagnoses in 2017 and a 22% increase in those of gonorrhoea. Other countries in western Europe have seen ever worse outbreaks, sometimes exceeding 50%. Dwindling public spending on STD prevention—which in America has fallen by 40% in real terms since 2003—is not helping matters. Yet the chief methods of prevention, abstinence and condoms, are tried and true. Should these options seem too chaste or chaffing, then prospective partners ought to get an STD test (especially since most infections can be cleared up with a simple course of antibiotics). Verified testing is vital since verbal assurances, especially on the cusp of a liaison, can be misleading.

Read the full article.