STD testing rates, service receipt among HIV-positive MSM remain low

From the American Journal of Managed Care

decorative imageThe CDC recommends regular testing for bacterial sexually transmitted diseases (STDs) among all sexually active gay, bisexual, and other men who have sex with men (MSM) because they have a higher risk of infection. Chief among these STDs are gonorrhea, chlamydia, syphilis, and hepatitis C virus (HCV). Those most at risk also should be receiving recommended STD counseling services.

“Having an STD (like gonorrhea) makes it easier to get HIV or give it to others, so it’s important that you get tested to protect your health and the health of your partner,” states the CDC.

Despite these guidelines, there has been a constant uptick in STDs over the past decade, particularly among HIV-positive MSM, even though they are receiving care for their HIV, according to the authors who investigated the receipt of STD testing and associated services among these individuals and published their results online today in Annals of Internal Medicine.

The primary outcome of their study was to determine both deficiencies in bacterial STD testing and what risky behaviors result in these deficiencies among HIV-positive MSM—especially because having an STD increases the risk of transmitting HIV.

Read the full article.

Young men unaware of risks of HPV infection and need for HPV vaccination

From Eurekalert.com

Young sexual minority men — including those who are gay, bisexual, queer or straight-identified men who have sex with men — do not fully understand their risk for human papillomavirus (HPV) due to a lack of information from health care providers, according to Rutgers researchers.

Doctors need to expand communication on risks and the importance of vaccination, Rutgers researchers say

A Rutgers study published in the Journal of Community Health, examined what young sexual minority men — a high-risk and high-need population — know about HPV and the HPV vaccine and how health care providers communicate information about the virus and vaccine.

About 79 million Americans are infected with HPV, with about 14 million becoming newly infected each year, according to the Centers for Disease Control and Prevention. As a sexually transmitted infection, HPV can lead to several types of cancer, including anal and penile cancer, and is particularly concerning for sexual minority men due to the high prevalence of HIV and smoking in this community and the low HPV vaccination rates overall among men.

“Particularly in light of the decades-long focus on gay men’s health care as HIV care, there is a missed opportunity for HPV prevention in the community,” said study co-author Caleb LoSchiavo, a doctoral student at the Rutgers School of Public Health.

Read the full article.

Trust and stigma affect gay couples’ choices on PrEP and PEP

From aidsmap.com

Both relationship-specific and structural factors influence whether coupled gay men living in New York City choose to use pre- and post-exposure prophylaxis (PrEP/PEP) for HIV prevention. Some men – particularly those in monogamous relationships – felt that discussing PrEP and PEP in the context of a relationship could threaten the relationship by raising issues of trust, while others felt that it had the potential to enhance sexual health and satisfaction.

Stigma from the gay community and healthcare providers around promiscuity also presented barriers to PrEP uptake. This qualitative research was conducted by Stephen Bosco, Dr Tyrel Starks and colleagues at City University New York and published in the Journal of Homosexuality.

Gay and bisexual men accounted for 66% of all new HIV diagnoses in the US in 2017. It is estimated that 35-68% of these infections happen within the context of a long-term relationship. This indicates that coupled gay men have the potential to benefit significantly from biomedical prevention strategies, such as PrEP (taken on an ongoing basis) and PEP (taken shortly after a suspected infection). However, only 7% of the potential 1.1 million gay and bisexual men who could benefit from PrEP were prescribed it in 2016. Black and minority men in the US remain most at-risk for HIV infection, while also having the lowest rates of PrEP uptake.

Read the full article.

Studies firmly establish “undetectable equals untransmittable”

From NIH.gov

Extensive evidence from HIV prevention research studies has firmly established that “Undetectable Equals Untransmittable,” or U=U. This means that people living with HIV who achieve and maintain an undetectable viral load — the amount of virus in their blood — by taking antiretroviral therapy (ART) as prescribed do not sexually transmit HIV to others. The U.S. Centers for Disease Control and Prevention estimates this strategy is 100% effective against the sexual transmission of HIV.

Now, a new study of nearly 112,000 men who have sex with men in the United States has found increasing acceptance of the U=U message in this population. Overall, 54% of HIV-negative participants and 84% of participants with HIV correctly identified U=U as accurate. The study was supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Study results were published online in the Journal of Acquired Immune Deficiency Syndromes.

“U=U has been validated repeatedly by numerous studies as a safe and effective means of preventing the sexual transmission of HIV,” said Anthony S. Fauci, M.D., NIAID Director. “The increased understanding and acceptance of U=U is encouraging because HIV treatment as prevention is a foundation of efforts to end the epidemic in the United States and around the world. This public health message has the power to reduce stigma, protect the health of people living with HIV and prevent sexual transmission of HIV to others.”

Read the full article.

Only 13% of the gay community utilize LGBT-specific clinics and providers Leave a reply

A new study from the Williams Institute at UCLA School of Law (Utilization of LGBT-Specific clinics and providers across three cohorts of lesbian, gay, and bisexual people in the United Statesfound that only a minority (13%) of LGB people have utilized LGBT-specific clinics and providers, but a majority (52%) expressed an interest in utilizing them in the future.

Researchers examined a representative sample of LGB people in the United States from three age groups—young (18-25), middle ( 34-41) and older (52-59)—to understand the factors that influenced past utilization of LGBT-specific clinics and providers and interest in using them in the future.

“The discrepancy between past utilization and interest in future use of LGBT-specific providers suggests there is a disconnect between the type of healthcare many LGB people would like to have and what they have access to,” said lead author Alexander J. Martos, former Research Analyst at the Williams Institute. “Younger, Black LGB people and those with lower incomes reported the greatest interest in LGBT community-based healthcare.”

Read the full article.

Health Alert: Get tested for HIV and other STIs

According to a CDC report, HIV continues to have a disproportionate impact on racial and ethnic minorities, gay and bisexual men, and other men who have sex with men. Yet, 15% of men who are infected with HIV don’t know it.
Also, according to CDC research, cases of gonorrhea, chlamydia and syphilis have risen for the fifth consecutive year.

Some STIs (including HIV) can go unnoticed since symptoms can be mistaken for minor health problems like a cold or sore throat. Some may have no symptoms at all. The only way to know if you’re infected is to get tested.

If you send us your zip code, we can help find local testing near you. Most are free. You can also ask us questions about basic sexual health, including PrEP. Send a message to m4mInformation@pitt.edu. We’re here to help

 

Health Alert: New drug-resistant STI spreading among men who have sex with men

Researchers at the University of Washington have identified a worrisome new bacterial cluster that’s growing in prevalence among men who have sex with men and is resistant to antibiotics.

The drug-resistant strains were identified in Seattle and Montreal, although researchers believe they’re common worldwide. Known as Campylobacter coli, the bacteria cause severe abdominal pain, bloody diarrhea, and fever and are estimated to affect about 1.3 million people in the United States annually. The journal Clinical Infectious Disease published the finding this month.

While the infection usually passes after a few days, it can pose a more serious threat to those with compromised immune systems.

Men who have sex with men are more prone to infection due to sexual practices like anal sex and rimming, according to the researchers. Transmission occurs when fecal matter enters another person’s body, and while it isn’t limited to any one population, gay men are more likely to experience drug-resistant infections because they’re more likely to have recieved antibiotics for similar infections in the past.

“The international spread of related isolates among MSM populations has been shown before for Shigella [another enteric pathogen], so it makes sense to see it in Campylobacter as well,” wrote the study’s lead author, Dr. Alex Greninger. “The global emergence of multidrug-resistant enteric pathogens in MSM poses an urgent public health challenge that may require new approaches for surveillance and prevention.”

Read more on Out Magazine online.

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.”

Sexual abuse against gay and bi men brings unique stigma and harm

From The Conversation

As trauma psychologists, we’re leading a team to help alleviate psychiatric distress in gay, bi and trans males who have been sexually abused or assaulted. In collaboration with two nonprofit organizations, MaleSurvivor and Men Healing, we recruited and trained 20 men who have experienced sexual abuse to deliver evidence-based online mental health interventions for sexual and gender minority males – an umbrella term for individuals whose sexual identity, orientation or practices differ from the majority of society.

This study should help men in this group who have been sexually assaulted know that they are not alone, that they are not to blame for their abuse, and that healing is possible.

But, there are some things that trauma psychologists already know about these men, such as how prevalent sexual abuse of men is and ways to help men recover.

Continue reading…

Scarcity of scientific studies on interventions to reduce health inequities in LGBTQ youth

From HealthNewsDigest.com

There is a dearth of scientifically investigated, evidence-based interventions to address substance use, mental health conditions and violence victimization in sexual and gender minority youth, according to a research review led by the University of Pittsburgh Graduate School of Public Health and published today in the journal Pediatrics.

After poring over thousands of research publications spanning nearly two decades, the scientists identified only nine studies that evaluated such interventions, and most of these used suboptimal study designs, thereby limiting the validity of the findings. None of the programs would be sufficient to mitigate the substantial inequities faced by lesbian, gay, bisexual, transgender and queer (LGBTQ) youth, the scientists concluded.

“While this knowledge gap is distressing, I think we can look at it as an opportunity,” said lead author Robert W.S. Coulter, Ph.D., M.P.H., assistant professor in Pitt Public Health’s Department of Behavioral and Community Health Sciences. “Promising programs are being created by community-based organizations that are ripe for rigorous evaluation by scientists to determine if they are successfully improving health among LGBTQ youth and, if so, whether they can be replicated in other communities.”

Compared with their heterosexual peers, sexual minority youth have up to 623% higher odds of substance use in their lifetimes; up to 317% higher odds of mental health conditions, such as suicidality and depression; and up to 280% higher odds of violence victimization, such as being bullied at school, or sexually or physically abused. Due to these health inequities, the federal government has designated LGBTQ youth as a priority population for research focused on preventing, reducing and treating these health issues.

Read the full article.

Use of HIV prevention pill rising among men who have sex with men

From Reuters Health

A growing proportion of American men who have sex with men know they can take a daily pill to avoid infection with HIV and more of them are using it, a U.S. study suggests.

So-called HIV pre-exposure prophylaxis (PrEP) is highly protective against the virus that causes AIDS, but many people worldwide don’t get this pill because they aren’t aware of it, don’t think they need it, or because it’s unavailable or unaffordable. Efforts to raise awareness among one high-risk group – men who have sex with men – have been complicated because some of these men don’t identify as gay or bisexual and mistakenly think heterosexual people don’t need PrEP.

In 2014, the U.S. Centers for Disease Control and Prevention (CDC) launched an effort to get PrEP to all men who have sex with men who might benefit from the pill, not just gay and bisexual individuals. The current study looked at national health survey data to track changes in awareness and use of PrEP from 2014 to 2017 in 20 American cities.

Overall, there was “a significant increase in the percentage of gay and bisexual men at high risk for HIV who are using PrEP,” said Teresa Finlayson, lead author of the study and a researcher at the CDC in Atlanta.

Read the full article.

Thoughts of self-harm still and epidemic among gay youth

From the San Diego Gay and Lesbian News

There were 34,000 respondents in what is being called the “largest survey of LGBT youth mental health ever conducted and provides a critical understanding of the experiences impacting their lives.”

According to the Washington Blade, here are some of the findings:

• 39 percent of LGBT youth seriously considered attempting suicide in the past 12 months with more than half of transgender and non-binary youth having seriously considered it.

• 71 percent of LGBT youth reported feeling sad or hopeless for at least two weeks in the past year

• Less than half of LGBT respondents were out to an adult at school with youth less likely to disclose their gender identity than sexual orientation.

If you or someone you know is feeling hopeless or suicidal, contact The Trevor Project’s TrevorLifeline 24/7/365 at 1-866-488-7386. Counseling is also available 24/7/365 via chat everyday atTheTrevorProject.org/help or by texting 678-678.

Most Americans have never been tested for HIV

From CNN

Most Americans have never been tested for HIV, the virus that attacks and weakens a person’s immune system.

The US Centers for Disease Control and Prevention is hoping to change that.
According to a new report, the agency found that fewer than 40% of people in the United States have been screened for HIV. It recommends that all people 13 to 64 be tested at least once.
Fifty jurisdictions across the country are responsible for more than half of all HIV diagnoses, yet only 35% of the people recommended for testing in those areas were screened in the previous year, the CDC says. And fewer than 30% of people across the country with the highest risk of acquiring HIV were tested in that period.
“Diagnosis and treatment are the first steps toward affording individuals living with HIV a normal life expectancy,” CDC Director Dr. Robert Redfield said in a statement. “As we encourage those at risk for HIV to seek care, we need to meet them in their journey. This means clearing the path of stigma, finding more comfortable ways of delivering health services, as well as learning from individuals already in treatment so the journey becomes easier for others who follow.”

Researchers receive NIH grant to develop rapid, low cost HIV test

From eurekalert.org

Currently, there is no reliable technology that can detect HIV during the early stages of the infection or measure viral rebound in antiretroviral therapy in treated patients in resource constrained point-of-care settings. There is therefore, an urgent need to develop a rapid, disposable, automated, and low-cost HIV viral load assay to increase timely access to HIV care and to improve treatment outcomes.

WASEEM ASGHAR, PH.D., PRINCIPAL INVESTIGATOR

That’s exactly what a researcher from Florida Atlantic University’s College of Engineering and Computer Science is developing. He has teamed up with a researcher from FAU’s Schmidt College of Medicine to combine their expertise in microchip fabrication, microfluidics, surface functionalization, lensless imaging, and biosensing to create a reliable, rapid and inexpensive device for viral load quantification at point-of-care settings with limited resources.

They have received a $377,971 grant from the National Institutes of Health (NIH) to develop a disposable HIV-1 viral load microchip that can selectively capture HIV from whole blood/plasma. The technology is being developed to be highly sensitive to quantify clinically relevant viral load during acute phase and virus rebound as well as inexpensive (costing less than $1), and quick (results in less than 45 minutes). Moreover, this technology is highly stable, and does not require refrigeration or a regular electric supply to enable HIV viral load at point-of-care settings.

Read the full article.

Rectal douching may increase odds of contracting HIV and other STIs

From HIVplusmag.com..

According to a study published in the journal Sexually Transmitted Infections, rectal douching might increase the odds of contracting HIV and other STIs — including hepatitis, chlamydia, and gonorrhea.

Researchers state that douching before sex can damage the lining of the rectum, which leads to an increased risk of transmission due to indirect entry into the bloodstream.

Rectal douching is a common practice among gay and bisexual men who prefer the “bottom” role in sex. It’s widely used in an effort cleanse the rectum before having anal sex. According to researchers, nearly half of men who have sex with men engage in the practice.

In this particular study, researchers examined 28 studies involving 21,570 MSM — 46 percent were in the U.S., 35 percent were in Europe, and the rest were in South America, Asia, and Africa, reports NAM AIDS Map. All of the studies were published between 1982 and 2018.

Twenty of the studies were particularly focused on the association between douching and HIV transmission. They found that men who practiced rectal douching were nearly three times as likely to contract HIV.

Read more.

Research continues to show AIDS drugs prevent sexual transmission of HIV in gay men

A European study of nearly 1,000 gay male couples who had sex without condoms – where one partner had HIV and was taking antiretroviral drugs to suppress it – has found the treatment can prevent sexual transmission of the virus. After eight years of follow-up of the so-called serodifferent couples, the study found no cases at all of HIV transmission within couples.

The study, which was conducted by researchers from the University College London and the University of Copenhagen, was published in The Lancet journal.

1 in 5 new HIV diagnoses are among Latinx gay and bi men

From pridesource.com

According to the CDC, one in five new HIV diagnoses in 2017 in the U.S. were among Latinx gay and bisexual men. While HIV rates are stable, or falling in other groups, they rose by 12 percent among these men from 2012-2016. Eighty-four percent of the increase among Latinx gay and bisexual men was in Puerto Rico, Arizona, California, Florida, Illinois, New York, and Texas. By looking at different factors and health outcomes, the authors highlight four policy actions to heighten attention:

  • Strengthen governmental responses to HIV that focus on the unique prevention and care needs of Latinx gay and bisexual men
  • Address the social determinants of Latinx gay and bisexual men’s health.
  • Support immigrants and migrants, including when providing HIV services.
  • Cultivate and support emerging Latinx leaders.

“There is much that we are getting right in our national response to HIV, as exemplified by declining HIV diagnoses and increased HIV viral suppression, yet these outcomes are not being equally shared. By understanding the challenges facing Latinx communities and more strongly embracing Latinx gay and bisexual men, we can turn this around and reduce these disparities,” says Jeffrey S. Crowley, program director of Infectious Disease Initiatives at the O’Neill Institute for National and Global Health Law at Georgetown Law.

Read the full article.

Fighting HIV: Gaps in treatment, testing drive new infections

From modernhealthcare.com

An estimated 80% of the nearly 40,000 new HIV infections that occurred in the U.S. in 2016 were transmitted from those who either did not know their diagnosis or were not receiving regular care to maintain their virus at nearly non-transmissible levels, according to health officials.

In a new report, the Centers for Disease Control and Prevention on Monday highlighted the gaps in access to treatment and testing resources that exists within the HIV care continuum. Those gaps have led to a halt in recent years to the progress made over the past two decades in reducing HIV infections.

An estimated 15% of people with HIV don’t know they have the virus, and that population accounted for 38% of all new infection, according to the study. Those who know their HIV status but are not receiving care make up 20% of people living with the virus but account for 43% of new infections.

CDC Director Dr. Robert Redfield said the epidemic could end over the next few years by expanding access to testing and consistent treatment.

Read the full article.

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.

Black and African American LGBTQ Youth Report

From the Human Rights Campaign

In 2017, the Human Rights Campaign Foundation partnered with researchers at the University of Connecticut to conduct a groundbreaking survey of over 12,000 LGBTQ youth and capture their experiences in their families, schools, social circles and communities. More than 1,600 Black and African American LGBTQ youth responded to the survey.

This resource presents data collected from these youth, shedding light on their challenges and triumphs encountered while navigating multiple, intersecting identities. This report utilizes the full sample (any respondent who answered more than 10 percent of the survey) and provides more detail than is captured in the 2018 Youth Report.

Find out more.