Category Archives: Research

Find out about research concerning health issues of men who have sex with men

Thoughts of self-harm still and epidemic among gay youth

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From the San Diego Gay and Lesbian News…

The Trevor Project conducted a report on LGBT youth mental health and although there might not be any surprises as far as psychological disparities, the percentage rates might be cause for concern.

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

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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

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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.

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

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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.

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

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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.

Black and African American LGBTQ Youth Report

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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.

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

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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

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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.

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

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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

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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.

Why STDs are on the rise in America

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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.

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

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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?

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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.

Smoking rampant in LGBTQ community, UIC researcher finds

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From dnainfo.com…

LGBTQ people smoke at twice the rate of straight people, a University of Illinois at Chicago researcher notes in a paper that offers five ideas to reduce the trend.

The paper, produced by a team led by UIC clinical psychologist Phoenix Matthews, said LGBTQ people are “at an elevated risk for tobacco related health disparities due to disproportionately high rates of tobacco use.”

Around 46 percent of gay men and 48 percent of adult lesbians smoke, according to the National Institutes for Health.

Many anti-smoking programs target specific ages, ethnicities and gender — but not sexual orientation, Matthews said in a press release about the paper, published in June by the Society of Behavioral Medicine. Cessation services, such as tobacco quit lines, “are underused by LGBT smokers,” Matthews added.

Matthews recommends that smoking surveys include gays and lesbians specifically and that anti-smoking media campaigns include messages that target them. In addition, the paper urges reducing menthol-flavored cigarettes, which are favored by young smokers, and creating a national clean air act aimed reducing second hand smoke.

Read the full article.

Who we are… 

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m4mHealthySex.org is a joint effort between the HIV Prevention and Care Project and the Pitt Men’s Study at the Graduate School of Public Health, University of Pittsburgh. Our goal is to provide up-to-date sexual health information for men who have sex with men. Click on the menu or the page links above to find testing and care resources, including information about PrEP.

You can also scroll down for the latest blog posts as part of our archive of sexual health information…

Is technology increasing the rate of STDs among certain populations?

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by Laurie Saloman, MS

It’s known that men who have sex with men tend to have disproportionately high rates of sexually transmitted diseases (STDs) compared with the general population, particularly African American and Latino men. A new study has discovered a link between the methods that these men use to find sexual partners and STD infection rates.   The study, conducted by scientists at the Centers for Disease Control and Prevention (CDC), was comprised of 853 African American and Latino men who lived in Chicago, Illinois, Kansas City, Missouri, and Fort Lauderdale, Florida, who indicated that they had engaged in sex with at least 1 man during the previous year. The men were recruited either online or through some form of community outreach. Questions included their HIV status, whether they identified as gay or bisexual, how many male partners they’d had in the previous 3 months, and whether they used the Internet (via computer) and mobile-phone applications (apps) to look for sex partners.

Read the full article.

Laurie Saloman, MS, is a health writer with more than 20 years of experience working for both consumer and physician-focused publications. She is a graduate of Brandeis University and the Medill School of Journalism at Northwestern University.

More gay, bi men with HIV receiving care, disparities remain

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From Reuters Health…

Gay and bisexual men in the United States who are diagnosed with HIV are promptly receiving the necessary treatments more often than in the past, according to a new report from the Centers for Disease Control and Prevention (CDC).

Still, black gay and bisexual men are less likely than their white counterparts to receive antiretroviral therapy (ART) to keep the human immunodeficiency virus in check, the researchers found.

They write in the Journal of Infectious Diseases that one goal of the National HIV/AIDS Strategy was to get 85 percent of people to a healthcare facility within three months of being diagnosed with HIV by 2015. By 2020, the goal is to get 85 percent of people diagnosed with HIV to care within one month.

The study team previously published 2008 and 2011 results from the CDC’s National HIV Behavioral Surveillance, which includes data from 20 cities on adult HIV-positive men who have sex with men – a group at particular risk for HIV infection. The new study adds data from 2014.

Altogether, 1,144 men provided data in 2008, 1,338 in 2011 and 1,716 in 2014. The proportion of white men taking the survey fell 14 percentage points between 2008 and 2014, but the proportion of black men participating increased by 13 percentage points during the same period.

The average age of the men dropped over the study period, too. Insurance coverage increased from 75 percent in 2008 to 86 percent in 2014, which was the first year of coverage expansion under the Affordable Care Act.

In 2008, 79 percent of the men were seen at a healthcare facility within three months of their diagnosis. That measure – known as linkage to care – increased to 87 percent by 2014.

With the 2020 goal in mind, the researchers analyzed how many men were seen at a healthcare facility within one month of their HIV diagnosis. In 2014, 78 percent of men were linked to care within one month, which the researchers say suggests the 2020 goal is feasible.

When the researchers looked at how many of the men were receiving ART, they found the rate increased from 69 percent in 2008 to 88 percent in 2014.

People with insurance or with higher levels of education or income were more likely to be linked to care within a short amount of time and be on ART.

In all years, a higher percentage of ARV treatment was observed among whites, according to the researchers – and this disparity persisted in 2014. The proportion of white men on ART were 9 percentage points higher than the proportion of black men.

“We’re moving in the right direction, but the fact that the disparities are persisting in 2014 when we’ve had access to antiretroviral therapy for so long is troubling,” said Jennifer Kates, who is vice president and director of global health and HIV policy at the Kaiser Family Foundation in Washington, D.C.

The findings suggest black men are being linked to care at roughly the same rate as white men, but they’re not getting equal access to ART, said Kates, who wasn’t involved in the new study.

“There are some systemic issues on the healthcare system side – from providers to insurance – that this study wasn’t designed to look at,” she told Reuters Health.

Read the full article.

Gay men syphilis rates over 100x greater than straight men

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From medpagetoday.com…

The first state-specific analysis of syphilis among men who have sex with men (MSM) shows they have dramatically higher incidence than men whose only sexual partners are female, the CDC is reporting.

Data from 2015, analyzed with a new methodology, show that the incidence of primary and secondary syphilis among MSM was 309.0 cases per 100,000 people, compared with 2.9 per 100,000 among men who reported sex with women only, according to Alex de Voux, PhD, of the CDC’s epidemic intelligence service, and colleagues at the CDC and Emory University in Atlanta.

The disparity was even more marked when the rate among MSM was compared with the 1.8 cases per 100,000 population seen among women, the researchers reported in the April 7 issue of Morbidity and Mortality Weekly Report.

County-by-county data from the U.S. Census Bureau’s American Community Survey included the number of households with a male head-of-household and a male partner, De Voux and colleagues reported, and that information could be used to estimate the MSM population per county.

For the syphilis analysis, the researchers used data from the 44 states that had information on the sex of partners in at least 70% of reported cases. Those states accounted for 83.4% of all 23,872 reported cases in 2015, De Voux and colleagues reported.

State-specific incidence rates among MSM ranged from 73.1 per 100,000 population in Alaska to 748.3 in North Carolina, the investigators found. Syphilis incidence among MSM was highest in the South and West and four of the five states with the highest rates among MSM — Louisiana, Mississippi, North Carolina, South Carolina, and New Mexico — were in the South.

The overall syphilis among MSM was 167.5 times the rate among women, with state-specific rate ratios ranging from 63.7 in Louisiana to 2,140.3 in Hawaii, De Voux and colleagues reported.

Interestingly, the highest overall syphilis rate in the U.S., seen in 1946, was 70.9 cases per 100,000 population — a rate exceeded by the lowest state-specific rate among MSM in 2015: the 73.1 cases per 100,000 observed in Alaska.

The researchers cautioned that the data are based on 44 states and might not reflect the nation as a whole. Similarly, the estimates rely on the American Community Survey data; under-reporting of same-sex households would skew the outcome.

As well, they noted, the analysis did not include cases in which the sex of partners was unknown and if MSM are less likely than other men to report the sex of their partners, the findings might under-estimate the rate of disease among MSM.

Finally, De Voux and colleagues cautioned, not all cases of syphilis are diagnosed and reported.

Editor’s note: To find free Syphilis testing near you, got to gettested.cdc.gov.

NASTAD: People living with HIV on antiretroviral therapy (ART) do not transmit the virus

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From LGBTweekley.com…

nastad-300x195WASHINGTON, D.C. – NASTAD (National Alliance of State & Territorial AIDS Directors), a leading non-partisan non-profit association that represents public health officials who administer HIV and hepatitis programs in the U.S. and around the world, published a new statement affirming that durably virally suppressed people living with HIV on antiretroviral therapy (ART) do not sexually transmit the virus. The statement accelerates NASTAD’s longstanding work to end HIV and promote policies and public health practice grounded in science.

”The science is clear that people living with HIV with a sustained undetectable viral load do not transmit the virus to others. What’s also clear is that we have the tools to end the HIV epidemic and HIV-related stigma and make new infections a thing of the past. Today, we tackle a major part of this work by raising awareness about the latest science of HIV transmission risk,” remarked NASTAD Executive Director Murray Penner.

Read the full article.

Professor Matt G. Mutchler examines HIV prevention with focus on communication among young Black gay and bisexual men

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From csudhnews.com…

Professor of sociology Matt G. Mutchler’s research over the past 20 years into HIV prevention and treatment issues, especially within the African American community, has garnered him more than 15 external research awards and respect as an expert in the field. In addition to serving as a faculty member at California State University, Dominguez Hills, he is currently a visiting professor with the Center for AIDS Prevention and Study at University of California, San Francisco, and director of community-based research with AIDS Project Los Angeles.

Mutchler’s more recent work addresses sexual communication among African-American gay and bisexual males and their close friends, and other sexual health issues related to gay men. He also investigates HIV treatment adherence programs.

Mutchler brings his expertise in community-based research to the CSUDH’s Urban Community Research Center (UCRC), where he serves as director. The multi-disciplinary, sociology-based applied research center focuses on the needs, problems and solutions that arise in urban areas. The center also offers CSUDH students hand-on research experience as they collaborate with CSUDH faculty, and a number of governmental, community-based, and university/research institutions, such as AIDS Project Los Angeles (APLA), Charles R. Drew University, Spectrum, REACH LA, and the RAND Corporation.

Mutchler recently shared insights about his studies and findings, the challenges and rewards of conducting his research within the African American community, and his latest work.

Read the interview with Professor Mutchler on csudhnews.com.