Category Archives: In the News

Most recent news concerning sexual health

LGBTQ Americans: Time to enroll in health care

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enroll in the affordable care actFrom AIDS.gov…

The 2016 open enrollment season has begun. Through January 31, 2016, you can apply for a 2016 health plan, renew your current plan, or pick a new plan through the Health Insurance Marketplace.

This is important news for all Americans, including those who identify as lesbian, gay, bisexual, or transgender (LGBT). On average, LGBT Americans experience greater exposure to violence and homelessness, as well as higher rates of poverty, HIV infection, tobacco and substance use, mental health disorders, and cancer. These disparities are even more pronounced for LGBT individuals who are also members of racial and ethnic minorities and have low incomes.

These health disparities are due in part to lower rates of health coverage. Now, thanks to the Affordable Care Act (ACA), LGBT Americans have increased access to quality, affordable health insurance.

Visit HealthCare.gov to enroll in a new plan, change your current plan, and get answers about the ACA. See HHS.gov’s LGBT Health and Well-being: The Affordable Care Act to learn how the ACA helps LGBT individuals and families.

People with HIV are at higher risk of several types of cancer, large study finds

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From aidsmap.com…

People living with HIV remain at risk of AIDS-defining cancers in the era of effective antiretroviral therapy, and also have higher rates of several non-AIDS cancers than the general population, including lung, anal and liver cancer, according to findings from a study of more than 86,000 HIV-positive people published in the October 6 Annals of Internal Medicine.

Since the advent of effective combination antiretroviral therapy (ART) in the mid-1990s, rates of the three AIDS-defining cancers – Kaposi sarcoma, non-Hodgkin lymphoma and cervical cancer – have fallen among people with HIV. These cancers are caused by opportunistic viruses that can take hold when the immune system is damaged and CD4 T-cell counts are low, though human papillomavirus (HPV) also causes cervical and anal cancer in otherwise healthy people.

Most studies, however, have found that HIV-positive people have a higher overall risk for other non-AIDS-related cancers compared to HIV-negative populations, although data have been inconsistent about specific cancer types. In fact, cancer rates among people with HIV have risen over time as they live long enough to develop malignancies.

Michael Silverberg of Kaiser Permanente Northern California and fellow investigators evaluated trends in cumulative incidence of common cancer types by HIV status among participants in the large North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

Read the full article.

‘Undetectable’ a new identity for gay men diagnosed with HIV

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From aidsmap.com….
status: UNDETECTABLE

Achieving an undetectable viral load is a key milestone in the period after diagnosis with HIV, qualitative interviews with Canadian gay men suggest. Men incorporated knowledge of their own undetectable status into their identities as HIV-positive gay men and their sexual decision making, according to a study published in the August issue of AIDS Education and Prevention. Being undetectable helped many men feel ‘responsible’ and ‘normal’.

The findings come from in-depth, qualitative interviews with 25 gay men diagnosed with HIV in British Columbia, Canada between 2009 and 2012. All had acquired HIV less than a year before their diagnosis and half had been diagnosed with acute (very recent) infection. Up to four interviews were done, in order to see how experiences changed during the year after diagnosis.

Interviewees typically reported a period of sexual abstinence immediately after being diagnosed with HIV. During this period of adjustment, many men had no sex drive. Avoiding HIV transmission was a major concern for many, including this man:

“First of all, I killed my sex life. I was like, you know, I don’t want to infect anyone, I don’t want to take the risk and I don’t want to disclose, so the way of not doing is just not having sex.”

When participants did start to have sex again, they found themselves in an altered sexual landscape, facing new scenarios, challenges and possibilities. Faced with the difficulty of talking about having HIV with new partners, some sought out other HIV-positive men. Others avoided anal sex, even with condoms.

Learning that one’s viral load was undetectable could open up new possibilities:

“I didn’t play around when I was not sure… if I was undetectable or not. I didn’t play. They [sexual partners] would be open to it, but I didn’t want… Personally I didn’t feel comfortable, so I didn’t play until I was undetectable.”

Read the full article.

Increasing levels of engagement with care is key to controlling HIV epidemic in US

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From aidsmap.com…

engagement with care key to controlling HIVTest-and-treat’ is unlikely to be an effective strategy to control the HIV epidemic in the United States without improvements in retention in care, investigators argue in the online edition of Clinical Infectious Diseases. A mathematical model suggested that without interventions to address poor levels of engagement in HIV care, there could be as many as 1.39 million new HIV infections in the US over the next 20 years, at a cost of $256 billion. Targeting testing and linkage would only prevent 21% of these new infections. But a package of interventions comprising testing, linkage and retention in care would prevent over half of the projected new infections, reduce AIDS-related mortality by almost two-thirds and be cost effective.

“To alter the course of the HIV epidemic in the United States, strategies of ‘test and treat’ alone may be insufficient; attention to the full continuum of care will be essential,” comment the authors.

United States guidelines recommend expanded HIV testing and antiretroviral therapy at any CD4 count as strategies to reduce rates of AIDS-related deaths and HIV transmissions. However, this approach may not be as effective as hoped. Recent research has shown that there is significant attrition at each stage of the HIV care continuum in the US. Up to a fifth of HIV-infected individuals are undiagnosed; 20% of recently diagnosed patients are not linked to care within 90 days; 54% of patients are not retained in care; only 30% of diagnosed patients have an undetectable viral load.

Continue reading.

Gonorrhea rising among gay and bi men

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From aidsmeds.com…

Diagnoses of gonorrhea among men who have sex with men are apparently rising in the United States. Centers for Disease Control and Prevention (CDC) researchers, in order to determine demographic information, interviewed a random sample of individuals diagnosed with the sexually transmitted infection (STI) in 12 areas across the country between 2010 and 2013. The researchers then used census and Gallup opinion polling data to estimate the respective sizes of the U.S. MSM, heterosexual male, and female populations by age group at the state, county and city levels.

In 2010, there were an estimated 1,169.7 diagnoses of gonorrhea per 100,000 MSM. In other words, about 1.17 percent of MSM contracted the STI that year. This rate rose 26 percent in three years, hitting 1,474.4 diagnoses per 100,000 MSM, or 1.47 percent, in 2013. Looking at MSM according to age bracket, those between 25 and 29 years of age  had the highest diagnosis rate: 3,400 per 100,000, or 3.4 percent.

During the study period, gonorrhea diagnosis rate among MSM was between 10.7 and 13.9 times higher than that of women or heterosexual men. While the researchers speculate that the rising gonorrhea rates may be indicative of a national trend, they caution that the data in this study is not nationally representative.

Read the full article.

Research shows structural barriers need to be addressed for PrEP to have an impact

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From aidsmap.com…

The uptake of PrEP in people who need it risks being limited due to low levels of awareness, gaps in health insurance, opaque bureaucratic procedures, under-usage of medical services, and limited awareness and skills in healthcare providers, according to an analysis published online ahead of print in Clinical Infectious Diseases. Also taking into account sub-optimal adherence among some PrEP users, the researchers conclude that just 15% of gay men in the American city of Atlanta who could benefit are likely to achieve protection from HIV with PrEP.

The PrEP care cascade

Colleen Kelley and colleagues at Emory University outline a ‘care cascade’ or ‘continuum of care’ for PrEP which identifies the key steps in the process of getting hold of PrEP and using it effectively. Analysis of the care cascade can help focus attention on where there are significant barriers to a person moving on to the next step.

Continue reading.

Exactly zero men on PrEP contract HIV in 2.5-year study

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From hivplusmag.com…

Zero men on PrEP get HIV new study findsAfter two and a half years of trials, a new study has found no new HIV infections among a group of people on pre-exposure prophylaxis (PrEP). For 32 months, researchers at the Kaiser Permanente Medical Center in San Francisco tracked the health of over 600 people as they used Truvada daily to prevent the virus in a real-world setting.

The average age of the study participants was 37, and 99 percent were men who have sex with men. The average length of individual usage was 7.2 months. Members of this group also reported a higher likelihood of having multiple sex partners than those not using PrEP. No one in the study contracted HIV.

Lead author Jonathan Volk, a physician at Kaiser Permanente San Francisco, emphasized that this is the first time such a study has been done in a clinical practice setting at this size. The findings were published Wednesday in Clinical Infectious Diseases, a leading journal of studies on infection disease.

Continue reading.

The medical staff at the Pitt Men’s Study emphasize that PrEP is not a substitute for condoms. It should be used in addition to condoms, to further reduce your risk. It is also important to note that PrEP doesn’t protect against other STDs like syphilis, chlamydia, and gonorrhea. To learn more about PrEP, check out the CDC’s Website. If you have questions about PrEP, you can speak to your doctor. You can also call the PrEP clinic at the University of Pittsburgh Medical Center: (412) 647-0996.

Few gay teenage boys get tested for HIV

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From Medicalpress.com…

Few gay teens tested for HIVThe greatest barriers to these teenage males getting tested are not knowing where to go to get an HIV test, worries about being recognized at a testing site and—to a lesser degree—thinking they are invincible and won’t get infected.

“Understanding the barriers to testing provides critical information for intervening, so we can help young men get tested,” said study first author Gregory Phillips II, a research assistant professor of medical social sciences at Northwestern University Feinberg School of Medicine and an investigator for the IMPACT LGBT Health and Development Program at Feinberg.

“Rates of new HIV infections continue to increase among young gay and bisexual men,” said Brian Mustanski, principal investigator of the study, an associate professor of medical social sciences at Feinberg and director of IMPACT. “Testing is critical because it can help those who are positive receive lifesaving medical care. Effective treatment can also help prevent them from transmitting the virus to others.”

The study will be published Aug. 26 in the Journal of Adolescent Health. Continue reading.

HIV prevention pill a tough sell among Latinos

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From NPR.org…

“It hasn’t really hit the Latino community yet,” Jesse Hinostroza, an HIV prevention specialist with AltaMed health clinics, says while sitting at a table with a bowl of condoms and a stack of bilingual pamphlets about the pill. “They aren’t educated about it.” In California, New York, Texas and elsewhere, health workers are trying to get more high-risk Latino men to use the drug, Truvada. AltaMed’s efforts are being paid for by Gilead, the pharmaceutical company that makes Truvada.

The medication, which is used for “pre-exposure prophylaxis,” or PrEP, was approved by the FDA in 2012 for HIV prevention and has been shown to be more than 90 percent effective when used correctly. But health workers are encountering barriers among Latinos. Those barriers include a lack of knowledge about the drug, and the stigmas attached to sleeping with men and to perceived promiscuity. Many Latinos also have concerns about costs and side effects.

Read the full article.

HIV PEP with emtricitabine/tenofovir/rilpivirine has excellent completion and adherence rates

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From aidsmap.com…

Daily post-exposure prophylaxis (PEP) with single tablet emtricitabine/tenofovir/rilpivirine (Complera, Eviplera) has excellent completion rates and good side-effect and safety profiles, Australian investigators report in the online edition of Clinical Infectious Diseases.

The open-label, non-randomised study involved 100 men who have sex with men (MSM) requiring PEP after possible sexual exposure to HIV. Treatment lasted 28 days and was completed by 92% of participants. Side-effects were mild, the most common being nausea and tiredness. There were no serious adverse events.

Prompt PEP, after possible sexual or occupational exposure to HIV, can reduce the risk of infection. Guidelines recommend triple-drug therapy, ideally commenced within 72 hours of exposure. Failure of PEP has been linked to poor treatment adherence or the premature discontinuation of treatment. A recent analysis of 97 PEP studies found that only 57% of patients completed their four-week course of treatment.

The combination pill emtricitabine/tenofovir/rilpivirine provides well tolerated and easy-to-take once-daily HIV therapy. Though it must be taken with food, investigators from Australia hypothesised that the combination pill would provide convenient and safe PEP.

Continue reading.

Black market for Truvada PrEP may undermine treatment adherence in marginalised people living with HIV

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From aidsmap.com…

The increasing demand for pre-exposure prophylaxis (PrEP) is likely to increase the likelihood that some marginalised individuals living with HIV sell some of their prescribed medication to pill brokers and drug dealers, according to a study presented to the Conference of the Association for the Social Sciences and Humanities in HIV in Stellenbosch, South Africa last week.

Steven Kurtz told the conference that several reports have documented street markets for diverted antiretrovirals (ARVs) in the United States. His own research focuses on south Florida, where he recruited 147 HIV-positive men who have sex with men (MSM) who regularly use cocaine, crack or heroin. He purposively sampled (over-recruited) individuals who had sold or traded their antiretrovirals, so that he could better understand the factors associated with doing so.

Economic vulnerability is the key explanation. Within this sample, men who had recently sold ARVs were more likely to have an income below $1000 a month, to have traded sex for money or drugs and to be dependent on drugs. Age, race and education were not relevant factors. Unsurprisingly, men who had sold their HIV treatment had poor levels of adherence to it.

Continue reading on aidsmap.com.

Study links homophobia with gay and bisexual men not seeking HIV-prevention and testing services

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From hcplive.com…

A Yale University study of 38 European countries’ attitudes about homosexuality has uncovered homophobia was associated with gay and bisexual men not seeking HIV-prevention services, HIV testing, and disclosing their orientation to doctors.   The authors believed their study highlighted a dangerous trend: One where men who live in more homophobic countries were not only becoming less knowledgeable about HIV treatment, prevention, and resources, but also that this demographic seemingly had more opportunities for sexual activity through “hook-up” mobile applications and websites, a Yale University statement pointed out.

For their study published in the June 19 issue of AIDS, investigators used data from the European MSM Internet Survey (EMIS), a questionnaire that delved into gay and bisexual participants’ HIV-related knowledge, behaviors, and healthcare use.

Continue reading on hcplive.com.

AIDSVu releases updated interactive online maps

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map2

Click on the map to go to AIDSVu interactive online maps

AIDSVu releases its annual interactive online maps that show HIV prevalence data for 34 highly-impacted U.S. cities, including for the first time Birmingham, AL, updated state- and county-level prevalence data, and year-by-year new diagnosis data for 2008 to 2013. HIV testing and treatment locator maps include, for the first time, housing opportunities for persons with AIDS, and also show NIH-funded HIV prevention, vaccine and treatment trials locations.

 

 

HIV testing ad causes controversy

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From OUT.com…

An ad for FreeHIVTest.net that appeared earlier this spring has caused controversy in Los Angeles, San Francisco, and other areas where it has appeared on billboards and on public transportation kiosks. In the “white” version, the AIDS Healthcare Foundation’s ad features a gay couple in bed, covered only by a sheet and looking ashamed of what they’ve just done. A blond man clutches his pillow and looks suspiciously over the shoulder of the other man who appears to be almost catatonic. Above them, written in big letters is, “Trust Him?”

 

trusthim_gayaa_1094x335After the campaign launched this spring in Los Angeles, it’s been slated to appear in Oakland, California; Washington, D.C.; Columbus, Ohio; and Broward County, Florida. In a press release, AHF president Michael Weinstein explained:

“In today’s tabloid culture when it can seem that the game called ‘Life’ should be more appropriately tiled ‘Lies,’ the old adage holds true now more than ever, ‘It’s better to be safe than sorry.’ While infidelity is nothing new, the level of risk in contracting STDS from bed-hopping partners is at an all-time high. We want to remind couples that STDs linger around much longer than a wandering eye and that secret sexual experiences can often produce much more than what one bargained for.”

For some, it’s just a cautionary PSA about the realities of HIV and the importance of getting tested. For others, it’s been seen as a scare tactic to shame people out of having sex and demonize people with HIV — and many have spoofed the ads.

Continue reading.

Human Rights Campaign (HRC) publishes updated guide to practicing safer sex

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Press release from the HRC…

The Human Rights Campaign (HRC) Foundation, in collaboration with Whitman-Walker Heath (WWH), released an updated guide to practicing safer sex that includes essential tips to minimize the spread of HIV and other sexually transmitted infections (STIs).

The guide, “Safer Sex,” an updated version of the first edition released five years ago, is written for people of all sexual orientations and gender identities, covering topics ranging from basic facts about HIV and STIs, and the importance of practicing safer sex, to the role of new HIV prevention regimens including Pre-Exposure Prophylaxis, or “PrEP.”

The pocket-sized publication is the latest collaboration between the HRC Foundation and WWH, building on their shared commitment to securing the health and well-being of LGBT people in the nation’s capital and beyond.

“It’s a fact that many LGBT people don’t see themselves, or their relationships, discussed in mainstream sexual health resources,” said Jay Brown, the HRC Foundation’s Director of Research and Public Education. “With rates of HIV and other sexually transmitted infections on the rise among young people and in communities of color, HRC and Whitman-Walker remain committed to providing crucial health and wellness information in a way that is medically accurate, culturally competent, and judgement-free.”

Read more on the HRC Website.

HIV risk among young gay, bi men tied to societal issues

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From Reuters Health…

Participants were recruited from the New York City area between 2009 and 2011 and were 18 or 19 when they entered the study. At that point they were all HIV-negative. Over the next three years, 43 participants became infected with HIV. About a third of black, Hispanic and mixed or other race participants became HIV-positive during the study, compared to about 7 percent of white participants. People who described themselves as being in low to average social and economic groups were more likely to become HIV-positive than those in higher socioeconomic groups.

Also, the authors found, young age at first sexual experience with another male was tied to an increased risk of becoming HIV-positive, compared to a first encounter at an older age. “The bigger point here is that it’s just too simplistic to (blame) everything on race,” Halkitis said. “We’re trying to get at the reason that’s happening. This paper starts to point to it.”

The researchers point out that social and economic status is closely tied to race in the U.S. People with lower social and economic status likely live in areas with more poverty, less access to healthcare and more untreated sexually transmitted infections (STI), they write. They also point out that young gay and bisexual men may not be properly educated about STIs, and their heterosexual parents may not be equipped to educate on those topics.

“I think that one way we can begin to address this issue is through comprehensive sexual health education,” said Jason Coleman, an expert on HIV and STI prevention at the University of Nebraska-Omaha.

Read the full article.

Social apps back in the news after Rhode Island study notes alarming rise of STDs

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From Latinos Health…

In the report by the Rhode Island Department of Health, researchers highlighted the alarming rise of STD’s in the state between 2013 and 2014, with HIV infections up by 33 percent, gonorrhea up 30 percent, and syphilis rising an alarming 79 percent.

“New cases of HIV and syphilis continued to increase among gay, bisexual, and other men who have sex with men at a faster rate than in other populations,” the report noted, adding that “infection rates of all STDs continued to have a greater impact on the African-American, Hispanic, and young adult populations.”

While better testing partly explains the increase, health officials also highlighted “high-risk behaviors that have become more common in recent years,” such as “using social media to arrange casual and often anonymous sexual encounters.”

Read the full article.

H.I.V. treatment should start at diagnosis, U.S. health officials say

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From the New York Times…

People with H.I.V. should be put on antiretroviral drugs as soon as they learn they are infected, federal health officials said Wednesday as they announced that they were halting the largest ever clinical trial of early treatment because its benefits were already so clear.

The study was stopped more than a year early because preliminary data already showed that those who got treatment immediately were 53 percent less likely to die during the trial or develop AIDS or a serious illness than those who waited.

The study is strong evidence that early treatment saves more lives, the officials said. Fewer than 14 million of the estimated 35 million people infected with H.I.V. around the world are on treatment now, according to U.N.AIDS, the United Nations AIDS-fighting agency. In the United States, only about 450,000 of the estimated 1.2 million with H.I.V. are on treatment, according to the Centers for Disease Control and Prevention.

“This is another incentive to seek out testing and start therapy early, because you will benefit,” said Dr. Anthony S. Fauci, director of the National Institute for Allergy and Infectious Disease, which sponsored the trial. “The sooner, the better.”

Continue reading on the New York Times.

CDC dedicates $185M to prevent HIV among trans and MSM

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From edgeboston.com…

The U.S. Centers for Disease Control (CDC) recently announced $185 million in funding for three new programs to prevent HIV infection among transgender people and gay, bisexual, and other men who have sex with men (MSM), with a particular focus on MSM of color.

The programs are part of a multi-pronged strategy to address the disproportionally heavy burden of HIV infection on MSM and transgender men and women. These programs will help health departments and local HIV prevention partners deliver and apply the most effective HIV prevention tools.

In particular, CDC plans to award up to $125 million over a three-year period to state and local health departments to expand the use of: 1) pre-exposure prophylaxis (PrEP) for uninfected MSM and transgender people who are considered at substantial risk for HIV infection; and 2) ongoing medical care and antiretroviral treatment for people already living with HIV. Health departments will be funded to provide PrEP information and referrals and to conduct outreach and training to increase the number of healthcare providers who are knowledgeable about PrEP and offer it to their patients.

Backlash to New York City’s fear-based HIV prevention campaign

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From aidsmeds.com…

The New York City Department of Health and Mental Hygiene’s recent fear-based HIV prevention campaign may have led to unintended consequences by stigmatizing young black and Latino men who have sex with men (MSM). Publishing their findings in Health Affairs, researchers analyzed the 2010 “It’s Never Just HIV” campaign, which used fearful, horror-movie-like imagery and messaging to highlight health problems tied to HIV or its treatment, such as osteoporosis, dementia and anal cancer.

“Relying on fear is risky business,” the authors write in the paper. The health department came to appreciate that its analysis of the campaign’s success could not be governed simply by HIV rates among the target population. Rather, the department needed to consider the campaign’s social and political impact. Not only was there a huge amount of controversy among people in the HIV community, but according to certain criticisms, people at risk of HIV and those living with the virus may have suffered stigma as a result of the campaign.

New York City has since moved away from fear-based HIV prevention campaigns. For example, “Be HIV Sure,” which launched on World AIDS Day 2014, encourages HIV testing as part of sexual intimacy.

To read a press release on the study, click here.