Low vitamin D linked to poor HIV treatment outcomes

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From aidsmeds.com…

There is an apparent association between low vitamin D levels and an elevated risk of HIV disease progression among people beginning treatment for the virus, aidsmap reports. Publishing their findings in The Journal of Infectious Diseases, investigators studied members of the PEARL trial in eight low- and middle-income countries, as well as in the United States.

The HIV-positive study participants had progressed to the World Health Organization’s stage 3/4 of HIV disease within 96 weeks of starting on antiretrovirals (ARVs), or they had experienced virologic failure (two consecutive viral loads over 1,000 16 weeks after starting ARVs), or they had experienced immunologic failure (CD4s dropping below 100 after 48 weeks of ARVs). The researchers compared these participants to randomly selected HIV-positive people to determine if their vitamin D levels when they started taking HIV therapy were linked to a raised risk of worse clinical outcomes.

Forty-nine percent of the participants had low vitamin D upon starting HIV treatment. Low vitamin D at this point was linked to a 2.13-fold increased risk of clinical disease progression and a 2.13-fold increased risk of virologic failure. Some evidence suggested that low vitamin D may also be linked to a worse CD4 response to ARVs, although there was not enough evidence to prove the association.

The researchers believe this research supports the need for future study into whether supplementing for vitamin D affects outcomes of HIV treatment. They say that there is a biologic plausibility that low vitamin D would increase the risk of worse clinical outcomes during HIV treatment.

To read the study abstract, click here.

Start talking and stop HIV

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The Centers for Disease Control and Prevention (CDC) has launched their latest communication campaign under its Act Against AIDS initiative – Start Talking. Stop HIV. This new national HIV prevention campaign is the result of input from more than 500 gay and bisexual men from various racial and ethnic groups, ages, and geographic areas across the United States. The campaign was created by and for gay and bisexual men to promote open communication about a range of HIV prevention strategies for sexual partners.

Start Talking. Stop HIV. features messages that engage, inspire, and spark conversations between sexual partners and provides gay and bisexual men with practical tools and tips for talking about important HIV prevention topics like:

  • HIV testing and their HIV status,
  • Condoms and engaging in lower-risk sexual behaviors,
  • Medicines that prevent and treat HIV, including the use of pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and antiretroviral therapy (ART).

More than thirty years after the first diagnosis of AIDS in the United States, gay and bisexual men continue to be the population most severely affected by HIV nationwide, due to a number of complex factors.

Research shows that communication between sexual partners is associated with reduced risk behavior and increased HIV testing and HIV status disclosure; however, many gay and bisexual men may still find it difficult to talk openly with their sexual partners about HIV prevention.

A dedicated campaign website and Facebook Page  provide conversation starters and accurate information to inform these life-saving conversations.

Study supports benefits of beginning HIV therapy early

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From aidsmeds.com…

Starting antiretroviral (ARV) treatment for HIV before CD4 cells drop too low reduces the risk of AIDS and HIV-related illnesses, according to the same large study that proved early ARV treatment reduces the risk of HIV transmission by 96 percent, aidsmap reports. Called HPTN 052, the study was a large multi-site trial conducted in 13 sites in nine countries. Results were published in Lancet Infectious Diseases.

The trial randomized 1,762 HIV-positive participants who had CD4s between 350 and 550 to either begin ARVs immediately or to wait until their CD4 levels had either dropped to 250 or until they developed a symptomatic disease related to HIV. The median CD4 count at the study’s outset was 436. The participants were followed for a median of 2.1 years.

A total of 57 participants (6 percent) who started treatment early and 77 (9 percent) who delayed treatment experienced one or more of the following (considered a “primary outcome”): death, an AIDS diagnosis, tuberculosis (TB), a severe bacterial infection, cardiovascular disease, serious liver or kidney disease, non-AIDS cancers or diabetes. The cumulative two-year probability of such an outcome was 4.8 percent for the early treatment group, compared with 7.9 percent for the delayed treatment cohort. Although there was a 27 percent reduced risk of a primary outcome among those who started early, this difference was not statistically significant, meaning it could have occurred by chance.

Five percent of those in the early treatment group were diagnosed with an AIDS-defining event, compared with 7 percent among those who delayed treatment. The cumulative two-year probability of an AIDS diagnosis was 3.3 percent in the group that started ARVs early and 6 percent in those who delayed. Starting treatment early lowered the risk of an AIDS-defining illness by 36 percent, a difference that was statistically significant.

 

Just-released guidelines: Pre-Exposure Prophylaxis (PrEP) use for HIV prevention

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From AIDS.gov…

The U.S. Public Health Service and the Centers for Disease Control and Prevention released guidelines for the use of daily oral antiretroviral pre-exposure prophylaxis, or PrEP, for HIV infection, entitled: Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2014 [PDF 867KB].

These guidelines provide health care providers with recommendations on the use of PrEP to prevent HIV, and include a supplement [PDF 690KB] with additional materials and tools for clinicians who prescribe PrEP and their patients. These guidelines replace previous interim guidance released by CDC for the use of PrEP.

CDC recommends PrEP for HIV-uninfected patients at substantial risk for HIV infection, including patients who have any of the following indications:

  • Is in an ongoing relationship with an HIV-infected partner;
  • Is not in a mutually monogamous relationship with a partner who recently tested HIV-negative; and is a
  • gay or bisexual man who has had sex without a condom or been diagnosed with a sexually transmitted infection within the past six months;
  • heterosexual man or woman who does not regularly use condoms when having sex with partners known to be at risk for HIV (e.g., injecting drug users or bisexual male partners of unknown HIV status); or
  • Has, within the past six months, injected illicit drugs and shared equipment or been in a treatment program for injection drug use.

PrEP is a powerful HIV prevention tool. However, for sexually active people, no prevention strategy is 100% effective. Therefore, the guidelines also recommend that physicians encourage patients to use PrEP with other effective strategies—like using condoms, testing for HIV with partners, reducing the number of partners, and having partners who are HIV positive take antiretroviral therapy—to provide even greater protection from HIV.

To achieve the full promise of PrEP, each of us has a critical role to play. Clinicians play a central role in increasing awareness and the delivery of this new prevention method when there are indications for its use. Advocates can help raise PrEP awareness and understanding about PrEP, especially in at-risk populations. Medical associations and professional organizations can help educate providers and share clinicians’ experiences delivering PrEP, and HIV prevention programs can integrate PrEP education into existing activities.

We mark a milestone with the release of these new guidelines—a promising tool for HIV prevention, and one that has the potential to alter the course of the U.S. HIV epidemic.

For more about PrEP and its use. Please visit the CDC PrEP page.

HIV associated with increased risk of melanoma

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From aidsmap.com:

HIV associated with risk of skin cancerHIV infection is associated with an increased risk of melanoma (skin cancer), according to the results of a meta-analysis published in PLOS ONE. In short, people living with HIV had a 26% increase in their relative risk of melanoma compared to the general population. The risk increases to 50% for white-skinned people living with HIV.

The authors of the analysis therefore recommend fair-skinned people with HIV should get regular screenings for suspicious skin lesions and should be warned about the dangers of prolonged exposure to the sun.  You can talk to your doctor about finding a specialist who can perform a skin cancer screening.  To help prevent melanoma, it is also important to use sun block with an SPF of at least 15 on exposed skin, when outdoors.

Read the full article on aidsmap.com.

To find out about how indoor tanning (tanning beds) also increases the risk of melanoma, go to the CDC information page.

For tips on how to spot a melanoma, go to the Skin Cancer Foundation.

To subscribe to Pitt Men’s Study Health Alerts, send an email to rgy2@pitt.edu with the word “subscribe” in the subject line.

Pitt breakthrough may improve HIV treatment

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From the Triblive.com…

A discovery about how HIV spreads through the human body could help doctors tame the virus in some infected patients, researchers say. Findings at the University of Pittsburgh Graduate School of Public Health show the disease moves slowly in people whose immune cells are low in cholesterol. That suggests HIV patients might live longer if researchers can regulate cholesterol metabolism in those cells, said lead author Giovanna Rappocciolo.

“We think it’s important because it’s a very new approach to the study of the HIV infection. I think it could be significant,” said Rappocciolo, an assistant professor in the Department of Infectious Diseases and Microbiology at Pitt. Her work with department Chairman Charles Rinaldo appears Tuesday in mBio, the journal of the American Society for Microbiology. Funded through the National Institutes of Health, their discovery caps several years of research focused on eight men in the Pittsburgh area.

The men are among 5 percent to 10 percent of the more than 1.1 million people in the United States living with HIV who can stay healthy for seven years — or longer — without conventional therapies, Rappocciolo said. Those patients had low cholesterol levels inside certain cells that spread HIV in the body, Rappocciolo and several Pitt colleagues found. Researchers relied on data assembled over 30 years through the Pitt Men’s Study, part of the NIH-supported Multicenter AIDS Cohort Study spanning four cities.

“Results like ours are the real payoff of the past three decades of meticulous data and specimen collection,” Rinaldo said in a statement. Rappocciolo said their department has received more than $70 million for research related to AIDS, the final stage of the HIV disease that severely inhibits the immune system. Rappocciolo stressed her findings do not mean that HIV patients with low-cholesterol diets are safeguarded.

Read more at triblive.com 

HIV infection increases risk of melanoma

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From aidsmap.com…

HIV infection is associated with an increased risk of melanoma, according to the results of a meta-analysis published in PLOS ONE. Overall, people living with HIV had a 26% increase in their relative risk of melanoma compared to the general population, the risk increasing by 50% for white-skinned people with HIV. The increased risk was statistically significant in white-skinned people diagnosed with HIV and of borderline statistical significance for all people diagnosed with HIV.

The authors recommend that fair-skinned people living with HIV should be regularly screened for suspicious skin lesions and should also be warned about the dangers of prolonged exposure to the sun.

Melanoma (skin cancer) diagnoses have increased markedly in the UK and many other countries in recent years. There is also evidence suggesting that people living with HIV have a higher risk of developing this skin cancer compared to individuals in the general population. Studies conducted before effective antiretroviral therapy became available in the mid-1990s showed that having HIV increased the relative risk of melanoma by approximately a quarter.

However, it is uncertain whether people living with HIV continue to have an increased risk of melanoma in the era of effective antiretroviral treatment. A team of Australian and UK investigators therefore conducted a systematic review and meta-analysis, looking at the association between HIV and the relative risk of melanoma in the periods before and after potent HIV therapy became available. The investigators’ analysis included cohort studies involving adult patients.

A total of 21 studies met their inclusion criteria. These were conducted between 1999 and 2013. Most (twelve) were conducted in the United States, eight in Europe and one in Australia. Most of the studies reported on cohorts of patients with HIV and those diagnosed with AIDS, but six studies defined their study population as patients with AIDS. The majority of studies (16) were population based, most of the patients being men (76-92%). One study included only men who have sex with men; one study included women only; a single study was restricted to veterans and two studies reported on single-clinic patient cohorts.

Continue reading on aidsmap.com.

Marking a scientific milestone

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research pageFrom the Huffington Post…
by John-Manuel Andriote
Journalist and author, ‘Victory Deferred: How AIDS Changed Gay Life in America’

Thirty years ago, in an April 23, 1984 press conference in Washington, D.C., the world learned that American microbiologist Robert C. Gallo and his colleagues at the National Cancer Institute had proved that a retrovirus first seen by their counterparts at Institut Pasteur in Paris was the cause of AIDS.

Secretary of Health and Human Services Margaret Heckler also announced that day that the Gallo team had created a blood test to detect antibodies produced by the body to fight infection. With it we finally had the ability to know who was infected, to screen donated blood and to track the spread of the virus.

By the time of the announcement, 4,177 AIDS cases had been reported in the United States across 45 states. New York City alone accounted for more than 1,600 cases. San Francisco, far smaller than the nation’s largest city and the East Coast’s biggest gay mecca, had more than 500 cases. The majority of these cases were among gay men of all skin tones.

Although the HIV test was originally intended to screen the blood supply, it became available to the public in early 1985. After early uncertainty about what, exactly, a positive test meant, it became clear it meant that a microbial time-bomb was ticking inside you, set to explode at some unpredictable time in a nightmare that would eventually lead to your death from the cancers, dementia, brain infections and other horrors that attack a body when HIV has destroyed the immune system.

Continue reading on the Huffington Post.

Combating HIV by zip code

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Minority neighborhoods in the U.S. are hit as hard by HIV as gay enclaves

From Healthline.com…

HIV rates in some urban American neighborhoods rival those of Haiti and Ethiopia, according to a researcher at Brown University in Providence, R.I.

And while affected communities include big-city gay enclaves, such as New York’s Chelsea district, minority neighborhoods in the Bronx and Harlem make the list, too. The difference is that those in mostly white neighborhoods are more likely to be tested and treated than those in minority neighborhoods.They are also less likely to die of AIDS.

In an era of Internet targeting, Dr. Amy Nunn’s approach of going door-to-door if necessary to reach people with HIV may seem old-fashioned. But in areas with limited access to health care, employment, and education, HIV experts agree that a new model is needed to reach at-risk groups of black and Hispanic Americans.

Of the 50,000 new HIV infections in the U.S. in 2010, gay and bisexual men accounted for two-thirds of them, according to the U.S. Centers for Disease Control and Prevention (CDC). Black men and women are eight times more likely to become infected than whites, based on population size. Of all groups, white men who had sex with men comprised the largest segment of new infections, at 11,200. Black men who had sex with men were second, with 10,600 new infections.

Dr. Nunn, an assistant professor of medicine at Brown, told Healthline that more money must be targeted toward poor and minority neighborhoods. “If this were happening to white people there would be protests,” she said. “It’s so easy to overlook poor people.”

Of the more than 1.1 million people in the U.S. living with HIV, almost 16 percent don’t know they have it, according to the CDC. Powerful antiretroviral medications available to most everyone in the U.S. can suppress viral loads to the point that transmission is unlikely. But they will only work if they are taken regularly.

“We’ve got to get these people into treatment come hell or high water,” Nunn said.

Continue reading on Healthline.com.

STD prevention is a part of HIV prevention: STD Awareness Month 

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A message from Gail Bolan, M.D., Director, Division of STD Prevention, Centers for Disease Control and Prevention (from AIDS.gov)…

Gail Bolan, M.D., Director, Division of STD Prevention, Centers for Disease Control and Prevention

Gail Bolan, M.D., Director, Division of STD Prevention, Centers for Disease Control and Prevention

April marks the annual observance of STD Awareness Month. And for this month, I’d like to focus on the link between STD prevention and HIV prevention.

The Centers for Disease Control and Prevention (CDC) has been invested in exploring the intersection of HIV and other STDs. Every year, 20 million new STDs occur including 50,000 new HIV infections. We know that people who have STDs such as gonorrhea, herpes, and syphilis are more likely to get HIV compared to people who do not. In fact, being infected with genital herpes makes you 3 times more likely to get infected with HIV, if exposed. And data collected from several major U.S. cities indicate that nearly 45% of gay and bisexual men with syphilis are also infected with HIV.

So this STD Awareness Month, I encourage the public, health care providers, and community-based organizations to bring a renewed sense of enthusiasm and focus to their STD awareness and prevention efforts. Individuals should know that the same behaviors that put you at risk for acquiring STDs can put you at risk for getting HIV. Physicians should follow recommended screening and treatment guidelines. And community-based organizations should support local STD and HIV prevention efforts.

The link between STDs and HIV is real. By educating yourself on ways to lower your risk, you can take action to protect your health. Not having sex is the most effective way to prevent STDs and HIV, but if you are sexually active, you can lower your risk of STDs and HIV by

  • Choosing one partner and agreeing to be sexually active only with each other. It is still important that you and your partner get tested for STDs and HIV and share your test results with one another.
  • Limiting the number of people you have sex with if you have more than one partner.
  • Using latex condoms or dental dams the right way every time you have sex.

STD and HIV testing is a critical part of preventing the spread of disease. I am urging providers to educate patients on their risk for STDs and HIV, and make taking a sexual history a priority. The behaviors and circumstances that put people at risk for STDs also put them at risk for HIV; take the opportunity to offer HIV testing to all patients who are tested for an STD. With 20% of new HIV cases being detected in STD clinics, it’s clear that a continued merging of STD and HIV prevention efforts is needed. As well, patients diagnosed with HIV at STD clinics have been found to have less-advanced disease.

You can go to the CDC Website to find out more about STD Awareness Month.

Hook-up risks higher with non-gay-identified men

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From the Washington Blade…craigslist image

A newly published study found evidence that men having sex with men use the Internet to find sexual partners who do not identify as gay, either to fulfill a fantasy or because it allows anonymous sexual encounters without discovery. The findings, conducted by Eric Schrimshaw, Ph.D. at Columbia University’s Mailman School of Public Health and Martin Downing Jr., Ph. D. of the National Development and Research Institutes, were published in the online journal “Psychology of Sexual Orientation and Gender Diversity” published by the American Psychological Association.

To examine the subgroup of men seeking non-gay-identified (NGI) men in the online sexual marketplace, the researchers reviewed 1,200 Internet personal ads posted on Craigslist and selected 282 for analysis. They performed comparisons of two categories of personal ads: those seeking encounters with NGI men, including straight, bisexual, married, curious and men on the “down low”; and a contrasting set of ads that did not specifically seek NGI men.

Among the ads studied, 11 percent were placed by men seeking NGI partners. Although men who posted NGI-seeking ads were more likely to self-identify as bisexual, married, and/or discreet and to seek out an anonymous encounter relative to the ads of comparison men, only 24 percent of online advertisements seeking NGI men were posted by men who were themselves non-gay-identified. This suggests that many of the posts are placed by gay men seeking NGI men, perceived by some gay men to be more masculine, dominant or “straight-acting.” Only a small number of ads by NGI-seeking men mentioned safe sex or condom use.

Obama appoints HIV/AIDS activist as new AIDS czar

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From the Washington Times…

President Obama on Monday appointed as his new AIDS czar Douglas Brooks, an activist on health care policy who has been living with the HIV virus for more than 20 years. Mr. Brooks has served most recently as senior vice president at the Justice Resource Institute in Boston, a nonprofit which provides outreach mental health treatment and services people with HIV/AIDS. He also has served on the National Black Gay Men’s Advocacy Coalition in Washington, and was appointed by Mr. Obama in 2010 to the Presidential Advisory Council on HIV/AIDS. “Douglas’s policy expertise combined with his extensive experience working in the community makes him uniquely suited to the task of helping to achieve the goal of an AIDS-free generation, which is within our reach,” Mr. Obama said in a statement. “I look forward to having him lead our efforts from the White House.”

As director of the White House Office on National AIDS Policy, Mr. Brooks will lead the administration’s work to reduce new HIV infections, improve health outcomes for people living with HIV, and eliminate HIV health disparities in the United States, the White House said. A licensed social worker, Mr. Brooks replaces Dr. Grant Colfax, who served in the post for two years.

Read more: http://www.washingtontimes.com

The fight against HIV/AIDS is vital to a future without tuberculosis

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From AIDS.gov…

On Monday, March 24, 2014, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) joined the international community in commemorating World TB Day and those who have lost their lives to this terrible disease; TB is second only to HIV/AIDS in global deaths due to infectious diseases. Moreover, the World Health Organization estimates that at least one-third of the nearly 36 million people living with HIV/AIDS are also infected with TB. TB is the leading cause of death among people living with HIV in sub-Saharan Africa. With these two diseases so closely linked, the 2015 Millennium Development Goal of a 50 percent reduction of TB-related deaths is integral to achieving an AIDS-free generation.

Despite the staggering cost of lives due to co-infection between TB and HIV, we at PEPFAR, in conjunction with our partners implementing TB programs around the world, are encouraged to see progress over the past few years in combatting co-infection. In 2012:

  • Rates of ART coverage among TB/HIV patients globally rose from 49 percent in 2011 to 57 percent.
  • 4.1 million people enrolled in HIV care were screened for TB in 2012, up from 3.5 million in 2011.
  • The percentage of TB patients who knew their HIV status rose from 69 percent in 2011 to 74 percent in sub-Saharan Africa.

The effects of co-infection between HIV and TB cannot be understated which is why PEPFAR addresses the deadly links between these two diseases as a top policy and programmatic priority. Our efforts are focused on prevention, care, and treatment programs as outlined in the 2012 PEPFAR Blueprint [PDF 2.83KB].

Read the full article on AIDS.gov.

Black voices: leveraging digital tools to reach and engage Black gay men

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From AIDS.gov…

More Americans than ever before have access to Internet-enabled technologies and are participating in online social networking platforms. This trend is particularly notable among women, African-Americans, and Latinos and provides hope that effective use of new social technologies could reshape how we reach, engage, and mobilize vulnerable populations such as Black gay men (BGM) and other men who have sex with men (MSM) who are disproportionately impacted by the domestic HIV epidemic. For example, recent data from the The Pew Research Center’s Internet & American Life Project indicate that while the digital divide persists as it relates to Internet access, African-Americans use mobile devices at the same rate as their peers and lead the way in participation in social media such as Twitter.

There is little data available about how BGM/MSM are using social technologies. So, last year, as part of ongoing efforts to improve the health and wellbeing of BGM/MSM, The National Black Gay Men’s Advocacy Coalition (NBGMAC) launched a national survey to learn about the online communication habits of Black gay men. The survey’s goals are to better understand how BGM/MSM use the Internet to communicate and receive national health policy and advocacy information. The data gathered from this survey will contribute to our understanding of how to effectively leverage the Internet for outreach and engagement around health information and national policy issues of importance to BGM/MSM across the nation.

Preliminary survey data highlight the importance of social networking platforms like Facebook in connecting with communities of Black gay men and sharing health policy and advocacy information. The data also reflect a notable level of interest in biomedical HIV prevention tools like Pre-Exposure Prophylaxis (PrEP). Findings like these point to the growing importance of making information available about HIV prevention in a way that meets the needs of the populations most impacted the epidemic. If you are a Black gay, bisexual or same-gender loving man, please take a moment to complete the brief survey and share with your networks. If not, please also consider sharing with any colleagues, friends or loved ones who may be willing to participate and help us to shed light on the communication, health information, and policy and advocacy needs of this underserved community.

To complete the survey, click here or copy and paste the survey’s URL into your Internet browser: http://svy.mk/15KFMwc .

Being out to your doctor is important in maintaining your health

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Why you should consider coming out to your doctor…

There are lots of reasons why men who have sex with men (MSM) don’t tell their doctors about their sexual preferences. But whatever the reason, it is important to keep in mind that who you have sex with can have a serious impact on your health. MSM need to be aware of the unique medical issues that their heterosexual counterparts may not have to worry so much about. For example, MSM have higher rates of HIV, Syphilis, HPV, anal cancer, and hepatitis (just to name a few). In short, your doctor can help you stay on top of the added health issues if he or she knows your sexual preference.

Finding an LGBT-friendly doctor…

The Gay and Lesbian Medical Association (GLMA) keeps an online list of gay-friendly medical providers. It’s especially helpful if you live in or near a large city. You can go to their Website, www.glma.org, and search under their resources link by zip code. If the GLMA database doesn’t have any options near you, and you’re not willing to make a road trip, you’ll have to go about finding a doctor the traditional way: Meet potential providers and interview them. Ask questions, be honest. Doctors work for their patients, not the other way around. Keep shopping until you find one that you can be honest with. It may take some detective work but maintaining your health is worth it.

To subscribe to Pitt Men’s Study Health Alerts, send a message to PMS@stophiv.pitt.edu with the word “subscribe” in the subject line.

Obamacare insurers prohibited from discriminating against same-sex marriages

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From  the Washington Blade…

The Obama administration clarified on Friday that insurers are prohibited from discriminating against same-sex marriages for the purposes of non-grandfathered family coverage — even if applicants are applying in non-marriage equality states. In guidance dated March 14, the Centers for Medicare & Medicaid says existing provisions in the health care reform law prohibiting discrimination by insurers on the basis of gender — which the Obama administration has interpreted to extend non-discrimination protections based on sexual orientation and gender identity — also requires insurers not to refuse family coverage for married same-sex couples.

The guidance is set up as Q&A. The question is “If a health insurance issuer in the group or individual market offers coverage of an opposite-sex spouse, may the issuer refuse to offer coverage of a same-sex spouse?” The response starts off simply, “No.”

“This section prohibits an issuer from choosing to decline to offer to a plan sponsor (or individual in the individual market) the option to cover same-sex spouses under the coverage on the same terms and conditions as opposite sex-spouses,” the guidance states. Alicia Hartinger, a CMS spokesperson, said the guidance spells out that non-discrimination is the rule for insurers — both on and off the health insurance exchanges — when selling policies.

Continue reading on The Washington Blade.

 

A guide for LGBT people choosing health care plans

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The Affordable Care Act (ACA) enrollment deadline is coming up on March 31st. There are a number of LGBT-specific resources available for you and your patients or clients to learn more about the ACA and how to get healthcare insurance coverage. Where to Start, What to Ask: A Guide for LGBT People Choosing Health Care Plans, developed by Strong Families, is a guide that can help you help your patients, clients, friends and family:
  • Evaluate their healthcare needs,
  • Navigate new insurance options and
  • Choose the best plan for them.
Access to affordable health insurance can help address the health disparities that exist in the LGBT community, can provide critical preventative care widely and can ensure all individuals and families can get the care they need without going bankrupt. Click here to download the guide now. Click here for more information from our friends at Out2Enroll.
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Risk of HIV transmission can vary over time

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From aidsmap.com…

A study that looked at the way risk of HIV transmission changed over time in a group of gay men during a six- to eight-year period has found that there was vast variation in the degree of risk men subjected themselves to, the length of time they were at risk and, as a result, HIV incidence.

The researchers analysed the number of times cohort members took sexual risks over the study period (by allocating a “risk score” to each six-month period) and found that men’s risk scores tended to be consistent, and to fall into three different groups.  It found that one-in-seven men belonged to a very high risk group, a third of whom became infected with HIV over the study period. Just under a quarter belonged to a moderate risk group, of whom 10% became HIV positive.

The other two-thirds were at low risk of HIV, except for short periods; 3% of them acquired HIV. Being in the one-third of the cohort that did take more risks was associated with being white, having a high income, and being younger; in addition, being in the most at-risk one-seventh of the group was associated with depression and taking recreational drugs.

The authors specifically did this cohort analysis because they wanted better information that could help in the targeting of pre-exposure prophylaxis (PrEP) at the right groups: one of the reasons this prevention method has taken off slowly in the US and not yet received approval elsewhere is concern about its cost. Cost-effectiveness studies suggest that PrEP will only be economical if taken by people with the highest risk of HIV infection (see this report for one example).

It is, however, of broader interest, as the first-ever study to demonstrate a relationship between specific characteristics and what the authors call “risk trajectories” – longitudinal patterns of risk over time.

To read the full aidsmap story, click here.

To read the study abstract, click here.

Pitt will be part of $3.2M grant to help solve epidemic among African-American MSM

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From the Pittsburgh Post Gazette…

African-American men who have sex with other men typically are more conservative in sexual behavior than gay men in general. So why are they far more likely to contract HIV/AIDS?

“Generally, they take far fewer risks than white guys. They are much more conservative than gay men in general. But it’s a 30-year-long epidemiological puzzle,” said Ron Stall, in the department of behavioral and community health sciences at the University of Pittsburgh Graduate School of Public Health. “Where’s all the virus coming from? If you can’t answer that question, you can’t do HIV prevention.”

The graduate school and the Center for Black Equity in Washington, D.C., now hope to answer that question. They’ve landed a $3.2 million grant through the National Institute of Nursing Research at the National Institutes of Health to answer the question and help put the brakes on the national epidemic of human immunodeficiency virus and the deadly disease that HIV causes — acquired immune deficiency syndrome, known as AIDS. The research team plans to survey nearly 6,000 African-American men who attend annual Black Gay Pride events in Atlanta, Chicago, Los Angeles, Philadelphia and Washington, D.C., which draw about 300,000 participants annually.

“We will bring the community, and Pitt will bring the science,” said Earl Fowlkes, president and CEO of CBE. “We hope to get answers to help both institutions and all of society. This is the most important thing we’ve done in the history of our organization.” The study will create the largest sample of HIV-related data ever collected from African-American MSM, “and that will yield important data about the health and well-being of our community,” Mr. Fowlkes said.

Read more: http://www.post-gazette.com/