#HIV

Report: First Known U.S. Case Of HIV Infection With Verified Adherence To PrEP

A 21-year-old Latinx man in San Francisco, California, has contracted HIV despite adhering to a daily PrEP regime.

According to TheBodyPro.com, he is the first known HIV seroconversion with verified adherence to PrEP in the United States,

Medical experts were informed of the news at the annual IDWeek conference, run by the Infectious Diseases Society of America, this past weekend in San Francisco.

Reports show the man began PrEP through a city health clinic in San Francisco in late 2016. At the time, he was confirmed to be HIV negative.

Repeat testing during return visits at the three, six and ten month marks showed he had been consistent in taking the medication and he remained HIV negative. By analyzing samples of his hair, doctors were able to confirm he had adhered to the PrEP regime on a regular basis for the previous six months.

In early 2018, during a followup visit, he tested negative through a rapid test, but a more comprehensive RNA test came back positive. Further testing showed he was indeed HIV positive.

He was immediately placed on HIV medications and his viral load was suppressed where it has remained since treatment began.

Health care experts were able to identify that the man had acquired a particularly resistant strain of HIV usually identified with those who have begun treatment with HIV medications but stopped.

Researchers were able to determine that the man’s primary male partner had been diagnosed with HIV, used medications for a period of time but had stopped. His viral load was found to be very high and matched the 21-year-old’s strain. He has since returned to treatment.

This marks the sixth reported case of HIV infection while using PrEP.

Four cases, two in 2016 in New York and Toronto, and two in 2017 in North Carolina and Australia, are believed to be due to exposure to high viral loads of resistant strains of HIV.

Medical experts believe the fifth previous case, in Amsterdam, was the result of a gay man having “unusually high number” of sexual partners - an average of 56 partners a month - which may have repeatedly exposed him to HIV, according to aidsmap.com.

Even in light of this new report, health care professionals insist PrEP (currently being taken on a regular basis by over 350,000 people around the world) is extremely effective in combating HIV infection.

"We know PrEP is greater than 99% effective," Robert Grant, M.D. of the University of California San Francisco told TheBodyPro.com. "There are some cases where HIV will break through. We only have a handful of cases now, and next year, we'll probably have a handful more. Fortunately, these cases are caught early, treated, and suppressed quickly. The person goes from taking one pill a day to one pill a day. The biggest difference is stigma."

NBC News recently reported that while 1.2 million in the United States would be considered appropriate candidates for PrEP, only 120,000 prescriptions have been filled between 2012 and 2017.

(h/t: TheBodyPro and aidsmap)

 

Venezuela Is Experiencing A Mass Exodus As Medicine Disappears

Latin America is currently experiencing the biggest modern exodus of people in that area.

More than a million Venezuelans have left the country after a recent economic collapse has led to food shortages and lack of access to medicine.

“The doctors would say, ‘Nothing this month, try next month,’” said Danielis Diaz, a transgender hairdresser who had to move from Venezula to Colombia in order to seek HIV medicine, told Reuters.

“Doctors told me to take vitamins and eat lentils while waiting for the drugs. While you wait, you’re waiting to go to the cemetery,”

Prior to moving to Colombia, Diaz once received free HIV medication for 12 years from the government. Unfortunately, that once celebrated national program has dried up along with the rest of Venezula’s public health field.

The lack of funds and medicine first led to a pause in regular check-ups before causing the end of antiretroviral drugs released in the country and then the departure of specialist doctors.

“We have now reached a crisis point in Venezuela,” said experts, according to Relief Web. “Access to healthcare, a fundamental responsibility of the State, is in a serious state of decay. It is shocking that hospitals themselves have become a place where people’s lives are being put at risk.”

Perhaps the two groups of people that have been hit the hardest are children and LGBTQ people. These shortages in antiretroviral drugs have obviously hit people living with HIV like Diaz.

In addition, several children are dying from causes that could have been prevented by better health care, according to the Organization of American States. So far, 16 children at one hospital have died due to poor hygiene and an undocumented number of deaths from other minors were caused by conditions such as malnutrition.

The UN has called on the Venezuela government to act and properly mobilize resources to the remaining citizens.

h/t: Reuters, Relief Web, The OAS

New CDC Report Says Number of Young Gay And Bisexual Men Diagnosed With HIV Keeps Increasing

The Centers for Disease Control & Prevention released new data on the changes in HIV infections in the USA.

The report, which was released on Thursday, focused on data from the 235,000 new gay and bisexual men diagnosed with HIV between 2008 and 2016. The study was focused on the rate of new infections and categorized the data by age group and U.S. region.

The results found that 45 percent of the 235,000 gay and bisexual men diagnosed HIV within that time were aged 13-29. Meanwhile, 43 percent were 30-49 and 12 were 50 or over.

Other results from the data were:

  • There was a 3 percent increase per year for new HIV diagnoses of men aged 12-29.
  • Meanwhile, 30-49-year-olds decreased by 4 percent in diagnoses each year.
  • Young men of color are still greatly affected by HIV. Black men make up half of the 13-29 age bracket of new HIV diagnoses in the recorded time span. Latinos account for another quarter.

Related: How Can We Help Gay Men of Color At Risk of HIV On This World AIDS Day?

Again, the data also focused on US region and not just age groups. The results found that the US South is the most effected region. 9 out of the 10 states with the highest percentages of 13-29-year-olds living with HIV are in the South.

In addition, the state of Georgia has specifically seen a rise in HIV rates (a fact we and Georgians have already noted).

In 2008, Georgia had 17,290 gay and bisexual men living with HIV. By 2015, the number had skyrocketed to 29,000. This now makes Georgia the state with the fifth-highest number of HIV-positive gay and bisexual men.

The CDC has already shared earlier this year that they think health experts need to reach out to Southern Gay Black men, and this new report strengthens that thought.

“To avert the most infections and improve health outcomes, gay and bisexual males at risk for HIV infection should be tested at least once a year, and, if positive, linked to and retained in HIV medical care to achieve viral suppression,” said Dr. Andrew Mitsch from the CDC’s Division of HIV/AIDS Prevention to Project Q.

“Those testing negative should be provided HIV prevention services, including pre-exposure prophylaxis, or PrEP," he added.

h/t: CDC, Project Q

U.S. Military Defends New Policy That Could Get HIV-Positive Soldiers Expelled

The Trump administration has announced a new military policy that would ultimately make HIV-positive service members incapable of serving, but the policy is already being indirectly challenged in court.

The new “Deploy or Get Out!” directive is supposedly meant to improve military readiness by getting rid of soldiers who can’t deploy for more than 12 consecutive months “for any reason,” according to Bloomberg.

The Trump administration defended the policy after being questioned on it by saying:

"The determination about whether to commission an officer is one involving an inherently military judgment about whether a service member is fit and qualified to serve in such a position.”

While this policy may not mean much to LGBTQ service members alone, its combination with an already applied policy has terrible repercussions.

An earlier directive brought in during the 1980s states that service members with HIV aren’t allowed to deploy overseas. The idea was that their HIV-statuses would have been too complicated for military missions and thus made them incapable of deploying.

Unfortunately, that now outdated policy is still in action today. Combining the new “Deploy or Get Out!” policy would mean that all HIV-positive service members, who can’t deploy because of the earlier directive, would automatically be fired. This is a clear violation of constitutional rights.

Thankfully, the older directive is already being challenged in court. On September 7, a HIV-positive, 41-year-old, National Guard member from Oklahoma filed a lawsuit with the help of OutServe-SLDN, an LGBTQ military organization.

"Thus, even with the significant advances in HIV treatment, the unique demands and challenges of military service have led DoD to determine that it is necessary to generally prohibit HIV positive persons from being appointed, enlisted, or inducted into the service," according to the filings.

Again, the lawsuit has only now been filed so there’s still a long journey ahead for the court battle.

h/t: Bloomberg

Pharma Giant Merck Gets FDA Approval On 2 New HIV Meds

Pharmaceutical drug giant Merck has obtained approval from the Food and Drug Administration (FDA) for two new medications to address HIV.

Pifeltro (doravirine) is a new non-nucleoside reverse transcriptase inhibitor (NNRTI). That medication is paired in a new three-drug single tablet dose to be marketed as Delstrigo (doravirine/lamivudine/tenofovir disoproxil fumarate).

Both are indicated for treating HIV-1 in adults with no prior anti-retroviral treatment.

The approval for the once-a-day pills come after two double-blind, active-controlled phase 3 trials showed positive results.

In a trial called “Drive-Ahead,” 728 patients were treated with either Delstrigo or Gilead’s Atripla for 48 weeks.

At the end of the study, viral suppression rates were similar with Delstrigo reaching 84% and Atripla achieving 81% suppression.

In addition to edging Atripla on viral suppression, Delstrigo patients saw better results regarding LDL cholesterol and non-HDL cholesterol.

The Delstrigo group also experienced lower incidence of neuropsychiatric adverse issues like sleep problems, dizziness and being able to concentrate more clearly.

While there is currently no cure for HIV/AIDS, the Centers for Disease Control have previously announced that when HIV+ folks stay on their prescribed medications on a daily basis, not only are viral loads lowered to ‘undetectable,’ but ‘undetectable’ means the virus is untransmittable.

(h/t PharmaPhorum)

Less UK Gay Men Have Been Diagnosed With HIV In Two Years

UK gay men are less frequently contracting HIV, according to the AIDS Map.

Public Health England recently released numbers on the amount of gay and bisexual men who have been diagnosed with HIV in the past few years.

Their records show that the number has been dropping in the past two years. While it reached 2290 in 2015, it then hit 2820 in 2016 and 2330 in 2017. That’s a 31% drop between 2015 and 2017.

On top of that, the biggest fall happened in London with diagnoses dropping to 41% whereas outside of London it was down 30%.

It wasn’t just gay men who saw this drop in diagnoses however as the total of 4363 people who were diagnosed with HIV in 2017 was lower than the 6043 in 2015 and the 5280 in 2016.

Current guesses are that the increase of HIV testing could have caused this general drop in diagnoses, but experts can’t confirm that idea just yet.

Unfortunately, it’s not all good news though as the percentage of people diagnosed late did not get better.

As the AIDS Map reports;

“42% of all diagnoses were made with a CD4 cell count below 350/mm3. The highest rates are in heterosexual men (58% and 72% in black African heterosexual men) but also of great concern in heterosexual women (50%) and injecting drug users (47%). The rates are lower in gay and bisexual men (32%).”

While all of this information has just been released, there’s even more waiting to be published through a full analysis that will drop in November.

h/t: AIDS Map

CDC Announces Gonorrhea Diagnoses Have Doubled Since 2013

At the National STD Prevention Conference in Washington yesterday, the Center for Disease Control released preliminary figures showing, for the fourth straight year, sexually transmitted diseases are on the rise.

In fact, 2017 saw a record 2.3 million cases of STDs in the United States.

The CDC described the increase as “steep” and “sustained” between 2013 and 2017.

At the top of the list was Chlamydia, accounting for a whopping 1.7 million diagnoses.

Additionally, Gonorrhea has jumped 67% and syphilis increased 76% in the four year time period. The CDC notes that 70% of those cases are among gay/bisexual men.

Guys - are you paying attention?

Dr. Jonathan Mermin, director of the CDC’s national STD agency, warned “We are sliding backward.”

“It is evident the systems that identify, treat, and ultimately prevent STDs are strained to near-breaking point,” he added.

Of great concern is gonorrhea’s increasing resistance to antibiotics.

For years, folks have felt that solving a gonorrhea infection could be as simple as a quick treatment with antibiotics. But medical experts say gonorrhea is becoming resistant to even the last remaining antibiotic used to treat the disease, ceftriaxone.

“We expect gonorrhea will eventually wear down our last highly effective antibiotic, and additional treatment options are urgently needed,’ said Dr Gail Bolan, director of CDC’s Division of STD Prevention.

David Harvey, executive director of the National Coalition of STD Directors, blames the steep rise in STDs on cutbacks in federal resources describing the STD prevention engine as “running on fumes.”

Some folks look to a rise in the use of PrEP (Pre-exposure Prophylaxis) as partly to blame for the increase in STD diagnoses.

A recent analysis of studies shows that while men on PrEP definitely see drop in HIV studies, chlamydia and syphilis increased by nearly 25% in first six months on PrEP.

But back in June, Matthew Hodson of Gay Star News opined that PrEP alone isn’t to blame. He named check dating apps, increases in chemsex, and even changing social attitudes towards sex.

What do you think is causing the steep rise in STDs, readers?

Less condoms? More PrEP? Perhaps dating apps? Or recreational drugs?

Sound off in the comments.

Reminder - the CDC recommends all sexually active gay and bisexual men to check in with their doctors regarding sexual health at least once a year. And get tested for STDs every 3-6 months if you’re playing with multiple partners.

(h/t Bloomberg.com)

Men Who Feel Isolated, Hopeless Are More Likely to Engage in High-Risk Sex Acts, Study Shows

It stands to reason that someone with a pervasively negative mental outset might engage in high-risk activities. A recent Chinese-American study of men who have sex with men (MSM) offers some numbers to back this up.

Pink News drew our attention to a report filed by experts from California and the Chinese cities of Nanjing and Beijing called "Depression, Loneliness, and Sexual Risk-Taking Among HIV-Negative/Unknown Men Who Have Sex with Men in China."

The study observed 507 Chinese men, and those who reported feeling lonely were 67% more likely to have receive bareback anal sex.

Of the subjects, 26.8 and 35.5% reported moderate-to-severe symptoms of depression and feeling lonely, respectively.

These depressed individuals also were twice as likely to feel “hopelessness for the future,” and more likely to bear internalized homophobia.

The study concludes that:

“MSM in China have significant rates of depression and loneliness. HIV prevention efforts should address the mental health needs of Chinese MSM such as providing safe environments for social support and role models.”

Note: This is not a slut-shaming study. No one is bashing bareback sex here or challenging anyone’s right to it. This is merely a thoroughly researched report that makes a connection between high-risk behaviors and mental health.

Mental health as a factor in gay and bisexual men becoming HIV-Positive has been a hot topic in recent years.

Somewhere between 30 and 60 % of LGBTQ+ people suffer from depression and/or anxiety at some point in life. That’s between 1.5-2.5% higher than straight, gender-conforming counterparts.

h/t: Pink News

Report: Archives of Sexual Behavior

Journalist Karl Schmid Speaks Candidly About Stigma Of Being HIV+

Karl Schmid, the handsome host of “On The Red Carpet” and reporter for ABC7 in Los Angeles who came out as HIV+ in a candid social media post this past March, spoke with The Today Show’s Megyn Kelly what it was like to share his status with the world.

With an upbeat tone and message, Schmid told the TV audience his goal in coming out was to hopefully breakdown the still-painful stigma surrounding HIV today.

The entertainment reporter hit several important points along the way, beginning with the fact that in some states you can be arrested, convicted and put in prison for 8 years as a felon for having consensual, protected sex without disclosing one’s HIV+ status.

After Kelly noted that some consider the idea of having sex with someone who is HIV+ a ‘death sentence,’ Schmid clearly (and correctly) states, “Undetectable equals untransmittable - I’m here to bang it into everyone’s heads.”

Dr. Antonio Urbina of Mount Sinai Hospital in New York City was on hand to help underscore that message.

“Right, so that’s that ‘U=U,’” said the physician. “A person living with HIV takes their medications, drives their viral load down to undetectable, their chances of transmitting is zero.”

Asked what his first thoughts were upon being told he was HIV+ almost ten years ago, Schmid candidly shared his mind went into ‘survivor mode’ telling himself, “Ok, this is what I have to do.”

But noting how difficult it is just to come out to our families as gay, the 37-year-old Australian said his first clear thought was, “Oh my gosh - I’ve let my parents down.”

“I think that most parents, when they find out their son is gay, one of the immediate fears is ‘Now he’s going to get AIDS.’”

Addressing the fears that come with HIV/AIDS, Schmid feels in the early years of the pandemic those concerns were necessary to help stop or slow the spread of the disease.

“People were dropping like flies, we had to stop this - it was very important,” said Schmid. “We had to scare the poo-poo out of people.”

Conjuring up the decades-old images of sickly, high-contagious HIV patients from the 1980s and early 1990s, Schmid admits many people still hold those ideas in their heads.

Turning to the camera, Schmid boldly stopped, gestured to himself, and declared, “This. This. This - hello, camera two - this is HIV+ in 2018. Take a look.”

He also told Kelly that the news of his status was met with great support in the workplace.

But in sharing some of the heartbreaking messages he’s received since coming out publicly, Schmid emphatically announced, “This stigma is real - and it’s unnecessary.”

It’s a tremendously powerful segment, both in the message and the facts.

Watch below.

 

 

Schmid prefaced his appearance with a Facebook post which read, “When I was 15 I first came to NYC and remember seeing Rockefeller Center and the NBC peacock and NBC News sign and saying to myself, “one day I’m going to be on The Today Show.”

“Little did I know 23 years later I would be on The Today Show with Megyn Kelly TODAY…talking about something much bigger than myself (for once)!” the 37-year-old Australian added. “The fight against HIV stigma. Hopefully I can help start a new conversation about what it means to be HIV+ in 2018. Oh yeah, and I hope I make my mum and dad proud.”

 

 

Here's Schmid’s original Instagram post from March of this year coming out as HIV+:

 

 

Hi. I’m a 37 year old HIV+ man who has been poz for almost ten years. I work in television. And on the side of the camera where, fo better or worse it’s considered “taboo” for people “like me” to be “like me”. For 10 years I’ve struggled with “do I or don’t I”? For ten years the stigma and industry professionals have said, “don’t! It’ll ruin you”. But here’s the thing. I’m me. I’m just like you. I have a big heart and I want to be loved and accepted. I may be on TV from time to time, but at the end of the day I’m just an average guy who wants want we all want. To be accepted and loved by our friends and family and to be encouraged by our peers. So here’s what I say, stand tall, and stand proud. You can’t make everybody happy but you can make you happy. And so long as you tell the truth, you will never have to remember anything. Labels are things that come and go but your dignity and who you are is what defines you. I know who I am, I know what I stand for and while in the past I may not have always had clarity, I do now. Love me or hate me, that’s up to you. But, for anyone who has ever doubted themselves because of those scary three letters and one symbol, let me tell you this, you are somebody who matters. Your feelings, your thoughts, your emotions count. And don’t let anybody tell you otherwise. I’m Karl Schmid, and I’m an HIV-positive man! #whatisrememberedlives @theaidsmemorial @theaidsmemorialtshirt Sent from my iPhone

A post shared by Karl Schmid (@karljschmid) on

 

The CDC Says Health Experts Need To Reach Out To Southern Gay Black Men

It’s been known for several years now that there’s a growing risk of HIV infection for men of color, and specifically black men, living in the U.S. South. That said, this silent epidemic is only now getting the attention it deserves through news coverage, documentary filming, and health alerts.

Now, the CDC is acknowledging this growing problem.

As reported by the Atlanta Journal-Constitution, the U.S. Centers for Disease Control and Prevention released a study on Thursday announcing the need to pay attention to black men and growing HIV infections among them.

“Although black (men who have sex with men, or MSM) received 6 percent of the HIV tests provided, they accounted for 36 percent of the new diagnoses in non–health care facilities,” the study found.

Plus, nearly two-thirds of black men diagnosed with HIV live in the South. The CDC wants health workers to find new ways to reach out to these men.

 “Black MSM in the southern United States are the group most affected by HIV, but only a small percentage of CDC tests in the southern United States are provided to this group,” the study added.

“Increasing awareness of HIV status through HIV testing, especially among black MSM in the southern United States, is essential for reducing the risk for transmission and addressing disparities.”

The study recommends testing outreach be made in nontraditional settings and in agencies that also provide health care.

One possible route that health experts could take is to use Northwestern University’s multimedia program, which not only educates LGBTQ men about safe-sex practices but also the realities of life with HIV.

Before this, the CDC started to have a shifty relationship with organizations that supported HIV/AIDS outreach work like AID Atlanta. Despite the CDC celebrating the program, they withdres their grant to AID Atlanta last year.

That said, the CDC recently saw a change in leadership in the spring. Robert Redfield, a lifelong AIDS public health researcher, took over and is directly working under Health and Human Services Secretary Alex Azar.

Hopefully, they can work together to find ways to reach out to LGBTQ black men in the South and chip away at the silent epidemic overtaking them.

h/t: the Atlanta Journal-Constitution

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