A new study has found that HIV screening every three months compared to annually will improve clinical outcomes and be cost-effective among high-risk young men who have sex with men (YMSM) in the United States. The report, led by researchers at the Massachusetts General Hospital (MGH), is being published online in Clinical Infectious Diseases.
“Young men who have sex with men account for one in five new HIV infections in the United States. Yet, more than half of young men who have sex with men and who are living with HIV don’t even know that they have it,” says Anne Neilan, MD, MPH, investigator in the MGH Division of Infectious Diseases and the Medical Practice Evaluation Center, who led the study.
“With so many youth with HIV being unaware of their status, this is an area where there are opportunities not only to improve care for individual youth but also to curb the HIV epidemic in the U.S. Despite these numbers, the Centers for Disease Control and Prevention previously determined that there was insufficient youth-specific evidence to warrant changing their 2006 recommendation of an annual HIV screening among men who have sex with men.”
It may seem obvious that if a person is infected with COVID-19, they risk infecting others during sex. But people still have a lot of questions. Here’s an excerpt on the topic form the Mayo Clinic Website:
The virus spreads by respiratory droplets released when someone with the virus coughs, sneezes or talks. These droplets can be inhaled or land in the mouth or nose of a person nearby. Coming into contact with a person’s spit through kissing or other sexual activities could expose you to the virus. People who have COVID-19 could also spread respiratory droplets onto their skin and personal belongings. A sexual partner could get the virus by touching these surfaces and then touching his or her mouth, nose or eyes. In addition, the COVID-19 virus can spread through contact with feces. It’s possible that you could get the COVID-19 virus from sexual activities that expose you to fecal matter.
There is currently no evidence that the COVID-19 virus is transmitted through semen or vaginal fluids, but the virus has been detected in the semen of people who have or are recovering from the virus. Further research is needed to determine if the COVID-19 virus could be transmitted sexually.
Since some people who have COVID-19 show no symptoms, it’s important to keep distance between yourself and others if the COVID-19 virus is spreading in your community. This includes avoiding sexual contact with anybody who doesn’t live with you. If you or your partner isn’t feeling well or think you might have COVID-19, don’t kiss or have sex with each other until you’re both feeling better. Also, if you or your partner is at higher risk of serious illness with COVID-19 due to an existing chronic condition, you might want to avoid sex.
In case that wasn’t clear, The National Coalition of STD Directors (NCSD), in partnership with National Alliance of State and Territorial AIDS Directors (NASTAD), released a frequently asked questionsresource regarding sex and COVID-19. In short, if you’re in the same room with someone who has the virus, you can get infected–sex or no sex.
If you have questions about getting tested, talk to your doctor or health care provider. You can also find testing in your area via a Google search. In Pennsylvania, call the Health Department at 1-877-PA-HEALTH (1-877-724-3258).
Bruce W. Furness, M.D., M.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues developed and evaluated a quality improvement initiative (Transforming Primary Care for LGBT People) to enhance the capacity of 10 federally qualified health centers (FQHCs; 123 clinical sites in nine states) to provide culturally affirming care.
The researchers found that FQHCs reported increases in culturally affirming practices, including collecting patient pronoun information (42.9 percent increase) and identifying LGBT patient liaisons (300.0 percent increase). Based on sexual orientation and gender identity (SOGI) from electronic health records among nine FQHCs, SOGI documentation increased from 13.5 to 50.8 percent of patients. Screening of LGBT patients increased from 22.3 to 34.6 percent for syphilis, from 25.3 to 44.1 percent for chlamydia and gonorrhea, and from 14.8 to 30.5 percent for HIV among the eight FQHCs reporting the number of LGBT patients.
“FQHCs participating in this initiative reported improved capacity to provide culturally affirming care and targeted screening for LGBT patients,” the authors write.
[On July 2, 2020], the U.S. Food and Drug Administration approved Rukobia (fostemsavir), a new type of antiretroviral medication for adults living with HIV who have tried multiple HIV medications and whose HIV infection cannot be successfully treated with other therapies because of resistance, intolerance or safety considerations.
“This approval marks a new class of antiretroviral medications that may benefit patients who have run out of HIV treatment options,” said Jeff Murray, M.D., deputy director of the Division of Antivirals in the FDA’s Center for Drug Evaluation and Research. “The availability of new classes of antiretroviral drugs is critical for heavily treatment-experienced patients living with multidrug resistant HIV infection—helping people living with hard-to-treat HIV who are at greater risk for HIV-related complications, to potentially live longer, healthier lives.”
Taken every 2 months, the long-acting injectable drug cabotegravir (CAB-LA) prevented more HIV infections than daily oral pre-exposure prophylaxis (PrEP) with tenofovir/emtricitabine (TDF/FTC), according to newly announced results from a major Phase 3 study. The results were released originally in May due to the overwhelmingly positive data on CAB-LA for PrEP, but researchers presented their final data in early July at the 23rd International AIDS Conference (AIDS 2020).
The data show that the experimental drug is superior to the current standard-of-care PrEP regien, which may open the door for a new biomedical HIV prevention option aimed at those who would prefer a shot six times a year over taking a daily pill.
“The HPTN 083 results demonstrating the superiority of CAB to TDF/FTC have the potential to transform the landscape of HIV prevention for cisgender MSM and transgender women,” said HPTN 083 protocol chair Raphael J. Landovitz, M.D. “We know that some people have difficulty with or prefer not to take pills, and an injectable product such as long-acting CAB [cabotegravir] could be a very important option for them. We want to thank the study participants and research staff, as this study would not have been possible without their dedication and commitment.”
As COVID-19 cases continue to rise, it is a sobering moment to recognize and take stock of another epidemic that we have been battling for nearly four decades. The first HIV Testing Day was 25 years ago and emphasized the opportunity for individuals to take control of their health by getting tested for HIV. It has become an annual reminder that the HIV epidemic is still with us. This year the SARS-CoV-2 pandemic threatens the ability of those with undiagnosed HIV and those with other serious conditions to take control of their health.
As an infectious disease physician specializing in HIV, I worry about the many individuals who do not have easy access to HIV testing now because testing venues have been shut down by the pandemic. Already too many of my patients do not discover they have HIV until they are ill with advanced disease or AIDS. In Georgia, the state with the highest rate of new cases in the U.S., nearly one-quarter of patients are diagnosed with AIDS within one year of being diagnosed with HIV.
This means they have been living, undiagnosed, with the virus for up to 10 years and have been unable to benefit from the HIV treatment that could have kept them healthy and prevented transmission to others. This is tragic given that a strong public health system with widespread testing could prevent death.
A message from HIV.gov and ADM Brett Giroir, MD, Assistant Secretary for Health, U.S. Department of Health and Human Services…
In the 25 years since National HIV Testing Day (NHTD) was first observed on June 27th, we’ve made remarkable progress on HIV prevention, treatment, and research—but people who haven’t been tested will not know their status or how to benefit from prevention tools or HIV medications.
So the theme for this year’s observance—“Knowing”—is particularly important. It means:
I invite you to watch this message from ADM Brett Giroir, MD, Assistant Secretary for Health, U.S. Department of Health and Human Services, about these important aspects of Knowing.
The only way to know your HIV status is to get tested—and taking that test is a key step down the path toward ending the HIV epidemic in the United States.
That’s the path we are walking with the Ending the HIV Epidemic: A Plan for America (EHE) initiative, which aims to achieve epidemic control in our nation within 10 years. How? By decreasing the number of new HIV transmissions by at least 90% by 2030. The first pillar of EHE is to diagnose all people with HIV as early as possible.
The history of HIV/AIDS is a long and complicated one. There are many conflicting details in its story, and each life touched by the virus has a complicated and beautiful story of their own. In this synopsis, we have tried our best to highlight the most crucial parts of the story of HIV in America, understanding that this is a near-impossible task. HIV stands out from many diseases, because today we are still without a cure—but also, perhaps more importantly, because the AIDS pandemic is now embedded into the histories and cultures of queer people, people of color, creative communities, and dozens of fringe and subculture groups; AIDS has become part of our own personal histories.
Scientists suggest that traces of HIV date as far back as 1931 in the Democratic Republic of Congo. Before the 1980s, researchers estimate that about 100,000 to 300,000 people contracted HIV around the world.
In 1969, a Black teenager in St. Louis named Robert Rayford died of an illness that baffled his doctors. Officially, his death was the result of pneumonia. Robert Rayford, also known as “Robbie” or “Bobbie,” was said to have been shy and socially awkward and possibly had a cognitive disability. Little is known about the young man’s life. His doctors have stated that Rayford often avoided or refused to share much information about his life or family; however, it has been suggested that he contracted an HIV-like virus through sexual assault. Nineteen years later, in 1988, molecular biologists at Tulane University in New Orleans tested samples of his frozen tissue and found evidence of HIV, although the lack of 100% certainty of these test results is still talked about in the scientific and public health communities. Still, Robert Rayford is often remembered as the first known case and fatality of HIV-1 in the United States.
Many people in the LGBT community and health care workers anecdotally say they were beginning to see people die mysteriously in the 1970s, from what they now believe were HIV-related illnesses. But it was on June 5, 1981, that the Centers for Disease Control and Prevention (CDC) noted in its Morbidity and Mortality Weekly Report the appearance of a rare pneumonia in five young gay men in Los Angeles. Additionally, the men, all of whom would die, showed compromised immune systems. Across the country, a New York dermatologist tipped the CDC to a baffling spate of cases of an aggressive cancer called Kaposi’s sarcoma. Each of these cases appeared in gay men. Newspapers and other media outlets began to report about a “gay men’s pneumonia” and “possible gay cancer.” Headlines across the United States and, shortly thereafter, the world, claimed a new “Gay Cancer” was responsible for the otherwise uncertain cause of death of multiple gay and bisexual men. At the close of 1981, there were 270 reported cases of severe immune deficiency among gay men, and 121 of them had already died. Uncertainty lead to fear in queer communities; acknowledgement and, therefore, action were almost nonexistent in mainstream culture and communities.
Health Resources and Service Administration (HRSA) is continuing to work with RWHAP recipients, subrecipients, and providers to identify and share effective strategies to meet the unique needs of this growing population. As part of this effort, HRSA HAB is hosting its second national webinar in its series on Thursday June 25, 2020, from 1:30-3:30 PM ET, for RWHAP recipients, providers, and people with HIV to share important information about the healthcare and psychosocial needs of people with HIV aged 50 years and older in the RWHAP.
The webinar titled “Psychosocial and Support Needs for People with HIV who are Aging in the Ryan White HIV/AIDS Program” will feature an epidemiologist, social gerontologist/medical sociologist, HIV advocate, and an AIDS Education and Training Center director who will present on epidemiological data, the significance of psychosocial support services, the impact of isolationism and HIV sigma, and community services.
In collaboration with Kaiser Family Foundation (KFF), NASTAD will host a webinar series titled Effectively Engaging Community in the Ending the HIV Epidemic Process Through Digital Technology. The series aims to support health departments and community-based organizations (CBOs) to accelerate jurisdictional efforts toward Ending the HIV Epidemic.
With the current challenges presented by COVID-19 and with expanded opportunities to use digital technology (e.g., internet, social media, virtual meeting spaces, digital devices) this series will explore the relationship between community engagement and digital technology, and how it can be leveraged to expand HIV prevention and care planning and service delivery.
This series will present on digital activities and tools from the perspectives of EHE HIV community planning, HIV service delivery, and determining where to direct funding. NASTAD, KFF, and peer jurisdictions present this information across three webinars:
Learning How to Apply Digital Technology to HIV Community Planning
Date: June 25, 2020 at 3:00 – 4:00 PM EDT
Exploring Digital Resources and Strategies to Expand HIV Services to Community
Date: July 14, 2020 at 2:00 – 3:00 PM EDT
Determining the Best Monetary Value When Using Digital Technology
Date: TBD
To register for the webinar series, please click here. Additional details about the webinars and presenters will follow. For questions or to learn more about the series, please contact Kristina Santana.
