HIV treatment that leads to viral suppression for at least 6 months is 100% effective in preventing the transmission of HIV, even in the absence of condoms or HIV prevention drugs, according to the Centers for Disease Control and Prevention. But not all care providers tell their patients that.
A survey in the Midwest showed that 22% of HIV physicians still don’t feel comfortable explaining to patients the science behind what is known in the community as U=U, or undetectable equals untransmittable.
And that number is even higher among the physician assistants, nurse practitioners, advanced practice nurses, and traditional registered nurses who serve people living with HIV, said Emily Petran, MPH, from the Minnesota site of the Midwest AIDS Training and Education Center (MATEC) in Minneapolis.
The National Institutes of Health has awarded approximately $11.3 million to 23 institutions across the United States to collaborate with community partners to develop locally relevant plans for diagnosing, treating and preventing HIV in areas with high rates of new HIV cases.
The awards will help enhance the implementation science knowledge base needed for the proposed Ending the HIV Epidemic: A Plan for America. The plan aims to leverage the powerful data and tools now available to reduce new HIV diagnoses in the United States by 75 percent in five years and by 90 percent by 2030. President Donald J. Trump announced this bold new initiative during the State of the Union Address in February. If funds are appropriated by Congress, the 10-year initiative will begin in fiscal year 2020. The awards announced today are one-year awards to support pilot and formative studies to prepare for more extensive implementation science research proposals expected in 2020.
“With existing, powerful HIV treatment and prevention tools, we can end the epidemic in the United States,” said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID) at NIH. “The new initiative is a practical, achievable implementation plan. By working directly with health departments and other community organizations, researchers can find the best ways to use the highly effective methods at our disposal to diagnose, prevent and treat HIV in the United States.”
People with HIV are more likely than people without the virus to have high blood pressure, in part because of treatments and repercussions of the condition itself, a new review of research shows.
Learning more about the underlying mechanisms of high blood pressure in people with HIV is critical in preventing one of the leading conditions that can cause premature cardiovascular disease in those adults, the researchers said. The implications are important in a population that has seen the rate of people dying from heart disease and stroke skyrocket over the last decade.
“I think that we really need to pay special attention to this population,” said Dr. Sasha Fahme, the study’s lead author and a global health research fellow at Weill Cornell Medical College in New York City. “Now that people [with HIV] are living longer, we are seeing the non-infectious consequences of HIV, and hypertension [high blood pressure] is one of them.”
“When a person comes out to you, keep in mind that the person has not changed. The relationship you established with that person stays the same. It’s just another label, and there are layers and layers of labels that we all put on ourselves and that we give to each other. So when you learn this new information about somebody, does it really change the soul of the relationship? Are your feelings rich enough and deep enough that you established a relationship because you love this person? Or were your feelings so superficial that now that you’ve learned this element about this person, it’s enough to cause you concern? It’s a personal question that you have to ask yourself. If you love a person, if you’re friends with a person, if you cherish a person, then those labels shouldn’t matter.”
There is a dearth of scientifically investigated, evidence-based interventions to address substance use, mental health conditions and violence victimization in sexual and gender minority youth, according to a research review led by the University of Pittsburgh Graduate School of Public Health and published today in the journal Pediatrics.
After poring over thousands of research publications spanning nearly two decades, the scientists identified only nine studies that evaluated such interventions, and most of these used suboptimal study designs, thereby limiting the validity of the findings. None of the programs would be sufficient to mitigate the substantial inequities faced by lesbian, gay, bisexual, transgender and queer (LGBTQ) youth, the scientists concluded.
“While this knowledge gap is distressing, I think we can look at it as an opportunity,” said lead author Robert W.S. Coulter, Ph.D., M.P.H., assistant professor in Pitt Public Health’s Department of Behavioral and Community Health Sciences. “Promising programs are being created by community-based organizations that are ripe for rigorous evaluation by scientists to determine if they are successfully improving health among LGBTQ youth and, if so, whether they can be replicated in other communities.”
How do we reduce rates concentrated among black and Latino men who have sex with men? Or meet the needs of HIV-positive patients caught between insurance plans or places to live? To end the epidemic, we must start where we began — by focusing on those most affected, uniting advocacy efforts, pushing for a cross-sector response and focusing on the social determinants of health.
As someone who has spent the better part of my professional career as both an advocate and HIV public health expert, I’ve been reflecting on the decades-long fight for gay rights sparked by people who gathered together at Stonewall in 1969 to demand change for the LGBTQ+ community and put an end to years of discrimination. Not long after, the AIDS epidemic swept across the country, closely intertwining the movement for increased LGBTQ+ rights with the AIDS response. Gay rights groups were relentless in pushing for increased government attention and funding as thousands died from the disease. Activists organized “buyers clubs,” lobbied for faster FDA approval of promising drugs and countered the fear and discrimination people living with AIDS faced.
Gay, bisexual and other men who have sex with men and transgender women with HIV, who are not in care, can be engaged in care when reached and connected with HIV treatment services, according to findings from a clinical trial supported by the National Institutes of Health. Nearly half of the study participants achieved and maintained viral suppression by one year, researchers reported today at the 10th IAS Conference on HIV Science (IAS 2019) in Mexico City.
Effective HIV treatment resulting in sustained viral suppression benefits the health of the person with HIV and also prevents sexual transmission of the virus to others. The clinical trial, called HPTN 078, assessed an HIV prevention strategy involving a peer-to-peer recruitment method to identify, recruit and link to HIV care men and transgender women with unsuppressed HIV in the United States. It also evaluated whether a case management intervention could help them achieve and maintain viral suppression.
is preparing to test an experimental HIV vaccine in the U.S. and Europe in a move toward developing the first immunization against the deadly disease after decades of frustration.
Some 3,800 men who have sex with men will receive a regimen of shots in a study that’s planned to be launched later this year, Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said in an interview. The agency and the HIV Vaccine Trials Network of testing sites will collaborate with J&J’s Janssen unit on the effort.
Since cases first began to gain notice in the early 1980s, scientists have been searching fruitlessly for a vaccine against the virus that causes AIDS and kills close to 1 million people worldwide annually. Efforts are continuing with at least two other promising candidates in late-stage studies.
This was a time when people weren’t even touching patients with HIV,” says Priyanka Chopra, a prominent supporter of the film on behalf of the AIDS charity RED, which will receive 30 percent of all box office proceeds. “They would lay in their soiled bedsheets for days where nobody would come and even enter their room to feed them. At that time, these nurses chose to not think about whether they would live or die and actually the nobility of the profession is what you see in this movie.”
The film, which received a four-minute standing ovation at the Cannes Film Festival last month, features the nurses of ward 5B at San Francisco General Hospital who didn’t allow societal ignorance, prejudice and fear curtail their drive to administer compassionate health care to patients who had otherwise been cast aside. These were patients who most health care professionals wouldn’t touch without wearing gloves, even a hazmat suit.
This story is part of Made In Philly, a series about young residents shaping local communities.
When Shanaye Jeffers was in fourth grade, she often skipped touch football and double-dutch jump rope at recess to read a book on puberty. In fifth grade, she jumped at the chance to do a school project on childbirth.
Most girls don’t know about the inner workings of their bodies, sexual-health experts say — especially black teenage girls, who often face stigma against asking questions at home and are poorly served by sex-education school curriculums tailored for a white majority.
“Sex ed is not serving young black women really at all,” said Jeffers, now a 28-year-old obstetrics and gynecology resident at Thomas Jefferson University Hospital. She’s trying to change that. As Philadelphia site director for Daughters of the Diaspora, a nonprofit founded in 2012 to teach black teenage girls about reproductive health and self-esteem, Jeffers is working to give other girls the same knowledge and passion to take charge of their health that she had as a child.