Highlights from the Ryan White Clinical Conference on HIV.gov…
The promise of long-acting injectable formulations of HIV medications to maintain viral load suppression is closer to reality, according to Constance A. Benson, MD, Professor of Medicine and Global Public Health at University of California San Diego. She shared her assessment during a session at the 2020 Ryan White HIV/AIDS Program Clinical Conference, held online earlier this month for over 600 physicians, nurse practitioners, physician assistants, and other key clinical decision makers in HRSA’s Ryan White HIV/AIDS Program-funded clinics and programs.
Levels of sexual health screening among gay men taking PrEP fall well below recommended levels, investigators from the United States report in the online edition of Clinical Infectious Diseases. Rates of testing for sexually transmitted infections (STIs) in the rectum and throat – which can be asymptomatic – were especially low, so too testing coverage in south-eastern US states which have an especially high burden of HIV and STI infections among gay and other men who have sex with men.
“Consistency of STI screening at PrEP care visits was lower than recommended, especially for rectal and pharyngeal infections that are mostly asymptomatic,” write the authors. “Our findings also highlight the regional variation in gaps between recommendations and PrEP clinical practice overall, and raise concerns about whether comprehensive PrEP care as currently practiced would be effective for STI control.”
Tenofovir-based PrEP is highly effective at preventing infection with HIV but the treatment provides no protection against STIs. Pre-existing research shows elevated STI rates among PrEP-using gay men, probably the result of increased surveillance and sexual risk behaviour. The Centers for Disease Control and Prevention (CDC) therefore recommends that gay men taking PrEP should have comprehensive check-ups for bacterial STIs every three to six months. These sexual health screens should include tests for chlamydia, gonorrhoea and syphilis, with swabs or samples taken from the urethra, throat and rectum.
What is the AHEAD Dashboard?
AHEAD is a data visualization tool created to support the efforts of local health departments towards reaching the goals of the Ending the HIV Epidemic: A Plan for America (EHE) initiative.
Who Can Use the AHEAD Dashboard?
AHEAD allows jurisdictions, community organizations, and other stakeholders to monitor progress towards meeting the goals of EHE and use data to inform national and jurisdictional action.
AHEAD graphically visualizes data and targets for jurisdictions to track their progress on the six EHE indicators:
• Knowledge of Status
• Linkage to HIV Medical Care
• Viral Suppression
• PrEP Coverage
Over the next year, AHEAD will add additional features and expanded data sets to further to encourage progress towards EHE initiative goals.
Explore the AHEAD Dashboard today and view our progress towards ending the HIV epidemic in America
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.
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.”
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.
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
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.
Amid the coronavirus pandemic, the hope and promise for a healthier tomorrow might feel reminiscent of another virus — one that ravaged the LGBTQ community in the 1980s and beyond. But in the years since HIV transmission was at its height, has HIV/AIDS started to feel like a bygone disease despite a death toll that has soared over 32 million people worldwide? In the United States, it depends on who you ask. And if you’re part of the Latinx community, the answer is complicated.
Toward the end of 2019, The New York Times trumpeted a promising headline: “New York Says End of AIDS Epidemic Is Near.” The optimistic article sourced the Center for Disease Control (CDC)’s 2010-2016 findings, that rates of infection among gay and bisexual men have remained stable, and that, per Governor Andrew Cuomo, New York is on track to end the AIDS epidemic in the state by the end of 2020.
But while most demographics have experienced a trend-setting decrease in infection rates, the CDC noted that for Hispanic/Latino men, “the annual number of HIV infections in 2016, compared with 2010, increased,” and that during those years, the infection rates for this demographic were “4.3 times that for white males.”
With extensive and varied work, healthcare advocates and community leaders are spearheading efforts across the country to tackle HIV prevention and awareness for the Latinx community. But for many, it’s still an uphill battle.
“I will say I’m proud to be there for them,” says Danny Ochoa of his community. A gay man living with HIV, Ochoa is a Prevention Intervention Specialist in the Community Health Department at Gay Men’s Health Crisis (GMHC). A leader in HIV/AIDS prevention, care and advocacy, GMHC’s mission has evolved since its 1982 founding to recognize the importance of inclusion and diversity and has now become a haven for the urban queer Latinx populations. This resource can be just as vital as hospitals and medical centers.