Research published in AIDS and Behavior show that parents in an intervention group with gay or bisexual sons can employ effective communication tactics, specifically about condoms and HIV, and other parenting behaviors to help keep their children healthy.
The study is the first to show evidence of positive effects in a randomized controlled trial with the parents of gay or bisexual sons, according to the authors. They added that these results are important because approximately 80% of all HIV infections among teens are from the gay and bisexual population. There were very few previous public health interventions seeking to lower the HIV risk among this group, according to the study.
“By focusing on the parents, this study shows we might be able to reduce HIV risk among gay and bisexual male youth,” said David Huebner, professor of Prevention and Community Health at the Milken Institute School of Public Health at the George Washington University, in a press release. “Parents represent an untapped yet promising resource in preventing HIV infection and improving sexual health among this underserved population.”
Saturday, April 10, marks National Youth HIV & AIDS Awareness Day (NYHAAD) 2021. Traditionally, it’s a “day to educate the public about the impact of HIV and AIDS on young people,” according to the nonprofit Advocates for Youth, which spearheads NYHAAD.
The group adds, “The day also highlights the HIV prevention, treatment and care campaigns of young people in the U.S.”
This year, the HIV awareness day also includes a call to action. Youth advocates want you to help them convince Congress to pass the REPEAL HIV Discrimination Act. “REPEAL” stands for: “Repeal Existing Policies that Encourage and Allow Legal” HIV Discrimination.
The REPEAL HIV Discrimination Act aims to modernize HIV crime laws, such as those that set harsh sentences for people with HIV who allegedly don’t disclose their status before sex—even if they’re undetectable and HIV was not transmitted. (To read a collection of POZ articles about such laws and efforts to change them, click #Criminalization.)
You can support Advocates for Youth’s call to action by filling out an online form that will generate a letter to send to members of Congress.
The Centers for Disease Control and Prevention (CDC) reports that some racial/ethnic groups are at higher risk for getting HIV than others.
CDC data shows that Black/African American communities account for a higher proportion of new HIV infections as compared to other races and ethnicities. In 2018, Black/African Americans accounted for 13% of the US population but 42% of new HIV diagnoses.
Similarly, in the same 2018 report, the CDC notes adult and adolescent Hispanics/Latinos made up 27% of the 37,968 new HIV diagnoses in the United States.
Why? Because these communities are impacted by demographic factors such as discrimination, stigma, and institutionalized health disparities—all of which affect their risk for HIV.
So what can we do?
People who know they’re infected can get into treatment and become HIV undetectable—which means the level of virus in the body is so low that it can’t be passed on to a sex partner. And people who know they’re not infected can take steps to prevent future infection by practicing safer sex (like using condoms) and taking the HIV prevention medication known as PrEP.
The first step, then, to preventing HIV is to get tested.
The good news is that anyone who resides in Pennsylvania can now get a free HIV self-test kit delivered in the mail.
“We created getmyHIVtest.com to make test kits available to anyone in the state who might be at risk for HIV,” explains Raymond Yeo, one of the project’s coordinators at the University of Pittsburgh. “Knowing your HIV status is key in the preventing HIV in our communities—especially those most at risk for new infections.”
The website, www.getmyHIVtest.com, provides easy-to-follow instructions and online form where PA residents can order their free kit, which typically arrives—in an unmarked package—within five to ten business days. Recipients of the kit are asked to provide basic demographic information and to take a follow up survey as a means to improve the program in the months ahead.
“This is a big development in the fight against HIV in Pennsylvania and we need all the input we can get,” added Yeo. “It’s unrealistic to think we can test everyone in the state so it’s important that we find ways to get our test kits into the hands of the people who need them the most.”
The Department of Health and Human Services announced that the Office for Civil Rights will interpret and enforce Section 1557 and Title IX’s prohibitions on discrimination based on sex to include: (1) discrimination on the basis of sexual orientation; and (2) discrimination on the basis of gender identity. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in covered health programs or activities. The update was made in light of the U.S. Supreme Court’s decision in Bostock v. Clayton County and subsequent court decisions.
“The Supreme Court has made clear that people have a right not to be discriminated against on the basis of sex and receive equal treatment under the law, no matter their gender identity or sexual orientation. That’s why today HHS announced it will act on related reports of discrimination,” said HHS Secretary Xavier Becerra. “Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences. It is the position of the Department of Health and Human Services that everyone – including LGBTQ people – should be able to access health care, free from discrimination or interference, period.”
Discrimination in health care impacts health outcomes. Research shows that one quarter of LGBTQ people who faced discrimination postponed or avoided receiving needed medical care for fear of further discrimination.
All youth deserve access to comprehensive sexual health education. National Youth HIV/AIDS Awareness Day (NYHAAD) is an opportunity to work together to make this a reality. By educating youth about the basics of HIV, how to protect themselves, find testing, treatment and care services, and confront HIV stigma in their communities, we are empowering them to take an active role in ending the HIV epidemic for future generations.
Today’s youth have many of the same hopes and dreams as previous generations. But we must also recognize they are distinct in many ways too. Their widespread passion for advocacy and social change sets them apart. They also face unique challenges and barriers when it comes to achieving those dreams.
In 2018, youth aged 13 to 24 made up 21% of the 37,832 new HIV diagnoses in the United States and dependent areas. Most new youth diagnoses were among gay, bisexual men, and men who have sex with men (MSM). Most of these new diagnoses occurred among young Black and Latinx MSM. Yet, in 2018, youth were the least likely age group to be aware they had HIV, remain in care, or achieve viral suppression. One of the most important things we can do to change this trend is to provide accurate, age-appropriate, and culturally sensitive information about HIV.
While the eyes of the nation are on the coronavirus pandemic, another threat to public health has been steadily growing in the United States. We’ve been battling rising rates of sexually transmitted infections (STI) for the last several years. In fact, 2020 marks the fifth consecutive year of increasing rates of gonorrhea, chlamydia and syphilis in the U.S., due in part to significant funding cuts to more than 50% of the nation’s public health STI programs. And now the COVID-19 pandemic has placed an even greater burden on our strained public health system and supply chains, shifting focus from one major public health issue to another.
We can’t risk losing one critical resource that will be essential to ending the STI epidemic — the availability of free and confidential STI testing for adolescents. Prior to the pandemic, national public health efforts were scaling up to improve STI and HIV testing, and quickly link youth to prevention services. Rapid identification and treatment of STIs not only has public health benefits in terms of lowering transmission, but when left untreated, STIs increase the risk of infertility, severe pelvic infection, chronic pelvic pain, ectopic pregnancy and HIV transmission.
While accounting for 25% of the population, adolescents and young adults comprise over 50% of STIs in the U.S. each year. Black, Latinx, and LGBT youth face the greatest burden of infections and risk of complications. Fortunately, significant advances have been made over the last several decades to improve rates of STI and HIV testing among adolescents and young adults. The American Academy of Pediatrics now recommends HIV screening by the age of 16-18 years for all youth regardless of their sexual activity.
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.”
Among young people living with HIV, having a detectable viral load is associated with a slight increase in the risk of cardiovascular disease.
Sitaji Gurung, MD, PhD, MPH, of Hunter College at the City University of New York, presented findings from a study of HIV-positive youth 14 to 26 years old at the 2020 Conference on Retroviruses and Opportunistic Infections in Boston last month.
The study relied on electronic health records from the Adolescent Medicine Trials Network 154 Cascade Monitoring, which derives its data from clinics across the United States that care for adolescents with HIV.
Communication between pediatricians and adolescent boys who engage in same-sex sexual intercourse may be a potential avenue to increase HIV testing in this population, according to a study published in Pediatrics.
Although it is estimated that 14.5% of HIV infections are undiagnosed in the United States, this estimation is 51.4% (>3.5-times higher) in individuals aged 13 to 24 years because of poor testing rates among those who are aged <18 years.
There have been few studies that have described HIV testing rates among minors; these data are needed to reveal opportunities for pediatrician-adolescent communication about HIV and sexual orientation, which could increase the odds of testing. This study described HIV testing rates and identified salient individual, family, school, and healthcare influences among adolescent boys who engage in same-sex sexual intercourse (ClinicalTrials.gov identifier: NCT03511131).
Despite similar rates of enrollment into medical care, youth with HIV have much lower rates of viral suppression — reducing HIV to undetectable levels — compared to adults, according to an analysis funded by the National Institutes of Health. Among more than 1,000 youth, most of whom were newly enrolled in care at treatment centers throughout the United States, 12% had attained viral suppression, far lower than the 32% to 63% observed in studies of adults over age 24. The findings suggest that after they enroll in an HIV treatment program, a low proportion of youth adhere to care regimens. The study appears in the Journal of Acquired Immune Deficiency Syndromes.
“Our findings indicate an urgency for research on how best to tailor HIV intervention services to the needs of youth,” said the study’s first author, Bill G. Kapogiannis, M.D., of the Maternal and Pediatric Infectious Diseases Branch at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The analysis was funded by NICHD, the National Institute on Drug Abuse and the National Institute of Mental Health.
