Despite Increasing Rates of STIs, Federal Investment Has Been Flat

From nationalacademes.org

Sexually transmitted infections (STIs) impose billions of dollars in medical costs in the U.S., but STI prevention and control is chronically underfunded, stigmatized, and siloed from efforts to promote overall health and well-being, says a new report from the National Academies of Sciences, Engineering, and Medicine. The report calls for modernizing national STI surveillance and monitoring systems, bolstering the STI workforce, developing and scaling up structural and behavioral interventions, and accelerating the development of vaccines, diagnostics, and therapeutics. Taking these strategic actions would also better position the U.S. to respond to COVID-19, HIV/AIDS, and future infectious disease outbreaks, the report says.

banana wearing a condom
Image courtesy of Charles Deluvio

The prevention and control of STIs requires a more holistic approach that promotes sexual health and expands access to comprehensive prevention and treatment services — rather than focusing on individual behaviors or blaming people who acquire STIs, says Sexually Transmitted Infections: Adopting a Sexual Health Paradigm.

Despite the economic burden and alarming increase of STI rates over the last 20 years, the Centers for Disease Control and Prevention’s STI funding has remained flat. Although HIV is an ongoing and highly significant concern, the mandate of the committee that wrote the report was to focus its recommendations on STIs other than HIV, due to increasing rates of chlamydia, gonorrhea, and syphilis. However, the report discusses the interplay between HIV and other STIs, and ways HIV and STI services can collaborate or integrate their prevention, care, and research efforts.

Read the full article.

MARCH 10 IS NATIONAL WOMEN AND GIRLS HIV/AIDS AWARENESS DAY

An open letter from Deron C. Burton, MD, Acting Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention…

March 10 is National Women and Girls HIV/AIDS Awareness Day (NWGHAAD), sponsored by the U.S. Department of Health and Human Services’ (HHS) Office on Women’s Health. As we continue our work toward ending America’s HIV epidemic, we acknowledge the challenges the COVID-19 pandemic has presented. For some women, the impact of COVID-19 has made it more difficult to access HIV services. On NWGHAAD, join us in making sure all women have continued access to HIV testing (including self-testing), prevention, and treatment and care. Together, we can prevent new HIV infections and help women with HIV stay healthy.

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In recent years, we have seen progress toward reducing HIV diagnoses among women in the United States and dependent areas. From 2014 to 2018, HIV diagnoses decreased 7% among women overall, including a 10% decline among Black/African American women. While these numbers are encouraging, there is still much work to do to address gender and race-related disparities. In 2018, more than 7,000 women received an HIV diagnosis. Black/African American women made up 57% (4,097) of those diagnoses, followed by White women (21%; 1,491) and Hispanic/Latina women (18%; 1,269). Making the most of the full toolkit of HIV prevention and treatment strategies can raise awareness and help to prevent new HIV infections among women.

Many women without HIV can benefit from proven prevention options such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and the related support services associated with these interventions. Women with HIV should be offered treatment and the appropriate services that help people with HIV get in care, stay in care, and adhere to antiretroviral therapy (ART) so that they become virally suppressed to protect their health and the health of their sexual partners. Condoms provide additional protection for women regardless of status to prevent HIV, sexually transmitted diseases, and unplanned pregnancy. Despite the promise of these tools to help end the HIV epidemic, they only work when the people who need them most can access them. Recent CDC data reveal that only 7% of women who could benefit from PrEP were prescribed PrEP. We must continue to help women get the tools they need to protect their health, including addressing structural barriers such as systemic racism that perpetuate health disparities.

As part of the HHS Ending the HIV Epidemic: A Plan for America initiative, CDC and other federal agencies are working together to prevent new HIV infections by ensuring everyone has access to HIV prevention options, such as PrEP. To address cost barriers, HHS launched Ready, Set, PrEP, a nationwide program that makes PrEP medications available at no cost to people who don’t have insurance that covers prescription drugs. The program also addresses transportation barriers by giving people a choice to have their PrEP medications sent directly to their home or health care provider. For women who don’t qualify for the Ready, Set, PrEP program, Gilead’s Advancing Access Program and other state PrEP assistance programs are available.

To raise awareness about the many HIV prevention options for women, we encourage you to download and use materials from CDC’s Let’s Stop HIV Together campaign. The new materials broaden our portfolio and build on the existing HIV prevention, testing, treatment, and stigma resources. You can also watch our new webisode, “Hey Friend: Let’s Talk Sexual Health,” which features Black women discussing sexual health. On NWGHAAD, keep the conversation going by sharing social media content from our digital toolkit using the #StopHIVTogether and #NWGHAAD hashtags.

Thank you for your continued commitment to HIV prevention during this challenging time. By ensuring women have equal access to quality HIV prevention and care services, we can achieve health equity and end the HIV epidemic.

Ten-year Italian study shows that people with HIV remain undetectable for 97% of the time

From aidsmap.com

Long-term monitoring of people with HIV with an undetectable viral load has shown that viral suppression is rarely lost, enforcing the validity of ‘U=U’ (Undetectable equals Untransmittable) messaging, according to Italian research published in the online edition of AIDS.  The study involved over 8000 HIV-positive individuals taking antiretroviral therapy (ART) and with viral suppression (a viral load below 200) at baseline. Regular monitoring of viral load (at least twice a year for most) showed that viral load remained suppressed 97% of the time.

However, some groups, including women, people who inject drugs and those with a past history of ART failing to control viral replication spent more time with a viral load above 200. The investigators suggest that people with these characteristics may need more support to maintain viral suppression.

“We found that in our population of people with HIV the ‘U’ status was maintained on average, for 97% of the following ten years of observation and the proportion of [time] spent in ‘U’ status showed a trend for an increase in recent years,” write the authors. “This data reassuringly suggests that U=U is an appropriate message to communicate to help decrease stigma and increase motivation to remain virally suppressed.”

Read the full article on aidsmap.com.

Injectable Long-Acting PrEP Is Safe, Highly Effective in Cisgender Women

From TheBodyPro.com

Injectable long-acting cabotegravir (CAB LA) has been proven safe and highly effective in preventing HIV infection among cisgender women, according to interim results from a major study announced in late January. The findings complement previously established strong results for cabotegravir-based injectable pre-exposure prophylaxis (PrEP) in cisgender men who have sex with men (MSM) and transgender women who have sex men, adding to evidence that injectable PrEP could ultimately have greater real-world efficacy than daily oral PrEP in many populations, thanks to better adherence.

The new data come from HIV Prevention Trials Network (HPTN) Study 084, interim results of which were presented at the biennial HIV Research for Prevention (HIVR4P) conference, which took place virtually this year in late January and early February. “These results complement data from HPTN 083, and confirm cabotegravir as the first safe and effective injectable PrEP agent for cisgender women,” said Sinead Delany-Moretlwe, MBBCh, Ph.D., the protocol chair and director of research at the Wits Reproductive Health and HIV Institute within the University of the Witwatersrand in Johannesburg, who presented the study. “We hope that these results will lead to the expansion of HIV prevention options for at-risk cisgender women globally, and ultimately reductions or elimination of HIV acquisition.”

Read the full article.

Health Alert: Pennsylvania reports highest rate of syphilis in 20 years

From outbreaknewstoday.com

Pennsylvania state health officials are reporting increased amounts of sexually transmitted infections, in particular syphilis, prompting officials to encourage the public to take steps to decrease their risk.

decretive imagePregnant women should be screened at first and third trimester because of the sharp increase in the number of babies born with the disease in the United States. Nationally, cases of congenital syphilis increased by 185 percent between 2014 and 2018. In 2019, five congenital syphilis cases were reported in the state of Pennsylvania, following seven cases reported in 2018. These reported cases of congenital syphilis in the state represented the highest number of cases in more than 25 years.Early syphilis in Pennsylvania is currently at the highest rate in more than 20 years. Over the last five years, early syphilis reported in women of child-bearing age (women aged 15 to 44) increased 114 percent, from 78 cases in 2015 to 167 cases in 2019.

“Sexually transmitted diseases are serious diseases that impact many Pennsylvanians each year,” Acting Secretary Beam said. “It is essential that all residents are aware of the risks and dangers associated with STDs. Many of these diseases can be easily diagnosed and treated, which is why we encourage all residents to talk to their doctor about getting tested so we can further prevent diseases and keep our residents healthy.”

Read the full article.

National Black HIV/AIDS Awareness Day Puts Focus on Need to Address Equity and Drivers of HIV Disparities in U.S.

From HIV.gov

By: Harold J. Phillips, MRP, Senior HIV Advisor and Chief Operating Officer for Ending the HIV Epidemic: A Plan for America, Office of Infectious Disease and HIV/AIDS Policy, U.S. Department of Health and Human Services

This year’s National Black HIV/AIDS Awareness Day (NBHAAD) observance comes amidst a national dialogue on systemic racism and calls for a greater focus on equity in all our work. We should use this opportunity to examine and address historic inequities experienced by Black Americans. For the HIV community, this means working to understand and address the circumstances that put people at risk for HIV or that create barriers to HIV care and treatment.

Black Americans continue to be disproportionately affected by HIV compared to other racial/ethnic groups. According to CDC data,

  • Black Americans represent 13% of the U.S. population, but 41% of people with HIV in the U.S. in 2018.
  • 42% of new HIV infections in 2018 were among Black Americans.
  • Among the estimated 161,800 people in the U.S. with undiagnosed HIV, 42% (67,800) are Black. That means that nearly one in seven Black Americans with HIV are unaware of their HIV status and are not receiving the care they need to stay healthy and prevent transmission to others.

Fewer Black Americans in HIV care are virally suppressed: In 2018, 60% of Blacks, 64% of Latinos, and 71% of whites with diagnosed HIV were virally suppressed.

Read the full article.

People who reside in Pennsylvania can now get a free HIV self-test kit delivered to their home

The Pennsylvania Department of Health, in partnership with the Pennsylvania Expanded HIV Testing Initiative (PEHTI) and the HIV Prevention and Care Project (HPCP), has introduced HIV Self-Testing (HST) for individuals who reside in Pennsylvania (excluding Philadelphia County). The goal of the getmyHIVtest.com program is to help people get tested who wouldn’t otherwise go to their doctor or to a testing clinic.

oraquick test kitTests are available from the website getmyhivtest.com. Individuals are asked to read the information on the website and answer a few questions in order to receive an FDA-approved, OraQuick home HIV test kit mailed to the address they provide. Support for clients who request and administer the HIV self-test is available through OraQuick and the HPCP, as noted on the website.

Individuals who reside in Philadelphia County should visit PhillyKeepOnLoving.com to order the HIV Self-test kit and for additional information about testing from the Philadelphia Department of Public Health.

If you have any questions, please send an email to info@getmyHIVtest.com.

FDA approves the first and only complete long-acting regimen for HIV treatment

A press release from ViiV Healthcare:

ViiV Healthcare, the global specialist HIV company majority owned by GlaxoSmithKline plc (“GSK”), with Pfizer Inc. and Shionogi Limited as shareholders, today announced that the US Food and Drug Administration (FDA) approved Cabenuva, the first and only complete long-acting regimen for the treatment of HIV-1 infection in adults. Cabenuva is provided as a co-pack with two injectable medicines — ViiV Healthcare’s cabotegravir and Janssen’s rilpivirine — dosed once monthly, as an option to replace the current antiretroviral (ARV) regimen in those who are virologically suppressed (HIV-1 RNA less than 50 copies per milliliter [mL]) on a stable regimen, with no history of treatment failure, and with no known or suspected resistance to either cabotegravir or rilpivirine. Prior to initiating treatment of Cabenuva, oral dosing of cabotegravir and rilpivirine should be administered for approximately one month to assess the tolerability of each therapy.

Lynn Baxter, Head of North America, ViiV Healthcare, said: “Today’s FDA approval of Cabenuva represents a shift in the way HIV is treated, offering people living with HIV a completely new approach to care. Cabenuva reduces the treatment dosing days from 365 days to 12 days per year. At ViiV Healthcare, we are dedicated to ensuring no one living with HIV is left behind, and adding this first-ofits-kind regimen to our industry-leading portfolio of innovative medicines reinforces our mission.”

Read the full press release (pdf file).

Mail Order Now an Option for “Ready, Set, PrEP”

From HIV.gov

The U.S. Department of Health and Human Services (HHS) recently enhanced mail-order delivery options for participants to receive PrEP HIV prevention medication at no cost to eligible individuals without prescription drug coverage. Ready, Set, PrEP participants can choose to have their PrEP medication sent directly to their home or healthcare providers (in participating states) when they enroll or continue to use the more than 32,000 participating co-sponsoring pharmacies.

The option of having PrEP delivered to a preferred location is not only convenient for participants, but it also allows Federally Qualified Health Centers (FQHCs) and Indian Health Service (IHS) facilities, Tribal Health Programs, and Urban Indian Organizations to provide “one stop shopping” for potential enrollees. They can now get tested, receive their PrEP prescription and get the prescription sent via mail in one visit by enrolling with a healthcare provider’s assistance through GetYourPrEP.com  or the call center by calling 855-447-8410.

“This option allows our IHS, Tribal and Urban facilities the ability to provide a wholly integrated service inclusive of HIV testing, PrEP prescriptions and now the ability for our healthcare providers to offer mail-order for Ready, Set, PrEP enrollees,” said Darrell LaRoche, director of the Office of Clinical and Preventive Services at IHS. “The convenience of getting tested, enrolled and prescriptions mailed in one visit, sent to their home or a healthcare provider, is particularly important in Indian Country where a health center or pharmacy may be hours away.”

Read the full article.

People living with HIV can get COVID 19 vaccine now

A message from Rob Ghormoz, Secretary of Intergovernmental Affairs, Office of the Governor…

The Pennsylvania Department of Health today will announce two additional categories of eligible individuals to receive the COVID-19 vaccination as part of Phase 1A. Beginning today, all individuals 65 and older, and individuals ages 16-64 with certain medical conditions, as defined by the Centers for Disease Control and Prevention (CDC) that increase the risk of severe illness from the virus, are eligible for the COVID-19 vaccination. The Departments’ Updated Interim Vaccine Plan can be found here.

Those conditions are outlined by the CDC here and include: Cancer; Chronic kidney disease; COPD (chronic obstructive pulmonary disease); Down Syndrome; Heart conditions such as heart failure, coronary artery disease, or cardiomyopathies; Immunocompromised state (weakened immune system) from solid organ transplant, blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines; Obesity; Severe Obesity; Pregnancy; Sickle cell disease; Smoking; and Type 2 diabetes mellitus.

If you are part of a group that is eligible for vaccination, you can use the Pennsylvania Vaccine Provider Map to find a place to schedule your vaccine. Contact the vaccine provider of your choice directly to schedule an appointment. This map will be updated as more locations receive vaccine. Although a provider may have received vaccine, there is no guarantee that they have open appointments as supply is still very limited. Check back frequently as the map will be updated multiple times per week.