HHS Prohibitions on Sex Discrimination in Line with Supreme Court Decision

From HIV.gov...

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.

Read the full article on HIV.gov.

Living with HIV in Pennsylvania? We need your input!

All individuals living with HIV in Pennsylvania are invited to share their opinions in this Priority Setting Survey!

Human Crowd Forming H I V Text On White Background Priority Setting is a part of HIV Planning in Pennsylvania and offers a special chance for individuals living with HIV to have their opinions recorded. These responses help the state’s HIV Planning Group and Pennsylvania Department of Health Division of HIV Disease make decisions about HIV spending and planning for a 5-year cycle. Individuals living with HIV are invited to rank a list of Ryan White Part B services, based on their own needs and the kinds of services that they find important.

Due to extended HIV Planning deadlines, we are reopening this year’s Priority Setting Survey, and are looking for your response!

We ask for your responses by Wednesday, June 30th .

Complete the Pennsylvania Ryan White Priority Setting Survey at this link:  https://bit.ly/3dZf3Hk. 

Please direct any questions to Maura Bainbridge at stakeholders@stophiv.org or 412-383-1619.

Stigma Remains a Barrier in HIV Prevention and Treatment

From newswise,com

Stigma and discrimination, such as homophobia and racism, impede engagement in HIV prevention and use of biomedical tools for treatment in both HIV-negative and HIV-positive gay and bisexual men, according to a Rutgers study.

The paper, published in AIDS and Behavior, examined the impact of stigma on HIV-related outcomes among gay and bisexual men in the U.S.

man standing alone on a dock

Despite recent advances in HIV prevention and treatment, and access to biomedical interventions that can hasten the end of the HIV epidemic, gay and bisexual men continue to be disproportionately affected by the virus.

Read the article on newswise.com.

NASTAD: COVID-19’s impact on PrEP/PEP and sexual health services

NASTAD, in collaboration with the National Coalition of STD Directors (NCSD), released “One Year Later: COVID-19’s Impact on PrEP/PEP and Sexual Health Services.” This resource explores the impact COVID-19 has had on the provision of sexual health and HIV prevention services over the last year.

NASTAD logoThis reflection piece details the many challenges and opportunities COVID-19 has brought to the HIV/STD prevention field, particularly in the southern United States, and showcases the innovative approaches sexual health providers implemented to further prevent service disruption.

While the COVID-19 pandemic is still ongoing, this document looks at what the sexual health workforce has been through, and continue to go through, navigating ending an HIV epidemic while in a global pandemic.

HIV & STI National Strategic Plans Call for Enhanced Coordination of Efforts

From HIV.gov

The recently released STI National Strategic Plan (STI Plan) and HIV National Strategic Plan were developed concurrently with the Viral Hepatitis National Strategic Plan and each calls for a more integrated approach to addressing the syndemic of HIV, STIs, viral hepatitis, and substance use and mental health disorders. Together, these three plans aim to enhance coordination of the activities of federal agencies and diverse community stakeholders to reduce morbidity and mortality, stigma, discrimination, health inequities, and disparities; improve outcomes; and fortify the public health and health care infrastructure to support prevention, diagnosis, care, and treatment across these infectious diseases. As federal agencies begin work to develop implementation plans for each of these five-year plans, we will explore opportunities to enhance integration of prevention, care, and treatment of STIs, HIV, viral hepatitis, and behavioral health issues by leveraging capacity and infrastructure across the domains and breaking down operational and funding silos.

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Such silos result in missed opportunities every day to test people for multiple infections and to scale up services in settings where people at risk receive other services. These missed opportunities translate directly into lost time and resources and may result in harm to people who remain undiagnosed, untreated, and at risk of severe outcomes or of transmitting HIV, an STI, or viral hepatitis to others. A reciprocal, integrated approach in our responses to infectious diseases and substance use and mental health disorders that puts patients first through a status-neutral and no-wrong-door approach will maximize their ability to access services that meet their health needs.

For example, HIV testing, prevention, and care programs can identify opportunities to screen for other STIs, viral hepatitis, and behavioral health issues and provide treatment and/or linkage to appropriate services. Current CDC PrEP guidelines recommend STI screening as part of PrEP care and the HHS HIV Treatment Guidelines provide information on screening, treatment, and prevention of herpes and syphilis.

Similarly, STD clinic patients represent a population at increased risk for HIV; so STD specialty clinics play a vital role in reaching people at risk for HIV who are not engaged in HIV prevention programs or other health care services, including those who are uninsured and those who seek confidential services. In addition, STD specialty clinics serve a high proportion of racial and ethnic minorities, gay and bisexual men, and transgender people so are ideally positioned to reach these populations disproportionately affected by HIV who could benefit from PrEP or PEP or reach people with HIV who are either unaware of their status or are not virally suppressed and could benefit from linkage to or reengagement in care.

April 10th is National Youth HIV/AIDS Awareness Day

From HIV.gov

sign saying National Youth HIV Awareness DayAll 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.

Read the full article.

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.