Former Act Up atavist searching for new ways to halt epidemics

From the New York Times…

Last fall, the MacArthur Foundation announced their annual “genius awards.” One name in particular stood out: Gregg Gonsalves, 55, an assistant professor of microbial diseases at the Yale School of Public Health.

In the 1980s, Dr. Gonsalves was a leading member of the AIDS advocacy group Act Up; he went on to found or support a number of domestic and international AIDS organizations.

The foundation cited his contributions in “training a new generation of researchers who, like himself, work across public health and human rights sectors, scholarly research, and activism to correct disparities in global public health.”

Read the interview with Dr. Gonsalves on NYTimes.com.

New immunotherapy kills HIV: Pitt Men’s Study participants “vital to the success of this study”

From Pitt Health Sciences…

In a first on the quest to cure HIV, University of Pittsburgh Graduate School of Public Health scientists report today in EBioMedicine that they’ve developed an all-in-one immunotherapy approach that not only kicks HIV out of hiding in the immune system, but also kills it. The key lies in immune cells designed to recognize an entirely different virus.

The discovery, made in the laboratory using cells from people with HIV, is yet to be tested in clinical trials, but could lead to the development of a vaccine that would allow people positive for HIV to stop taking daily medications to keep the virus in check.

“A lot of scientists are trying to develop a cure for HIV, and it’s usually built around the ‘kick and kill’ concept – kick the virus out of hiding and then kill it,” said senior author Robbie Mailliard, Ph.D., assistant professor of infectious diseases and microbiology at Pitt Public Health. “There are some promising therapies being developed for the kill, but the Holy Grail is figuring out which cells are harboring HIV so we know what to kick.”

Antiretroviral therapy (ART) typically controls HIV infections so well that the virus is virtually undetectable in the blood and cannot easily infect other people. But if a person with HIV stops taking the daily regimen of medications, which come with many side-effects, the virus can rage back and turn into full-blown AIDS. This is because the virus goes into a latent, inactive phase where it incorporates itself into the DNA of certain immune cells called “T helper cells,” and lurks while a person is taking ART.

Mailliard and his team decided to look at a different virus that also goes latent and infects more than half of adults – and 95 percent of those with HIV: Cytomegalovirus (CMV), which can cause eye infections and other serious illnesses, but is usually controlled by a healthy immune system.

“The immune system spends a lot of time keeping CMV in check; in some people, 1 one out of every 5 T cells are specific to that one virus,” said co-author Charles Rinaldo, Ph.D., professor and chair of Pitt Public Health’s Department of Infectious Diseases and Microbiology. “That got us thinking – maybe those cells that are specific to fighting CMV also make up a large part of the latent HIV reservoir. So we engineered our immunotherapy to not only target HIV, but to also activate CMV-specific T helper cells.”

To run the experiment, the team needed blood – and lots of it – from people with HIV controlled by ART. Nearly two dozen participants stepped up from the Pitt Men’s Study, the Pittsburgh site of the Multicenter AIDS Cohort Study (MACS), a research study of the natural history of treated and untreated HIV/AIDS in men who have sex with men.

“The MACS participants were vital to the success of this study,” said first author Jan Kristoff, M.S., a doctoral candidate at Pitt Public Health. “You have to collect a lot of blood to find T cells latently infected with functional HIV in people on ART – it could be as few as 1 out of every 10 million cells. So the men would sit for as long as four hours hooked up to a machine that processed their blood and came back multiple times to give more samples.”

Dr. Anthony Fauci discusses the case of the London Patient

From NBC News…

Dr. Anthony Fauci, one of the nation’s top HIV/AIDS doctors, cautioned that the highly publicized case of the so-called London Patient — the second person in the world confirmed to be cured of HIV infection — does not mean a widely available cure is on the horizon anytime soon.

“To think that bone marrow transplantation is going to be a scalable, feasible, safe way to treat infections is really, unfortunately, misleading, because it is not,” Fauci, director of the National Institute for Allergy and Infectious Disease, said Tuesday on MSNBC.

The ‘London Patient’ was cured of HIV in the process of being treated for a much deadlier disease: Hodgkin’s Lymphoma. This cancer of the lymphatic system can be treated with a risky bone marrow transplant from a donor whose marrow matches. “This was really his last chance of survival,” Dr. Ravindra Gupta, the patient’s doctor, told Reuters.

Watch the video here.

April is STD awareness month: Get tested and protect your health

If you are sexually active, getting tested for STDs is one of the most important things you can do to protect your health. Make sure you have an open and honest conversation about your sexual history and STD testing with your doctor and ask whether you should be tested for STDs. If you are not comfortable talking with your regular health care provider about STDs, there are many clinics that provide confidential and free or low-cost testing.

Below is a brief overview of STD testing recommendations. STD screening information for healthcare providers can be found here.

All adults and adolescents from ages 13 to 64 should be tested at least once for HIV.
All sexually active women younger than 25 years should be tested for gonorrhea and chlamydia every year. Women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STD should also be tested for gonorrhea and chlamydia every year.
All pregnant women should be tested for syphilis, HIV, and hepatitis B starting early in pregnancy. At-risk pregnant women should also be tested for chlamydia and gonorrhea starting early in pregnancy. Testing should be repeated as needed to protect the health of mothers and their infants.
All sexually active gay and bisexual men should be tested at least once a year for syphilis, chlamydia, and gonorrhea. Those who have multiple or anonymous partners should be tested more frequently for STDs (i.e., at 3- to 6-month intervals).
Sexually active gay and bisexual men may benefit from more frequent HIV testing (e.g., every 3 to 6 months).
Anyone who has unsafe sex or shares injection drug equipment should get tested for HIV at least once a year.

You can quickly find a place to be tested for STDs by entering your zip code at gettested.cdc.gov.

Study shows high HIV prevalence in Black, gay men taking PrEP

From thevitalvoice.com…

Black men who engage in sex with men have a 1 in 2 chance of getting HIV in their lifetime, according to the National Institutes of Health. This is unconscionable when a drug called PrEP (a once-a-day pill that prevents HIV) exists. However, as recently published in the Journal of AIDS, black men who have sex with men on PrEP had a higher incidence of HIV than those not on PrEP, due to poor adherence to the drug. The study suggests that PrEP alone is not enough to stop the spread of HIV. The study does not, however, challenge the efficacy of PrEP itself but rather the uptake of the surrounding preventative package including behavioral risk reduction support, STI treatment, and medication adherence counseling.

Two health technology startups, UrSure and Healthvana, have separately made enormous strides in reducing HIV. UrSure improves adherence to HIV medications with diagnostic tests, while Healthvana’s platform/app is being used by clinics and their 250,000 patients who are at high-risk for HIV or are HIV positive. Collaboratively, the two startups are now working to build the most technologically innovative PrEP programs in the 48 counties in the U.S. with the highest prevalence of HIV, as identified last week by HHS Secretary Azar.

HRC: The Black & African American LGBTQ Youth Report

From the Human Rights Campaign...

In 2017, the Human Rights Campaign Foundation partnered with researchers at the University of Connecticut to conduct a groundbreaking survey of over 12,000 LGBTQ youth and capture their experiences in their families, schools, social circles and communities. More than 1,600 Black and African American LGBTQ youth responded to the survey.

This resource presents data collected from these youth, shedding light on their challenges and triumphs encountered while navigating multiple, intersecting identities. This report utilizes the full sample (any respondent who answered more than 10 percent of the survey) and provides more detail than is captured in the 2018 Youth Report.

Find out more.

Sharp increase in the number of babies born with syphilis in the United States

Recently, there has been a sharp increase in the number of babies born with syphilis in the United States. Protect your baby from congenital syphilis by getting tested for syphilis during your pregnancy.

From the Centers for Disease Control and Prevention…

How common is CS?

After a steady decline from 2008–2012, data show a sharp increase in CS rates. In 2017, the number of CS cases was the highest it’s been since 1997.

Public health professionals across the country are very concerned about the growing number of congenital syphilis cases in the United States. It is important to make sure you get tested for syphilis during your pregnancy.

I’m pregnant. Do I need to get tested for syphilis?

Yes. All pregnant women should be tested for syphilis at the first prenatal visit (the first time you see your doctor for health care during pregnancy). If you don’t get tested at your first visit, make sure to ask your doctor about getting tested during a future checkup. Some women should be tested more than once during pregnancy. Talk with your doctor about the number of syphilis cases in your area and your risk for syphilis to determine if you should be tested again at the beginning of the third trimester, and again when your baby is born.

Keep in mind that you can have syphilis and not know it. Many people with syphilis do not have any symptoms. Also, syphilis symptoms may be very mild, or be similar to signs of other health problems. The only way to know for sure if you have syphilis is to get tested.

Is there treatment for syphilis?

Yes. Syphilis can be treated and cured with antibiotics. If you test positive for syphilis during pregnancy, be sure to get treatment right away.

If you are diagnosed with and treated for syphilis, your doctor should do follow-up testing for at least one year to make sure that your treatment is working.

Find out more on the CDC Website.

Meth abuse driving spike in syphilis cases?

From HealthDay News …

A startling increase in syphilis cases among Americans may be linked to addiction to methamphetamine and other drugs, federal health officials said Thursday.

Between 2013 and 2017, the rate of syphilis infection among heterosexual men and women who use methamphetamine more than doubled, according to the U.S. Centers for Disease Control and Prevention report.

“While we don’t know the precise role that substance use may play in syphilis increases, we do know that substance use, particularly methamphetamine and injection drug use, has been associated with sexual behaviors that increase risk of acquiring syphilis and other STDs,” said lead researcher Dr. Sarah Kidd. She is a medical officer in the CDC’s division of STD prevention.

It is the risky behaviors that tend to go along with drug use that make one vulnerable to STDs, Kidd noted. These include having multiple sex partners, practicing inconsistent condom use, and exchanging sex for drugs or money.

“We also know that substance use can hamper prevention efforts,” Kidd added. People who use drugs may be less inclined to seek health services, and they may also be reluctant or unable to identify or locate sex partners, which can cause delays in diagnosis and treatment, she said.

Read the full article.

HIV isn’t just a gay issue, it’s a ‘social justice issue’

From out.com...

Writer and activist George M. Johnson instructs us, on National Black HIV/AIDS Awareness Day, on the role we all play in the

The late activist and writer Joseph Beam once deemed the act of a Black man loving another Black man a “revolutionary act.” I imagine that doing so, while also living unapologetically with HIV, is doubly insurgent. But that’s perhaps the only way to describe the life and work of George M. Johnson. A writer, activist, and soon-to-be author, he’s committed to the work of toppling the patriarchy, challenging anti-Blackness, and confronting homophobia, transphobia, and HIV stigma wherever he sees it.

With over 40,000 Twitter followers and a much larger community that reads his words at Teen Vogue,Entertainment Tonight, The Root, Ebony, and countless others, Johnson is outspoken and defiantly visible as a Black gay man living with HIV, with which he was diagnosed at 25. Now, he’s set on being the resource he wishes he had when he was younger for other folks who are or might become HIV positive.

On National Black HIV/AIDS Awareness Day, Out spoke to Johnson about his activism, the state of HIV advocacy, and what those living with the virus and those not can do to combat stigma.

Read the full article/interview here.

Experts debate if HIV prevention pill contributes to rise in other STDs

Prevention program manager Adam Weaver talks about sexually transmitted diseases in the testing room at Palmetto Community Care in North Charleston

From postandcourier.com…

The STD explosion has led to a debate over a possible connection since the introduction of the HIV prevention pill.

PrEP is not a cure for HIV, and it also is not 100 percent effective, but, taken as directed at the same time once a day, it comes pretty close — up to 99 percent successful in preventing HIV, according to Palmetto Community Care, formerly Lowcountry AIDS Services, in North Charleston.

The drumbeat of safe sex practices hasn’t changed among health officials. Abstinence, using condoms and being in a monogamous relationship are still the best ways to help prevent STD infections.

But the naked truth is people don’t always follow that advice.

“After they start taking PrEP, we don’t see a great shift in risk behavior,” said Aaron O’Brien with Roper Hospital’s Ryan White Wellness Center.

Aaron O’Brien, quality and development manager of Roper Hospital’s Ryan White Wellness Center.

He puts condom users into two groups: those who use them regularly and those who don’t, and, based on his talks with patients, that doesn’t change much once they start taking the pill.

Adam Weaver, prevention program manager at Palmetto Community Care, agrees with O’Brien.

“What we are finding is that the people we are putting on PrEP aren’t changing their condom use,” he said.

They also don’t believe PrEP’s introduction, in and of itself, contributed to the explosion in STDs.

They say it has more to do with better reporting since people taking PrEP must check in with their doctor or provider every three months or so for regular testing.

Read the full article.