Category: Commentary

Why the HIV battle continues for gay men

From the Huffington Post…

Ace Robinson
Global Health Policy Analyst

September 27th was National Gay Men’s HIV/AIDS Awareness Day. It’s the day that approximately 80 gay and bisexual men will become infected with HIV. Thirty (30) of those men will be Black. Twenty-five (25) will be White and twenty-one (21) will be Latino. Some of those men will find out about their status very early, will be engaged in competent healthcare, and will live a full productive life while managing this chronic illness. But to this day, that will be the exception and not the rule.

Ace Robinson Global Health Advocate

Like just about all viral illnesses life the flu, treating HIV right away and staying on treatment will not only stop you from getting sicker, but stop you from being able to transmit that virus to others. The same is true for HIV. Last month, Dr. Carl Dieffenbach, Director of the Division of AIDS at the National Institutes of Health confirmed what global experts had been saying for years: “Once you begin therapy and you stay on therapy…you are NOT capable of transmitting HIV to a sexual partner.” It is called Treatment as Prevention (TasP). That is excellent news. But that is only true for 30% of Americans. The vast majority of People Living with HIV (PLWH) are not benefitting from the advances in treatment due to not knowing their HIV status, lacking access to care and treatment, lacking social support, or a mix of all the above.

Of those infected each day in the United States, two-thirds are gay and bisexual men. In vast parts of the USA, gay and bisexual men do not receive the type of needed support to access and stay on treatment which puts them at risk for HIV progression and potentially transmitting the virus to another person. Due to homophobia, some men do not have support from their families, have reduced access to jobs and housing, and have had poor experiences in healthcare settings. That creates the perfect storm for the continued epidemic that has gripped this globe for over 35 years.

Today, we live in an age that PLWH can live nearly their entire expected life span IF they receive sustained treatment. We also live in an age that people can take a daily pill (PrEP) that can prevent HIV infection before exposure. And if that is not enough, we also live in an age that people can take a course of treatment that can prevent HIV infection after exposure(PEP).

But what good does TasP, PrEP, and PEP do if people most at-risk for infection are not aware of it. They are really just a jumble of letters. In my circles, it seems that everyone know about these things. But that’s not the norm. For so many, there is nearly no knowledge of these ways to treat and prevent HIV. A couple of weeks ago, I was in southern Georgia visiting my mother and we went on a mini-vacation to Jekyll Island. I was chatting with a young Black gay man who worked at the local hotel. Eventually, we started chatting about what I do and I off-handedly starting rambling on about PrEP and PEP. If you could have seen the look on his face, you would have thought that I had told him that aliens had landed in Times Square. For that young man, we had failed him. He should have known sooner.

The HIV prevention and treatment toolbox is filling faster today than ever before. But not everyone knows what is in it. Awareness, advocacy, and access will be the ultimate tools in the HIV toolbox to ultimately end HIV in mine and others’ communities. We must strive to continue not only raising awareness, but also advocating for access for gay men who have been disproportionately impacted by HIV for far too long.

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HIV/AIDS in 2016

From The Journal of the American Medical Association (JAMA)…

Overshadowed by the Zika epidemic, concerns about terrorism and security, and the US presidential election, the global HIV/AIDS pandemic persists, with 2.1 million new HIV infections and 1.1 million deaths worldwide in 2015 (http://bit.ly/2ambo2P). The 21st International AIDS Conference in Durban, South Africa, in July highlighted the remarkable progress since 2000, when the conference was last held in Durban and very few people in Africa received antiretroviral therapy.

patf_mentorAt present, 3.4 million people in South Africa are being treated for HIV infection, more than in any other country in the world; between 2005 and 2015 overall life expectancy at birth in South Africa increased from 53.5 years to 62.5 years (http://bit.ly/1swJbPo). In 2000, 490 000 new HIV infections occurred among children throughout the world; in 2010 the figure decreased to 290 000 and in 2015 to 150 000 (http://bit.ly/2ambo2P). Unlike the $10 000 annual cost of HIV treatment in 2000, the price tag for some first-line antiretroviral regimens now is only $100 per year.

The recent conference aimed to catalyze the work that remains—further scientific advances, addressing stigma, discrimination and other structural barriers within society, and securing the political commitment, including financial resources for prevention, diagnosis and treatment (http://bit.ly/2960ttk). However, fewer people may have been listening than in the past. Among the more than 15 000 participants from 153 countries, including 800 media delegates, few journalists from a US newspaper or television network were on-site in Durban. Although the conference was covered from afar, it was relatively underreported in the United States.

Read the full article.

 

“Why I wiped HIV off my face”

By Mark S. King

From TheBody.com…

mark2014Some years ago, I told someone that I was HIV positive before I agreed to his invitation for a date. “Yeah, I know,” he casually replied, and then he looked a little embarrassed, as if he shouldn’t have said it. It was too late, of course; I knew exactly what he meant. He could tell my HIV status by my face.

I had The Look. The sunken, wasted cheeks of someone living with HIV. It became a common manifestation in the 1980’s and persisted until the medications that caused the condition, known as facial lipoatrophy, were changed or abandoned for better treatment.

Today, facial lipoatrophy is almost exclusively limited to long-term HIV survivors who used medications like d4t and ddi more than twenty years ago.

I’m one of those long-term survivors. I am proud of my history advocating and living with HIV. But as uncomfortable as it may be to admit, it’s a lot easier to live openly as a person with HIV when you don’t look like it.

When the symptoms began to appear, it meant that the choice to share my status, as an activist or on a personal level, had been taken away. My HIV was written across my face for all to see.

I felt ashamed, and then conflicted. For someone who has been fighting so hard to reduce HIV stigma, what is there to be ashamed of, exactly? Many of the physical signs of HIV treatment — from weight loss to fat redistribution to facial wasting — are worn as battle scars, if not badges of honor, by thousands of people living with HIV. My disease is mirrored in my physicality. What’s wrong with that?

Eventually, I realized that correcting my facial wasting was no different than improving my t-cell counts. I wasn’t making a political statement — I was improving my health and well-being.

And so, I began a journey that would include multiple visits to a specialist and more than $20,000 worth of various “facial filler” products injected into my face…

Read the full article.

 

San Diego activist shares his experience taking PrEP for 100 days

 From Gay San Diego…

Activist Rick Cervantes
Activist Rick Cervantes

In February, I thought long and hard about whether or not I wanted to go on PrEP. Do I really want to take a pill every day? Do I want to see a doctor every three months? And my own fears kicked in — what if it doesn’t work? I made an appointment with a doctor at Sharp, we talked about it honestly and I was sold.

I had to get some initial bloodwork done, of course an HIV test, and some other general health tests. My test came back negative that same day and the doctor wrote a prescription for Truvada. My prescription was ready later that day, and the next morning I was taking my first pill. I’ve taken one pill every day since then — now over 100 days — and I’m so glad I made that choice.

Sure, it was a little hard at first. After the first couple of days, when the medicine started to settle into my body, I didn’t feel so good. I had some mild nausea and decided to take a couple of days off work to let the symptoms subside — which they did after three days. I’ve never had another side effect since then and I’ve taken other medications in my life that were a lot more common than Truvada and had much worse side effects.

I’ve proudly posted about taking PrEP on my personal social media and many other online groups related to PrEP and HIV, and, as I mentioned earlier, it’s really caught people’s attention.

Working with the #BeTheGeneration campaign, we’ve really made an impact, and I hope more and more people continue to reach out to me, Benny and others at The Center to ask questions. We want people to know about the options available to them, and we want to help people stop being so fearful and put an end to the stigma and shaming.

I know that being on PrEP has made feel more confident and healthier and has given me a better outlook on sex and I want you to be able feel this freedom too. Please don’t hesitate to contact me or anyone else at The Center’s #BeTheGeneration campaign, for more information or just to talk.

Together, we can end new transmissions of HIV!

—Rick Cervantes is the social media coordinator at The San Diego LGBT Community Center and active in its #BeTheGeneration campaign. Reach him at 619-692-2077 ext. 220 or follow his journey on Twitter @mistercervantes.

Why getting tested could help your community

 From the Huffington Post…

One of the biggest misconceptions about the AIDS epidemic in the United States is that it’s over. This belief is also part of why the disease is so dangerous — and why campaigns like this week’s National HIV Testing Week are so necessary.

Nationally, 1.2 million Americans live with HIV or AIDS and about 50,000 more are diagnosed with HIV each year. But for a more complete view of the virus’ impact, localized data is telling. Philadelphia has a citywide HIV infection rate that’s five times the U.S. national average, and the infection rate in one of the city’s southwestern neighborhoods is comparable to rates in Sierra Leone and Ghana.

A full two-thirds of new HIV infections occur in just 3 percent of U.S. counties, according to newly released statistics from AIDSVu, a data project developed by researchers at Emory University’s Rollins School of Public Health that maps data about the disease using information from the Centers for Disease Control and Prevention and the U.S. census. These counties are found in both cities and rural areas, but they have one thing in common: a lack of resources.

Continue reading.

It’s National Testing Week…and Pennsylvania is the place to get free testing

 From theweekender.com…

By

AR-306249997Get a load of this: There are 721 people known to be HIV-positive or diagnosed with AIDS in Northeastern Pennsylvania. For Ken Zula, executive director of Wyoming Valley AIDS Council in Wilkes-Barre, the more alarming number is 6.06 percent. That’s the chunk of the population in Luzerne and Lackawanna counties infected with HIV or AIDS, he says.

The naked truth about how close to home the disease is to our area is perhaps more discomforting when adding that AIDS.gov reports 1 in 7 people infected with HIV don’t even know they have the illness. Knowing that, it’s basic math to apprehend thousands of people throughout NEPA could be walking around with HIV, unenlightened of their status. They’re clueless that they may be passing HIV to other people. They could pass HIV to you. Since National HIV Testing Week is June 21-27 in the United States, Weekender is encouraging NEPA to get tested and know their status. Getting tested is quick and painless.

Continue reading.

New York Times opinion piece: New blood-donor policy, same gay stigma

By I. Glenn Cohen and Eli Y. Adashimay 

The Food and Drug Administration released highly anticipated draft recommendations that would allow gay men to donate blood after one year of celibacy. While an improvement from the current, highly criticized lifetime ban, the new policy, which was announced in December, still caters to fear and stigma rather than science. It should be reconsidered.

In 1983, early in the AIDS crisis, the F.D.A. categorically prohibited any man who had had sex with a man since 1977 — even once — from ever donating blood. (The ban was one year for men who had had heterosexual sex with someone known to be H.I.V.-positive.) As we argued in The Journal of the American Medical Association last year, this policy was deeply misguided. It lacked solid public health evidence to support it, and was at variance with the policies of other countries — including Britain, Canada and South Africa — that had rescinded such lifetime bans without seeing an increase in infected blood in their supply. The ban meant that the F.D.A. was forgoing an estimated 615,000 pints of blood annually that would be donated to save lives. And it deeply stigmatized gay men.

Continue reading on the New York Times.

An era of new possibilities: HIV prevention for gay and bi men

From aids.gov…

By Eugene McCray, M.D., Director, Division of HIV/AIDS Prevention, CDC

CDC McCray_Eugene_2007_301_hiresWe have achieved some hard-won victories against HIV in recent years. New infections among women and injection drug users are declining, people with HIV are living longer, and more people than ever know their HIV status.  But one population — gay and bisexual men –is seeing infections rise, driven by increases among young gay men.

As I wrote last year, reducing new infections among gay and bisexual men, who bear the brunt of the new infections, is CDC’s top HIV prevention priority.  If we are to bring down new HIV infections from 50,000 per year, we must focus on the tools with the greatest potential to slow the spread of the HIV – including powerful new prevention approaches that weren’t on our radar just a few years ago.

To help meet this challenge, the Centers for Disease Control and Prevention (CDC) has announced new prevention initiatives up to $125 million to expand use of two potent but underutilized tools to slow the spread of HIV among gay and bisexual men, particularly men of color.  One is pre-exposure prophylaxis, or PrEP.  The other, called Data to Care, is a new way of using surveillance data to help people living with HIV stay in care, protect their health, and reduce the risk of transmission to others.  These two approaches reflect how CDC is reshaping its HIV prevention strategies in an era of new possibilities.

Continue reading on aids.gov.

“What does the Affordable Care Act (ACA) mean for 1.2 million Americans living with HIV or AIDS?”

An excerpt from TheBody.com…
By Kellan Baker, M.P.H., M.A.

LGBT people with incomes between 139% and 200% of the Federal Poverty Level made particularly significant gains: Between 2013 and 2014, uninsurance in this income range dropped by 22 percentage points, from 48% to 26%.

Of all respondents who explored their coverage options during the first open enrollment period,

  • 35% found out they were eligible for Medicaid coverage — of whom 78% enrolled.
  • Among those who were not Medicaid-eligible, 20% purchased a plan through a Health Insurance Marketplace.
  • Almost half of those who purchased coverage were able to select a plan that costs less than $100 per month.

But much work remains to be done to ensure that the ACA effectively addresses uninsurance in LGBT communities. We found that 26% of LGBT people who could potentially get financial help to get covered were uninsured in 2014 — compared to an estimated 20% among the general population in the same income range.

Reasons given for uninsurance included employment discrimination, which traps many LGBT people in poverty and lower-wage jobs that don’t offer benefits, and insurance exclusions targeting transgender individuals and others considered to have pre-existing conditions. Respondents in same-sex relationships also reported persistent barriers to coverage: In both 2013 and 2014, approximately 50% of those who had tried to access coverage for a same-sex spouse or partner reported encountering trouble, and nearly three in four reported feeling discriminated against in the process.

Read the full article here.