Ending the HIV Epidemic: Culturally Attuned Educational Materials for American Indians/Alaska Natives

From HIV.gov….

As one of several Indian Health Service activities supported by the Minority HIV/AIDS Fund (MHAF) in Fiscal Year 2020, the Urban Indian Health Institute (UIHI) is currently leading a project focused on creating  culturally attuned HIV education materials—including print, digital, and video formats—for both American Indian and Alaska Native patients and the healthcare providers who serve them.

UIHI , located in Seattle, Washington, works to provide information to and assist urban Indian-serving organizations to better the urban Indian community’s health nationwide. Seven out of 10 American Indians and Alaska Natives currently live in urban settings away from federally defined tribal lands. Since 2016, UIHI has led several projects that promote culturally attuned HIV prevention and treatment.

Among the new materials being developed under this project, in March 2020, UIHI released a short film, Positively Native , in which long-time HIV survivors Bill Hall (Tlingit), Shana Cozad (Kiowa), and Hamen Ides (Lummi) discuss their lived experiences with HIV stigma, discrimination, and advocacy. Along with the film, UIHI released an accompanying toolkit that includes a facilitator’s guide, discussion questions, and a presentation on the basics of HIV. The organization presented Positively Native to an audience of 38 people at the International Indigenous Pre-Conference on HIV/AIDS in July 2020.

Read the full article on HIV.gov.

J&J developing immunization against HIV

From Bloomberg.com

is preparing to test an experimental HIV vaccine in the U.S. and Europe in a move toward developing the first immunization against the deadly disease after decades of frustration.

Some 3,800 men who have sex with men will receive a regimen of shots in a study that’s planned to be launched later this year, Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said in an interview. The agency and the HIV Vaccine Trials Network of testing sites will collaborate with J&J’s Janssen unit on the effort.

Since cases first began to gain notice in the early 1980s, scientists have been searching fruitlessly for a vaccine against the virus that causes AIDS and kills close to 1 million people worldwide annually. Efforts are continuing with at least two other promising candidates in late-stage studies.

Most Americans not tested for HIV

From CNN

Most Americans have never been tested for HIV, the virus that attacks and weakens a person’s immune system.

The US Centers for Disease Control and Prevention is hoping to change that.
According to a new report, the agency found that fewer than 40% of people in the United States have been screened for HIV. It recommends that all people 13 to 64 be tested at least once.
Fifty jurisdictions across the country are responsible for more than half of all HIV diagnoses, yet only 35% of the people recommended for testing in those areas were screened in the previous year, the CDC says. And fewer than 30% of people across the country with the highest risk of acquiring HIV were tested in that period.
“Diagnosis and treatment are the first steps toward affording individuals living with HIV a normal life expectancy,” CDC Director Dr. Robert Redfield said in a statement. “As we encourage those at risk for HIV to seek care, we need to meet them in their journey. This means clearing the path of stigma, finding more comfortable ways of delivering health services, as well as learning from individuals already in treatment so the journey becomes easier for others who follow.”
To find HIV testing near you, go the CDC testing locator. Most locations are free.

Truvada going generic

Get PrEP-ared for generic Truvada in the next year, according to an official document that Gilead, the pharmaceutical company that manufactures the drug, released on their website.

According to a quarterly report filed to the Securities and Exchange Commission, Gilead announced that it reached an agreement to allow a generic version of Truvada to be manufactured in the United States on September 30, 2020.

In a statement, Aaron S. Lord, a physician and member of PrEP4All, called the decision a “victory for the LGBTQ+ community, for HIV activists, and for U.S. taxpayers,” and cautioned that the fight for widespread PrEP access is not over. Lord specifically pointed to the fact that only Teva will be allowed to manufacture generic PrEP.

“This will do little to reduce price in a way that will increase access and PrEP4All remains suspicious of the terms and lack of transparency surrounding the Teva settlement,” Lord wrote in the statement. “I have to ask, what’s to stop them — other than a desire for profit margins — from releasing the rights now?”

Read the full article.

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

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.

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.

Most doctors would give HIV prevention drugs to teens

(Reuters Health) – Last month U.S. regulators said a pill that helps prevent infection with HIV is safe for use by adolescents, and a study suggests most physicians would be willing to prescribe this medicine to teens.

So-called pre-exposure prophylaxis (PrEP) with Truvada, a daily pill combining the medicines tenofovir and emtricitabine, can lower the risk of getting HIV from sex by up to 90 percent, according to the U.S. Centers for Disease Control and Prevention. Truvada has long been used to treat HIV and as a prevention strategy for adults.

The current study was conducted between October 2016 and January 2017, before the U.S. Food and Drug Administration approved PrEP for teens who weigh at least 35 kg (77 pounds).

Researchers surveyed 162 doctors who worked with adolescents and young adults. While 93 percent of the clinicians had heard of PrEP, only 35 percent had prescribed it.

About 65 percent of the survey participants said they would be willing to prescribe PrEP to adolescents, and another 19 percent were willing to refer teens to another clinician for the prescription.

Among those who were unwilling to prescribe it themselves, about two-thirds said they would prescribe it for teens if it had FDA approval for these patients.

“Everyone, including adolescents, should know whether they could benefit from PrEP,” said lead study author Dr. Geoffrey Hart-Cooper, a pediatrician at Stanford Children’s Health and a HIV prevention specialist at the San Francisco Department of Public Health.

NIAID review: HIV undetectable = untransmittable

HIV positive people with an undetectable viral load cannot sexually transmit HIV. That’s the unequivocal conclusion from one of the leading health agencies in the US.

Researchers from the National Institute of Allergy and Infectious Diseases (NIAID) undertook a review of recent research. Their conclusion is simple: Undetectable = Untransmittable (U=U). It’s the same message now backed by over 300 health agencies all around the world.

The results of the NIAID review were published yesterday in the Journal of the American Medical Association (JAMA). One of the reports co-authors is NIAID Director, Dr Anthony Fauci. He is widely regarded as one of the world’s leading HIV experts.

In a statement, NIAID called evidence for Undetectable = Untransmittable ‘overwhelming’. Not only does getting those diagnosed with HIV on to Antiretroviral Therapy (ART) ensure their long term health. But it also significantly reduces HIV transmission rates. This is because those with the virus suppressed in their body cannot pass it on.

The authors pointed to research that looked at over 77,000 examples of condomless sex between serodiscordant male couples. One half of the couple had HIV and the other did not. There was not a single transmission of the virus from the HIV positive person to the negative person.

Read the full article.