Addressing stigma, coping behaviors and mechanisms in persons living with HIV could lead to better health outcomes

From medicalxpress.com

Investigators from the University of Alabama at Birmingham have developed a new conceptual framework highlighting how unique dimensions of individual-level HIV-related stigma might affect the health of those living with HIV. According to the paper’s authors, little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes.

The framework, published in the American Journal of Public Health, looks at perceived community stigma, experienced stigma, internalized stigma and anticipated stigma as barriers to both HIV prevention and engagement in care. An intersectional framework looks at how multiple social statuses intersect at an individual level, such as HIV status, race, gender or sexual orientation, and a broader level, such as structural stigmas in society including racism, sexism, HIV-related stigma and classism, to produce health inequalities.

The conceptual framework suggests that individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources and biological stress pathways.

“Those living with HIV often fight fear and experiences of HIV-related stigma, affecting their quality of life and mental health, as well as engaging poorly in their HIV care and treatment,” said Janet Turan, Ph.D., professor in the UAB School of Public Health Department of Health Care Organization and Policy. “Our proposed conceptual framework for individual-level dimensions of stigma and potential individual and interpersonal mechanisms explains how stigma affects each individual’s HIV-related health.”

HIV-infected individuals may be judged by others to be in marginalized social groups, causing social stress because of their minority social position, which could lead to important implications for their health.

Read more at: https://medicalxpress.com.

The media can play an important role in helping to eliminate HIV stigma

From the HRC

by Diego Mora Bello, HRC Global Fellow

Stigma and discrimination continue to be common barriers for people living with HIV. Fortunately, the media can play an important role in helping to remove these and other barriers. In my own survey of Latin American news articles mentioning HIV and AIDS, and in meeting with media professionals and advocates, I found that Latin American Media has room to improve its use of correct and destigmatizing language when talking about people living with HIV. Covering HIV both correctly and responsibly is important, because doing so is an essential part of raising awareness, debunking common myths, and giving voice to an already marginalized group of people.

The importance of using correct and responsible language in journalistic coverage of HIV inspired me to research this topic and share my findings. The ultimate goal of HIV in the Media is to report on this subject in a scientifically accurate and responsible way that inspires others to follow suit.

Based on my research, here are the top three reasons why language is important when covering HIV and AIDS in the media.

Read the full article on the HRC Website.

Philly LGBTQ conference addresses deadly stigmatization of HIV

From Newsworks

“We can find a way to end HIV. We got heart, and maybe that’s enough to fight the racism, stigma, homophobia, gender inequity …. We got to stick together. We got to stay strong.”

Performer Todrick Hall
Performer Todrick Hall

Todrick Hall sang these words, kicking off “Convergence: Forging the Path to End HIV,” a panel discussion plenary at the five-day Creating Change Conference, hosted by the National LGBTQ Task Force in Center City Philadelphia. Hall, an openly gay and popular YouTube entertainer, received great applause from the audience.

The aim of the discussion was to address the stigma surrounding HIV in hopes of eliminating the virus.

When compared to other countries, the United States has a realtively low suppression rate, which is the number of people living with HIV but undergoing treatment, thereby decreasing the likelihood of spreading the virus.

Panelist Dr. Richard Elion of George Washington University explained that, “[In] Uganda, the rate of suppression runs at about 55 percent, compared to 30 percent in the United States. So clearly, our country is not doing something that we need to be looking at.”

Elion said there is more to decreasing the spread of HIV than affordable diagnosis and treatment options, and that combating the stigma of HIV is vital.

Read the full article. 

Why aren’t HIV prevention pills going to the people who need them?

From Rolling Stone online

When Truvada was introduced four years ago as a way to prevent HIV, public health leaders didn’t welcome the drug with open arms. The head of the AIDS Healthcare Foundation panned the once-daily pill as a “party drug.” Other health officials claimed that taking Truvada would cause a wave of wild unprotected sex. Even members of the LGBTQ community parroted the criticism, with one gay journalist (regretfully) labeling some users “Truvada whores.”

But the last four years has seen a shift in attitude. More andgetting-prep-to-people-who-need-it more Americans are embracing pre-exposure prophylaxis (PrEP), the HIV prevention method that requires a daily dose of Truvada to reduce viral risk. And more and more prescriptions are being written for the antiretroviral drug. While PrEP is growing in popularity, a new study out of the University of California released last month suggests that the populations most at risk of HIV infection are not the ones benefitting from the prevention strategy.

In a survey of gay and bisexual men in California, only a handful of participants reported having taken PrEP. PrEP use was highest among young white men, at 13.9 percent. For young Latino men, that figure was cut by more than half, while young black men represented less than 10 percent of people who started PrEP.

“This is not reflective of the HIV epidemic at all,” says Shannon Weber, founder of Please PrEP Me, an online directory of over 230 clinics in California that provide PrEP. “It is reflective about access, and where and how people are getting that information.”

Read the full article.

Web series explores what it means to be undetectable

From the Huffington Post

A new web series from Todd Flaherty is elevating the conversation surrounding what it means to have an undetectable HIV-positive status and helping to break down stigma for those living with HIV.

what is undetectableAccording to Tyler Curry, creator of The Needle Prick Project, “an HIV-positive person can achieve undetectable levels after undergoing antiretroviral therapy (ART). A level of a person’s HIV viral load is what causes them to be more or less likely to transmit the disease. An undetectable viral load reduces the likelihood of transmission by 96 percent.”

Many people, queer and straight alike, are still uneducated about what exactly undetectable means. Flaherty’s new web series, appropriately titled “Undetectable,” follows a fictional gay man after he finds out about his own HIV diagnosis and his subsequent journey.

The Huffington Post chatted with Flaherty this week about his new project.

‘Undetectable’ a new identity for gay men diagnosed with HIV

 From aidsmap.com….

status: UNDETECTABLE

Achieving an undetectable viral load is a key milestone in the period after diagnosis with HIV, qualitative interviews with Canadian gay men suggest. Men incorporated knowledge of their own undetectable status into their identities as HIV-positive gay men and their sexual decision making, according to a study published in the August issue of AIDS Education and Prevention. Being undetectable helped many men feel ‘responsible’ and ‘normal’.

The findings come from in-depth, qualitative interviews with 25 gay men diagnosed with HIV in British Columbia, Canada between 2009 and 2012. All had acquired HIV less than a year before their diagnosis and half had been diagnosed with acute (very recent) infection. Up to four interviews were done, in order to see how experiences changed during the year after diagnosis.

Interviewees typically reported a period of sexual abstinence immediately after being diagnosed with HIV. During this period of adjustment, many men had no sex drive. Avoiding HIV transmission was a major concern for many, including this man:

“First of all, I killed my sex life. I was like, you know, I don’t want to infect anyone, I don’t want to take the risk and I don’t want to disclose, so the way of not doing is just not having sex.”

When participants did start to have sex again, they found themselves in an altered sexual landscape, facing new scenarios, challenges and possibilities. Faced with the difficulty of talking about having HIV with new partners, some sought out other HIV-positive men. Others avoided anal sex, even with condoms.

Learning that one’s viral load was undetectable could open up new possibilities:

“I didn’t play around when I was not sure… if I was undetectable or not. I didn’t play. They [sexual partners] would be open to it, but I didn’t want… Personally I didn’t feel comfortable, so I didn’t play until I was undetectable.”

Read the full article.

HIV/AIDS still holds a powerful stigma

head-shot-will-you-still-love-me-bbf66e1c54ba224d30e4f1b43a80b972571de120-s800-c85From NPR.org

Indiana was hit with an outbreak of HIV/AIDS this spring, and it got a lot of attention because it is so exceptional.

Our perception of HIV/AIDS has changed since the disease emerged in the early 1980s. There are all kinds of treatments and resources — things that simply didn’t exist when the epidemic began.

In the U.S., an estimated 1.2 million people are living with HIV, according to the CDC. New infections are down from the peak in the 1980s, but the epidemic is nowhere near over. HIV/AIDS has affected millions of people around the world. In this country, gay men have been hardest hit.

Today on For the Record: HIV then and now. Two survivors, from two different generations, tell their stories. Click the audio link on this page to listen to the full conversation.

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.

HIV risk among young gay, bi men tied to societal issues

From Reuters Health

Participants were recruited from the New York City area between 2009 and 2011 and were 18 or 19 when they entered the study. At that point they were all HIV-negative. Over the next three years, 43 participants became infected with HIV. About a third of black, Hispanic and mixed or other race participants became HIV-positive during the study, compared to about 7 percent of white participants. People who described themselves as being in low to average social and economic groups were more likely to become HIV-positive than those in higher socioeconomic groups.

Also, the authors found, young age at first sexual experience with another male was tied to an increased risk of becoming HIV-positive, compared to a first encounter at an older age. “The bigger point here is that it’s just too simplistic to (blame) everything on race,” Halkitis said. “We’re trying to get at the reason that’s happening. This paper starts to point to it.”

The researchers point out that social and economic status is closely tied to race in the U.S. People with lower social and economic status likely live in areas with more poverty, less access to healthcare and more untreated sexually transmitted infections (STI), they write. They also point out that young gay and bisexual men may not be properly educated about STIs, and their heterosexual parents may not be equipped to educate on those topics.

“I think that one way we can begin to address this issue is through comprehensive sexual health education,” said Jason Coleman, an expert on HIV and STI prevention at the University of Nebraska-Omaha.

Read the full article.