Category: Sexual Health

Immediate HIV treatment can save additional millions, WHO says

 

The World Health Organization (WHO) recently came up with new guidelines that could expand population on HIV drugs by millions.

In the past, the HIV infected would start treatment when their viral load reaches a certain level of severity. Under the new guidelines, however, anyone infected with HIV is recommended to begin treatment immediately after diagnosis. This expands the number of people who are eligible for anti-retroviral drugs to about 28 million to 37 million over the world.

In addition, the guidelines recommend protective medications for those who are at substantial risk of HIV infection as studies on pre-exposure prophylaxis, or PrEP, have shown to be effective to lower the risk of becoming infected.

The WHO hopes that the revised guidelines will help halt the epidemic, but who will pay for the cost to execute those remains questionable.

 

Bias on using HIV-blocking drug

The Boston attorney, as a gay man, thought he was discriminated for having HIV-blocking drug.

The attorney tried to ask his doctor to prescribe Truvada, an HIV-blocking drug, to be responsible for preventing himself from being infected by HIV. But he failed to get long-term care insurance from Mutual of Omaha. The reason why Mutual of Omaha turned him down is it does not cover anyone who takes the drug. As a result, the man will sue the insurer for the discrimination of being gay. He already filed a complaint with the Massachusetts Commission Against Discrimination this Wednesday.

According to the article published in the associated press, the man said:”I thought maybe they misunderstood me. I’m HIV-negative. I’m not HIV-positive. I was taking Truvada as a prophylactic.” The objective for him to sue the insurer is to ensure that people like him will not be worried about the discrimination for using Truvada.

Truvada, a preventive drug, was approved for reducing the risk of being infected by HIV among uninfected people by FDA. Moreover, in accordance with the data published by CDC, Truvada is able to largely reduce the risk in people at-risk.

However, there are a group of critics of Truvada claim that the use of Truvada may increase the prevalence of risky sexual behavior such as condom-less sex, though it is effective to some extent.

What do you think about the advantages and disadvantages of HIV-blocking drug? Will it really increase risky sexual behaviors in people at-risk?

Photo credit:http://www.wehoville.com/2014/04/08/worth-read-truvada-lifesaver-party-drug/

Drug Shown to be Effective in Preventing HIV Infection

What if there was a pill that could protect against the HIV virus?

What many people don’t realize is that such a drug already exists and has proven to be incredibly effective at blocking the spread of the virus.

Last week, Kaiser Permanente published their findings for a 2.5 year study of Truvada, the pre-exposure prophylaxis drug for HIV. Truvada is actually a combination of two medicines, tenofovir and emtricitabine, that when taken daily can prevent HIV infection in an HIV-negative person if they are exposed to the virus.

Of the 657 people who began using PrEP over the 32-month observation period, none contracted HIV during the study. Previously conducted clinical trials had shown efficacy rates as high as 92% for preventing infection when the drug was taken properly, but the Kaiser Permanente study was the first to produce evidence supporting the drug’s efficacy in a real world setting.

It is important to note that Truvada is only recommended for people who are continually at high risk for contracting HIV (due to sexual practices or injection drug use)*. It is also a promising option for HIV discordant couples (in which one partner is HIV positive and the other is negative).

Also, to be effective Truvada needs to be taken very consistently each day which raises questions of practicality and concerns about the regular access to healthcare services that successful management requires. Still, PrEP remains a very promising tool for the continued battle to control the spread of HIV worldwide.

You can find more information on PrEP from the CDC: http://www.cdc.gov/hiv/prevention/research/prep/

 

*If a person is exposed to HIV in a single high-risk event, they could begin treatment with postexposure prophylaxis (PEP) within 72 hours of their exposure to the virus to mitigate the chance of infection.

Early treatment saves more lives

The benefits of early treatment are clear for both people living with HIV (PLWH) and the whole society. Last Wednesday, based on the findings of the largest clinical trial, federal health officials announced that the benefits of the early treatment are obvious. Besides, they also said that people with HIV should take antiretroviral drugs as soon as they are diagnosed.

This trial is a strong evidence to show that those who got treatment immediately were 53 percent less likely to be infected and develop AIDS or die during the trial. Therefore, the early treatment saves more lives. At present, according to the Centers for Disease Control and Prevention (C.D.C.), 450,000 of the estimated 1.2 million with HIV are on treatment. Although the influence of early treatment is sound and profound, only 37 percent of infected Americans had the access to get the prescriptions of the drugs. This small percentage is partly due to the limited access to HIV testing, health insurance. Therefore, people infected by AIDS could not afford the drugs or did not see doctors.

In addition, though the substantial evidence of the benefits of early treatment is defining, the shortage of funding is the main cause of a small amount of people living with HIV have the access to the early treatment — antiretroviral medicines. For instance, the Global Fund to Fight AIDS, Tuberculosis and Malaria constantly struggle to raise money.

It’s true that antiretroviral treatment (early treatment) is the best way to curb AIDS. The shortage of money is the mainly daunting challenge facing organizations targeting at HIV.

Photo credit from: http://www.bchdmi.org/cchs/hiv

“Epidemic Bad Laws” vs. Human Rights

What is “an epidemic of bad law?” According to Global Commission on HIV and the Law, the “bad law” punishes and discriminates people living with HIV. For instance, HIV travel restriction allows to detain or deport foreigners who pose risks to the economy, the security, the public health, or the morals. At present, there are 50 counties impose this restriction on entry or stay of people living with HIV (PLWH).

These “bad laws” violate the human rights, especially for vulnerable groups of people such as transgender people, sexual workers, and injection drug users. Based on an article published in the New York Times, a Chinese transgender sex workers was punished by a policeman.  Xiao Tong (the transgender sex worker) was selling sex on the streets of Beijing when a man lured her into his car. The man took her to the police station and punched her. It is obvious that Xiao Tong, as a transgender sex worker, is the most marginalized and vulnerable populations in China. She was discriminated and punished by the policeman due to the absence of non-discrimination laws. However, the precondition of this case is Xiao Tong was selling sex in public place. Although it is inhumane to punch her, she deserves punishment from my point of view.

I do not believe that it is legal to sell sex in public places in other counties! It is true that we need some laws to protect vulnerable groups such as prisoners, sexual workers, injection drug users, transgender people, women and children. But the precondition is those groups of people do not influence or damage other people’s interests.

Therefore, what is “bad law?” I think a new definition is needed.

Photo credit: http://business-ethics.com/2010/02/10/1241-catching-bad-guys-international-law-enforcement-ups-the-ante/

 

 

DC Takes on HIV: An Evaluation

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Campaigns such as DC Takes on HIV acknowledge that marketing is not just for commercial products. Using a social marketing approach, the campaign promotes HIV testing, medical care, and treatment, condom use, and healthy relationships. The umbrella campaign consists of several topic specific campaigns, including Ask for the Test (HIV testing), Know Where You Stand (intimate partner communication), Rubber Revolution (condom use), and I Got This (HIV treatment).

A recent study evaluating the effectiveness of the campaign shows that the efforts were successful, especially among those most affected by HIV. According to the report, Public Awareness, Resident Engagement, and a Call to Action, the campaign had high visibility in terms of reach as well as a high degree of recall from the 810 participants, who were interviewed by telephone interviews.

It appears that the campaigns helped facilitate an increase in awareness of Washington’s free condom (71% gained knowledge) and HIV testing services (50% gained knowledge). On the behavioral side, 36% reported getting more HIV information, 35% reported finding out their STD status, 28% reported using condoms more frequently, and 27% reported getting tested for HIV.

The DC Department of Health will be hosting a webinar on implementing social marketing campaigns for HIV/AIDS prevention.

 

Sources:

http://dctakesonhiv.com

http://doh.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/DC_Takes_on_HIV_Public_Awareness_Resident_Engagement_and_a_Call_to_Action.pdf

http://www.multivu.com/players/English/7379651-dc-department-of-health-study-shows-dc-takes-on-hiv-campaign-effective/#body_text

 

Tanzania’s HIV/AIDS Campaigns Get Motorized

On the crowded dirt roads of Tanzania yellow taxis are not available for the locals to use when they need a quick ride across town. Instead, there are these very unique motorbike taxis, known locally as “boda bodas,” that can bob and weave through the hectic African traffic.

Revered for their life on the road as opposed to the far more common farm life, boda boda drivers (who are overwhelmingly male) are very popular and influential in the Tanzanian community. But the thrilling life as a boda boda driver does come with a price – there is a high risk of injury and fatality.

But earlier this spring, IntraHealth International hosted a two-day event in which more than 400 boda boda drivers gathered in Kahama Town, Tanzania to learn about motorcycle safety and male circumcision – an event IntraHealth refered to as a “public health one-two punch” for increasing driver safety and decreasing the risk of HIV/AIDS transmission.

Like many of the African countries, Tanzania unfortunately suffers from high prevalence and transmission of HIV/AIDS. For years, both local and international organizations have worked to combat the deadly virus through awareness campaigns and free sexual and reproductive health services, but even today over 1 million Tanzanian adults live with the virus and over 2 million Tanzanian children have been orphaned by it.

As a result, HIV/AIDS campaigns have been forced to get creative – even motorized. For the two-day motorcycle safety and male circumcision event not only raised awareness, it provided male circumcision services to 474 Tanzanian boys and men.

In addition, IntraHealth gave the event’s participants motorcycle helmets and safety reflector jackets decorated with the message, “Pata tohara ya Mwanaume, punguza uwezekano wa kuambukizwa VVU”—“Get circumcised and reduce the chances of getting HIV.”

According to the project’s director from IntraHealth, prior to this event boda boda drivers had never been reached by an organization with a health message. For years these drivers have been zipping by projects as an untapped resource, but in the course of two days IntraHealth was not only able to provide hundreds of men with much needed male circumcision services, but the organization got a crucial HIV/AIDS prevention message out and on the backs of the popular boda boda drivers.

It’s too early to determine what the effect of the boda boda campaign will have on male circumcision rates and HIV/AIDS prevention, but at least it came with a 474-person head start!

 

Post source:  “Hundreds of Motorcycle Taxi Drivers Gather to Learn Road Safety and HIV Prevention in Tanzania” by IntraHealth International, published on April 22, 2014 at http://www.intrahealth.org/page/hundreds-of-motorcycle-taxi-drivers-gather-to-learn-road-safety-and-hiv-prevention-in-tanzania

Image courtesy of IntraHealth International

AIDS Turns 30

“First, the probable cause of AIDS has been found: a variant of a known human cancer virus. Second, not only has the agent been identified, but a new process has been developed to mass produce this virus. Thirdly, with the discovery of both the virus and this new process, we now have a blood test for AIDS. With a blood test, we can identify AIDS victims with essentially 100% certainty.”   -Margaret Heckler, President Ronald Reagan’s Health and Human Services Secretary, May 6th, 1984

Margaret didn’t give a perfect speech that day.  She claimed U.S. credit for what was partly a French discovery, misidentified the virus, and predicted that there would be an effective vaccine ready within 2 years (there still isn’t one.)

But this speech, given 30 years ago last week, did inform the country about the source of what would become one of the worst plagues in human history, and sparked huge amounts of change in the worlds of science, medicine, and society, much of which is still going on today.

There are some like David Patient who have had the virus for over 30 years, since before doctors even knew how it spread and during a time when it was called GRID (Gay Related Immune Deficiency Syndrome).  In the early 1980s experts discovered that this virus also killed hemophiliacs and injection drug users, as well as their partners and newborns, and was spreading all over the world.

HIV (Human Immunodeficiency Virus) is a virus that, at the final stage of infection, leads to a condition called AIDS.  Our immune systems are usually able to attack and clear out viruses.  This is not the case with HIV, for which there is still no cure.

Gay, bisexual, and other men who have sex with men (MSM), especially young black/African American MSM are currently the groups most seriously affected by HIV.

From 1996 to 2000, annual AIDS deaths declined by nearly 60% in the United States (from 38,000 to 16,000).  Unfortunately, during the same time the global toll rose by the same proportion during that period, growing from 1 million to 1.6 million a year.

There are currently more than 1 million people living with HIV in the United States.  Of these, 1 in 6 are unaware of their infection.

Though we can’t completely defeat it, modern medicine has made it possible for those infected to successfully control HIV.  But in order to control the virus, the individual first has to know they have it.

If you or someone you know might have HIV, make sure they get tested as soon as possible at a local testing site.

 

Photo Credit:  Luiz Sousa

How to Honor Mandela? – Healing our History with HIV

In a beautiful article on President Nelson Mandela’s life, Archbishop Desmond Tutu makes an honest tribute. He lauds Mandela for his integrity, and also pulls at the productive tensions they felt, as leaders of conscience (and co-Nobel Laureates) in South African anti-apartheid struggles. Both leaders — one now passed on — worked to foster recognition of their people’s dignity, and understanding of the fight against HIV/AIDS.

In his honest celebration of Mandela on AllAfrica, Tutu posits that Mandela did not pay as much attention to the AIDS crisis as he could have during his presidency in the mid 1990s. But he, and others, mention what Mandela has done in the years following his presidency — including trying to persuade fellow ANC (African National Congress) leaders and dignitaries on the continent to declare the AIDS epidemic the emergency it was and is. Mandela became one of the first African leaders to “truly break the silence on HIV,” says Michel Sidibe, head of UNAIDS. After his presidency, one of Mandela’s many roles, for which he is now remembered, was as “AIDS activist.”

Asked why the issue of HIV/AIDS was at first taboo, President Mandela mentioned something with which most of us around the world (and certainly in this author’s position in the Southeastern US) are quite familiar — a populace who are “very conservative on questions of sex. They don’t want you to talk about it.” As covered by the Global Post, Mandela continues, “I told them we have got this epidemic which is going to wipe out our nation if we don’t take precautions. I could see I was offending my audience. They were looking at each other horrified.”

Echoing the calls of World AIDS Day this past week, I want to cover 2 key areas in which Mandela shifted our global landscape of AIDS communication and action.

1) Drug Access

From the late 1990s onward, Mandela campaigned (a) to get world leaders to declare a “global war on AIDS”, and (b) for access to needed antiretroviral medicines among all HIV+ persons who need them in order to live. This campaign reached particular success with a coalition of organizers, who worked to reduce AIDS drug costs and put pressure on governments across the world (including in South Africa) to legislate provision of ARVs, especially to pregnant women, beginning in the early 2000s.

Antiretroviral drugs help treat persons who are HIV+ in order that they might live — by lowering the viral load in the body. Thus, at the same time, ARVs help reduce the transmission of HIV itself (reducing the concentration or proliferation of the virus in one person’s body, and thus from sexual partner to sexual partner, mother to child, or persons using needles). However as Mandela’s work and its unfinished nature reveal, most HIV+ people who need ARVs have to fight for them, amid scarce resources the world over

2) Stigma

In 2005, Mandela bravely spoke in public about his own son’s death, from AIDS-related complications. He hoped his public announcement would reduce stigma on an international scale, particularly in the valences of “moral” judgment so commonly cast through HIV-related discourse, tied to gender, race, homophobia, income and health access, and fear of discussing sex, drugs, and inequality. “To come out and to say somebody has died because of HIV… people will stop regarding it as something extraordinary, as an illness reserved to people who are going to go to hell and not heaven,” said Mandela, in 2005.

Mandela made a “decision in 2005 to go public with the news that his own son, Makgatho, had died of AIDS-related causes. His public revelation helped drive debate about HIV. And his support to people living with HIV helped to break down stigma and discrimination,” UNAIDS said in a press release honoring Mandela’s life this week.

In Mandela’s spirit, we might now ask ourselves:

In the wake of this year’s World AIDS Day, where can we push our communities, governments, family and friends, further toward a World Without AIDS? What has been overlooked in the fight against AIDS? Toward which ends can we seek collective health through concerted action — as global and local community, heeding Nelson Mandela’s call?  In logics made possible by Mandela and Tutu, and now in the frame of HIV activism, is it possible to seek not only well-being in the face of crisis, but well-being with just access for all?