The pandemic that has upended life in the U.S. could lead to increased STD rates and setbacks in the fight against HIV as public health resources are shifted to the coronavirus response.
Access to STD and HIV testing and treatment services are dwindling as local health departments shuffle staff to respond to COVID-19 and clinics reduce hours or close altogether and cancel outreach programs.
“We are seeing a complete disruption to STD prevention here in the United States,” said David Harvey, executive director of the National Coalition of STD Directors (NCSD). “We expect to experience even higher STD rates as a result.”
When most respondents in a population don’t know about a particular medication, that means that the word is not getting out. Although efforts may have gotten better since 2013, the reality is that most women still are not considered in the marketing of PrEP especially among people that have some high-risk activities within their lifestyle.
The parallels of this lack of knowledge continue a legacy of female bias when it comes to sexual health topics. The female condom is one example of a tool that was meant to empower women to protect themselves. However, the commitment by the health community to engrain it in our cultural sexual education failed and it is always seen as an option that men and women don’t fully embrace.
We all know that HIV is no longer a death sentence, but to deny that some people still experience it that way — due to fear, stigma, history, and lack of access — is to miss what happens to young Black men today. The ability to get and stay on treatment, to get to undetectable within weeks, to never transmit the virus and live a normal, healthy life isn’t something you can take for granted if you are a working class person of color in the U.S., much less in a different country (read our feature on HIV-positive asylum seekers from Africa on page 32). If you’re a working class, Black or brown woman with HIV, you know this well too: you may dream of affording the “self-care” everyone recommends for you (massages, acupuncture, vacation) but struggle to pay the rent and buy the kids’ school lunches, much less fork over $50 to feel good for an afternoon.
I’m relieved that my friends who lived are now healthy long-term survivors. I’m thrilled that PrEP uptake has risen almost 500 percent, scientists now universally agree that treatment can make you undetectable (and unable to transmit the virus), and that new research has us closer than ever to a vaccine and a functional cure.
But let’s not forget that while most people today won’t ever see their diagnosis devolve into stage three HIV (formerly known as AIDS), some untreated folks will. Without treatment, AIDS can progress quickly, much like it did in those early years.
Despite recent progress that has seen new HIV diagnoses decrease by 21 percent from 2010 to 2016, black women still accounted for 6 in 10 new HIV infections among women in 2016.
…Prep is one way for black women to protect themselves from the virus.
“When we look at the use of Prep, we find that there are disproportionate uses of the drugs. We find that communities of color use Prep less than other communities. Some are not even aware that Prep is out there,” Angarone said.
…Cost also plays a crucial role in black women seeking treatment. Public health experts believe that making Prep and HIV-treatment medications, such as Truvada, affordable to all populations is vital.
“Cost plays a significant role in women seeking treatment. They want to know that insurance covers it. Insurance coverage for Prep is also important,” Angarone said.
“Ultimately, the health of black women has to be made a priority,” Angarone said.
“We have to ask ourselves as a community, how do we get all of the testing strategies that have been working for other populations in place to bring about similar outcomes to the African American female community?”
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.”
Currently, there is no reliable technology that can detect HIV during the early stages of the infection or measure viral rebound in antiretroviral therapy in treated patients in resource constrained point-of-care settings. There is therefore, an urgent need to develop a rapid, disposable, automated, and low-cost HIV viral load assay to increase timely access to HIV care and to improve treatment outcomes.
That’s exactly what a researcher from Florida Atlantic University’s College of Engineering and Computer Science is developing. He has teamed up with a researcher from FAU’s Schmidt College of Medicine to combine their expertise in microchip fabrication, microfluidics, surface functionalization, lensless imaging, and biosensing to create a reliable, rapid and inexpensive device for viral load quantification at point-of-care settings with limited resources.
They have received a $377,971 grant from the National Institutes of Health (NIH) to develop a disposable HIV-1 viral load microchip that can selectively capture HIV from whole blood/plasma. The technology is being developed to be highly sensitive to quantify clinically relevant viral load during acute phase and virus rebound as well as inexpensive (costing less than $1), and quick (results in less than 45 minutes). Moreover, this technology is highly stable, and does not require refrigeration or a regular electric supply to enable HIV viral load at point-of-care settings.
In a new report, the Centers for Disease Control and Prevention on Monday highlighted the gaps in access to treatment and testing resources that exists within the HIV care continuum. Those gaps have led to a halt in recent years to the progress made over the past two decades in reducing HIV infections.
An estimated 15% of people with HIV don’t know they have the virus, and that population accounted for 38% of all new infection, according to the study. Those who know their HIV status but are not receiving care make up 20% of people living with the virus but account for 43% of new infections.
CDC Director Dr. Robert Redfield said the epidemic could end over the next few years by expanding access to testing and consistent treatment.
We’ve all been there: getting hot and bothered and oh-so-turned on and can’t wait to just go for it. Hopefully you reach for the box of condoms before you do anything. Using protection greatly reduces the chance of contracting STDs, and there are some nasty ones out there. But are you using the right size condom? Unfortunately, many sex-ed classes are severely lacking in teaching proper condom use which can lead to a whole slew of unpleasant things.
For many people, they will just grab the standard box of Trojans and call it a day. However, there is a variety of different sized condoms available to purchase, each with their own fit. Unlike some clothing, condoms aren’t a one-size-fits-all thing and it’s very important that people use the right size for their little (or big) man.
Truvada was approved by the Food and Drug Administration in 2012. But over six years later, the United States is failing miserably in expanding its use. Less than 10 percent of the 1.2 million Americans who might benefit from PrEP are actually getting it. The major reason is quite clear: pricing. With a list price over $20,000 a year, Truvada, the only PrEP drug available in the United States, is simply too expensive to become the public health tool it should be.
[…] The disparities in PrEP access are astounding: Its use in black and Hispanic populations is a small fraction of that among whites. In the South, where a majority of H.I.V. infections occur, use is half what it is in the Northeast. Women use PrEP at drastically lower rates than men, and while there’s no national data on PrEP and transgender Americans, it’s almost certainly underused. The issue of PrEP access has become an issue of privilege.
The ability of PrEP to greatly reduce new H.I.V. infections is no longer in question. In New South Wales, Australia, a program providing free access to PrEP led to a drop in H.I.V. diagnoses in the most vulnerable communities by a third in just six months, one of the fastest declines recorded since the global AIDS crisis began.
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.