Most doctors would give HIV prevention drugs to teens

From 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.

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Here are things not to put in your vagina

From the New York Times
By Jen Gunter

People always want to know the most unusual object I’ve retrieved from a vagina.

I’ll never tell.

One, because the woman involved could recognize herself and feel betrayed. Yes, some items are that unusual.

The other reason is that the unfortunate sequence of events that ends with a visit to my OB-GYN practice or the emergency room is almost always the unanticipated consequence of sexual experimentation. Lots of objects seem sexually adventurous until the moment one realizes they are not. And realizes that they are stuck.

Sexual experimentation with household items is nothing new, though the nature of the object has changed slightly to match the times — think along the lines of a progression from a soda bottle to a diet soda bottle to an energy water bottle to a Kombucha bottle — over my 25 years of practice.

Another change I’ve noticed in that time is the increased touting of various “natural” and “ancient” vaginal remedies with household items. The reasons could range from “vaginal maintenance” (a term that, as an expert, I struggle to further qualify) to the treatment of yeast infections to contraception to improving sex lives.

There are two themes at play that seem simultaneously opposing yet complementary: that natural is best and that the vagina is so dirty, fragile or in need of nourishment (or all three) that it is one wrong pair of underwear or wet bathing suit away from complete catastrophe.

And this is how lemon juice (ouch), yogurt, garlic (double ouch), cucumber and oregano oil (super, mega ouch) are finding their way into vaginas worldwide. No, you are not reading a recipe for tzatziki sauce.

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It’s not just HIV stigma – sexism, racism and poverty stigma commonly reported by women living with HIV in the United States

From aidsmap.com

Women living with HIV perceive many forms of stigma in addition to HIV-related stigma, according to a qualitative study published in the July edition of Social Science & Medicine. Stigma related to living with HIV intersected with stigma associated with gender, race, poverty, incarceration and obesity, according to the interviewees.

“Our findings highlight the complexity of social processes of marginalization, which profoundly shape life experiences, opportunities, and healthcare access and uptake among women living with HIV,” say Whitney Rice and colleagues.

They conducted semi-structured interviews with 76 women living with HIV in Birmingham, Alabama; Jackson, Mississippi; Atlanta, Georgia; and San Francisco, California. The interviewees were invited to describe their experiences of stigma and discrimination, whether in relation to their HIV status or another aspect of their identity.

The majority of interviewees were black (61%), heterosexual (83%), had children (68%) and had a monthly income of less than $1000 (57%).

Most participants were conscious of men having greater power than women. Women said they were undervalued in educational and employment contexts due to their gender. In interpersonal relationships, men would frequently disregard women’s needs and preferences, while parents would typically favour sons over daughters.

Women were also conscious of being subject to different expectations concerning sexual behaviour than men. Stigmas related to gender and HIV intersect, as this interviewee explained:

“It’s not so bad for [men] to have many sex partners but it’s horrible for a woman to have that many… And she’s a whore and all the other words… But it’s OK for him. That existed before HIV and it’s still in play now… Some dirty woman gave him [HIV] … and they’re the bad person —and then the women … you got it because you was sleeping around.”

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Gilead Sciences will begin airing television ads for PrEP

From NBC News

In a major shift, pharmaceutical giant Gilead Sciences will begin airing television ads for PrEP, its HIV prevention medication. The company said the ads, which will start in June and run through August, are “designed to encourage candid conversations around sexual health and promote public awareness of HIV prevention.”

PrEP, or pre-exposure prophylaxis, involves taking a daily pill to prevent HIV transmission. Major clinical trials have shown that PrEP — also known by its brand name, Truvada — is safe and effective at preventing HIV if taken daily. The pill is also recommended by the Centers for Disease Control and Prevention for at-risk groups.

Since the Food and Drug Administration (FDA) approved Truvada for HIV prevention in 2012, Gilead has leaned on public health agencies to promote the drug. New York City has for years placed advertisements on subways and buses to promote PrEP, and the District of Columbia’s health department aired its own racy HIV PrEP television ad earlier this year.

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Latinx People Living With HIV Share How They Came to Terms With Their Diagnosis

From thebody.com….

Coming to terms with an HIV diagnosis is rarely as easy as “just dealing with it.”

Depending on where you’re diagnosed, when you’re diagnosed, who you are, and where your life is, it can be a huge challenge to figure out how to make sense of living with HIV. It’s a process that can easily take years, and involves a ton of factors: your emotional health, your physical well-being, your support network — not to mention potential issues with family life, access to health care, housing, substance use, and so many other concerns.

We asked Latinx people living with HIV in the U.S.: How did you come to terms with your HIV diagnosis and develop the confidence to stay healthy? Here are the stories they shared.

Read the article on thebody.com.

HIV Among Pregnant Women, Infants and Children in the United States

From theBody.com

Perinatal HIV transmission, also known as mother-to-child transmission, can happen at any time during pregnancy, labor, delivery, and breastfeeding. CDC recommends that all women who are pregnant or planning to get pregnant take an HIV test as early as possible before and during every pregnancy. This is because the earlier HIV is diagnosed and treated, the more effective HIV medicine, called antiretroviral treatment (ART), will be at preventing transmission and improving the health outcomes of both mother and child.

Advances in HIV research, prevention, and treatment have made it possible for many women living with HIV to give birth without transmitting the virus to their babies. The annual number of HIV infections through perinatal transmission have declined by more than 90% since the early 1990s. Today, if a woman takes HIV medicine daily as prescribed throughout pregnancy, labor, and delivery and gives HIV medicine to her baby for 4-6 weeks after delivery, the risk of transmitting HIV to the baby can be as low as 1% or less. When the HIV viral load is not adequately reduced, a Cesarean delivery can also help to prevent HIV transmission. After delivery, a mother can prevent transmitting HIV to her baby by not breastfeedinga and not pre-chewing her baby’s food.

For babies living with HIV, starting treatment early is important because the disease can progress more quickly in children than adults. Providing ART early can help children with perinatal HIV live longer, healthier lives.

It is important that all women who are pregnant or trying to get pregnant encourage their partners to also get tested for HIV. Women who are HIV-negative but have an HIV-positive partner should talk to their doctor about taking HIV medicine daily, called pre-exposure prophylaxis (PrEP), to protect themselves while trying to get pregnant, and to protect themselves and their baby during pregnancy and while breastfeeding.

For women living with HIV, stress can become overwhelming

From TheBody.com

Everyone deals with a certain amount of stress every day. But if you are a woman living with HIV (HIV+), stress can become overwhelming. Long periods of high stress can damage your immune system and cause physical and emotional illnesses. Research has shown that stress can speed up the progression of HIV.

In the U.S., recent studies have shown that women living with HIV are five times more likely to have post-traumatic stress disorder (PTSD) and two times more likely to have survived domestic violence than women in the general population who are not living with HIV. In addition, women living with HIV who experienced recent trauma were four times more likely to stop adhering to their HIV drug regimens and to have higher viral loads than women living with HIV who did not experience trauma.

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Why I Didn’t Get Tested for HIV Until I Was 25

From intomore.com

“…It took about 30 minutes for the nursing staff to return to our small waiting room with his results. In those 30 minutes, I began to sweat, and imagine what my response could be if he turned out to test positive for something. What if he had HIV? How would I explain this? My boyfriend, of course, had his own sexual history, but I was the one with a raunchier past. I knew he had been tested before, and I knew he was negative, but I couldn’t help but be fearful of having given him something I didn’t know I had myself.

36.7 million people were living with HIV in 2016, according to UNAIDS, the Joint United Nations Programme on HIV/AIDS. Startlingly, only 60 percent of those with HIV were aware of their status, meaning over 14 million people were living life not knowing they carried the virus. Despite the myths surrounding the disease, it’s not easy to know you’re living with it.”

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Heroic in the face of stigma

From the San Francisco Examiner

Mike Shriver has been living with HIV for 32 years. His diagnosis has survived five mayoral administrations, two high-pressure years doing AIDS prevention and policy work in Washington, D.C., and death threats from haters. His physical and mental health have taken a toll, and his faith has been tested.

But he’s doing just fine.

“I really am the luckiest man alive,” he said. “I’m very privileged and I know it and I don’t ever forget how lucky I am.”

Mike Shriver leans against the National AIDS Memorial Grove’s large memorial boulder in Golden Gate Park (Kevin N. Hume/S.F. Examiner)

When Shriver began advocating for AIDS treatment in the 1990s, at the epidemic’s peak, one in 25 San Franciscans were said to have HIV and one in 50 had an AIDS diagnosis. Comparatively, HIV infections and deaths in The City today are at their lowest rate in decades, thanks to advancements in treatment and prevention and the work of Shriver and his cohorts fighting for funding and a cure.

After a sabbatical to tend to his own health issues, including diabetes and Hepatitis C, Shriver has returned to advocacy — as co-chair of the city and county’s HIV Community Planning Council and as a steering committee member of Getting To Zero SF, working to reduce HIV transmission and deaths by 2020. His hiatus helped him achieve a new level of physical wellness and a deeper awareness of what personal balance and recovery from grief and trauma look like.

“I’m no longer so self-destructive,” he said, referring to his former lifestyle that put community work first and his own health second. “Workaholism is the most socially acceptable and rewarded addiction.”

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Social isolation is bad for your health

From thebody.com

No one living with HIV/AIDS is immune from the impact of isolation. Numerous studies find that social isolation is a problem among the aging population in general, and especially among the elderly living with HIV. Younger persons are also affected. One study found that younger people living with HIV/AIDS experience more disconnectedness from family and friends than their older peers do. Researchers believe this is due to a combination of factors, including stigma, feeling blamed by others for their illness and younger people not identifying with the need to battle a chronic illness. It should also be noted that persons affected by HIV/AIDS, especially those who went through the 1980s and 1990s, can experience the same symptoms of trauma and isolation as people who are HIV-positive.

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