Tag Archives: HIV

Mental Health’s Influence on HIV Prevention

The HIV epidemic has changed a lot within the past 20 years, and still yet, continued high risk behaviors have remained the same.  Contributing factors to these behaviors include a lack of power or oppression, marginalization, sexual abuse, sexual compulsivity, low self esteem, depression, and loneliness.  These are not issues that can be fixed quickly.  Addressing these issues requires effort and time and may extend beyond the capabilities of many HIV programs for prevention.

An important thing learned from HIV prevention research is one size doesn’t fit all. Programs require different components that address the various different needs of clients.  Increased access to syringes for people who inject drugs, and condoms to those who have sex are necessary to win the battle against HIV.  Skill building and increasing knowledge about HIV are good methods for prevention, but they don’t work for everyone.  For most, the obstacles related to behavior changes involves dealing with mental health problems.

What people experience and what they do have effects on their mental health. Substance abuse and use (even when the drugs are not abused), marginalization, poverty, and discrimination are all serious factors that can have a big impact on one’s mental health and can place some people at a higher risk for contracting an HIV infection.

Mental Health's Influence on HIV Prevention

Do Issues with Mental Health Affect HIV Risk?

Yes. When someone decides to engage in a risky drug or sexual act, it doesn’t always occur due a consciously made decision.  Instead, these decisions are sometimes based on an attempt to get satisfaction for another need related to a mental health condition. For example:

  • Low self-esteem: For many men who have sex with other men (MSM), internalized homophobia and low self-esteem can impact their risk of of contracting HIV.  Internalized homophobia is a feeling which results in a person having a lack of self-acceptance, feeling unhappy, or self-condemnation for being gay.  In one study, it showed that men who did test positive for HIV were the ones that were in fact the ones that experienced internalized homophobia.  These men seemed to spend less time with others who lived the same lifestyle, and they also showed less satisfaction in their relationships.
  • Male to female transgender persons, also known as MTFs, identify depression, rejection, feelings of isolation, and low self esteem as barriers to risk of HIV reduction.  Many MTFs state that they take part in unprotected sex because it verifies their identity and helps boost their self esteem.
  • Post traumatic stress disorder:  People who are diagnosed with PTSD seem to partake in high-risk sexual behaviors.  One study showed that 59% of the women who were HIV positive had full PTSD due to traumas, such as rape, assault, or witnessing a murder. Non-violent traumas including serious accidents, loss or children, or homelessness.  Still yet, these women were not being treated for PTSD.  A national study performed on veterans found that substance abusers who had PTSD were more than 12 times as likely to be HIV infected than those veterans who were not suffering from PTSD or substance abuse.
  • Depression and anxiety: Those suffering from depression and anxiety are more likely to take part in high- risk sexual activities, such as substance abuse, including injection drug use, prostitution and choosing a high-risk partner.  A study following city youths for over a several year time period found that the change in risk behaviors wasn’t associated with access to information, counseling or knowing someone had AIDS.

What can be done?

As you can clearly see, mental health conditions by far increase risky sexual behaviors.  In order to address mental health issues, it is important that a person visit an individual therapist or counselor, as well as a physician to be put on appropriate medication(s). It’s also important for such people to have access to structural and community level programs that address mental health needs and HIV.

Individuals with HIV Age 14 Years Faster, According to Study

A diagnosis of HIV is no longer the death sentence it used to be; we’ve come a long way. However, there is a new study that was published in PLOS One that shows that although HIV positive individuals are typically living longer, they may be aging more quickly than expected. The study shows that those with HIV are at a greater risk of age-related diseases including kidney disease, frailty, osteoporosis, neurocognitive disease and some cancers.

Researchers are not pointing to the medications used to treat HIV as being the reason for faster aging; they think it’s HIV itself and that it speeds the process by 14 years.  Scientists from the Multi-Center AIDS Cohort Study and the UCLA AIDS Institute and Center for AIDS Research looked at whether HIV induced epigenetic changes that are age-related, meaning those changes to the DNA that do not change the genetic code, lead to changes in expression of genes. These types of transitions are triggered by the aging process itself or environmental factors.

Individuals with HIV Age 14 Years Faster, According to Study

One of the study’s senior authors, Beth Jamieson, professor of medicine in the division of hematology/oncology at the David Geffen School of Medicine at UCLA, director of the UCLA Flow Cytometry Core said, “While we were surprised by the number of epigenetic changes that were significantly associated with both aging and HIV-infection, we were most surprised that the data suggests HIV-infection can accelerate aging-related epigenetic changes by 13.7 to 14.7 years.”  There is published data and anecdotal evidence that lines up with this number. It suggests that treated HIV positive adults may develop age-related diseases, about a decade sooner than those who are uninfected.

The study looked at 96 samples of white blood cells from both young and old HIV patients before they began Antiretroviral Therapy (ART). DNA was then extracted and looked at for changes. When studied, there was a lot of overlap when the pattern of changes was compared to the pattern connected with aging. After extrapolating the biological ages of the HIV positive patients, researchers found that the patients were 14 years older than their actual age on both a cellular and physiological level.

Researchers say that this data suggests that HIV speeds up some aspects of the aging process, and there are common mechanisms found in both HIV-related aging and general aging. They consider the results of the study to be an important start in the attempt to find therapeutic approaches to mitigate the effects of HIV and aging.

Gay Men “Serosort” to Prevent Contracting HIV

One study in Seattle showed that approximately 40 % of men who are HIV negative make sure to only have sex with others who share their serostatus in order to attempt to prevent contracting the virus. A similar German study found that 10 percent of HIV positive gay men believe they are noninfectious if they have a viral load that is undetectable. Both studies’s results were presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

In Seattle, two different questionnaires that included 1902 gay men accessing an HIV/ STI clinic between February and August of 2013,  were conducted by researchers.  The first one asked questions about their recent sexual behavior.  For example, the HIV status of their partners, what role they played during sex, whether they use condoms, and other topics were brought up. The second questionnaire asked about what they did to reduce their risk of HIV.

Both questionnaires were completed by a total of 964 people, including 835 (87%) who were HIV negative and 129 (13%) who were HIV positive. Forty-two percent of HIV negative men were strict serosorters; they reported to only have sex with other HIV negative men (with or without a condom). Thirty-nine percent of these men said this was a deliberate strategy. A total of 6.5% practiced condom serosorting, which means they only  reported  having sex without a condom with other HIV negative men. 5.2% said this was deliberate. Lastly, 7.1 % were seropositioning, which means they only had condomless sex if they were the top, no matter their partner’s HIV status; 6.5% said this was a strategy.

Gay Men "Serosort" to Prevent Contracting HIV

Thirty-two percent of HIV positive men were strict serosorters, 25% of them doing this deliberately. Eleven percent engaged in condom serosorting and 10% in seropositioning.

In the German study presented at CROI, researchers asked 269 gay men who were HIV positive about whether they thought they could infect somebody if they had a viral load that was undetectable.  Ten percent of this group thought they were noninfectious, with a fully suppressed virus and they held this belief when making choices about sex.  Of these viral sorters, 57.5 %  reported condomless sex,  compared with 36% of men who were not viral sorters. Nineteen percent of the viral sorters said that recently they told someone about their status, while 22 % had not discussed HIV recently at all.  On these two counts, the respective figures for the rest of the men were 42% and 44%.

6 Major Reasons We Need to Rethink HIV Prevention

Many HIV prevention campaigns rely on appealing to our emotions, but are not taking a good look at the HIV research and information available. Read on to see why we should rethink HIV prevention.

60 Percent of young people with HIV do not know their status
According to the Centers for Disease Control (CDC), 60 percent of young individuals have no idea that they have HIV. Some men and women who are HIV negative think that it is too big of a risk to be with someone who discloses that they are HIV positive, yet they might go on to have sex with someone who believes they’re HIV negative, but hasn’t been tested to verify. Those undiagnosed carry a higher viral load than those who are aware of their status and on treatment.

91 percent of new HIV transmission happen by those who are not diagnosed or haven’t been treated
This statistic comes from a new study released by JAMA Internal Medicine. In 2009, there were more than 1.1 million people living with HIV; of these people 207,600 were undiagnosed and 519,414 knew they were HIV positive, but were not receiving medical care. In comparison to those who were undiagnosed, those who knew about their status, yet not receiving medical care were 19 percent less likely to transmit the virus.

6 Major Reasons We Need to Rethink HIV Prevention

Those who are HIV positive and receiving antiretroviral therapy (ART) who have achieved an undetectable viral load are 96 percent less likely to spread HIV
There hasn’t been a reported case of anyone living with the virus with an undetectable viral load who has transmitted the virus.

Truvada has been shown to reduce HIV transmission by 96 – 99 percent, when used daily
One new study also shows when PrEP is used as needed (a user taking Truvada 2-24 hours before sex and one pill 24 and 48 hours after) has shown to be 86 percent effective in preventing HIV. With all that’s available–TasP, PrEP and condom use, there seems to be much less of a reason to fear sex with someone with someone of opposite HIV status. Be open and honest with your partner.

Three out of 10 in the US have their virus under control
The care continuum, which is also known as the HIV treatment cascade, showed that even though 86 percent of people living with HIV were diagnosed, only 30 percent of them had  an undetectable viral load. The majority of those living with HIV know they have it, but are either too scared or unable to do what is needed to control it.

You can expect to live an additional 51 years if you’re newly diagnosed in your 20’s
That is, if you enter proper treatment. This is roughly the same number of years as a person without HIV would live. Many need only take one pill each day to manage HIV. Of course, there are mental and emotional health issues to treat as well.

HIV Used to Fight Cancer

HIV and cancer are the most feared diseases on the planet.

But now researchers at the University of Pennsylvania are using one to fight the other. 125 patients with either non-Hodgkin’s lymphoma or chronic leukemia took part in this study, 36 of which were children. Two-thirds of participants had either gone through partial or full remission due to the experimental procedure.

Researchers at the university’s School of Medicine are reprogramming billions of cells in the body’s own immune cells to attack the cancer, a tactic which originated from studying HIV. The portion of the virus that allows it to pass into white blood cells is being used to fight cancer. What they are using isn’t HIV per se, but the genetic portion that gives the virus this ability. This method could replace bone marrow transplantation in some instances. This is the current treatment which is complex and can be dangerous.

HIV Used to Fight Cancer

The genetic material fashioned from the type HIV uses is inserted into the patient’s T-cell, an immune system cell known to fight pathogens. Certainly it isn’t the virus itself nor can patients develop HIV from the procedure. When the new cells are refurbished as cancer fighters, they are once again reintroduced into the body, where they can do mighty battle and crush cancer. These cells also reproduce spreading throughout the body and taking the fight right to cancer.

Dr. Doug Olson was diagnosed with Leukemia in 1996. He has undergone four treatments since. The cancer keeps resurfacing. By 2010, around half of all the bone marrow cancer in his body was infected with cancer. With few options left, he underwent this new treatment. Four weeks later, he was cancer free. Oncologists and others wonder if this sort of therapy can be adapted to fight other forms of cancer.

An HIV Cure is Still a Long Way Away

Though HIV treatment today is better than at any time in the past, challenges remain.

We have antiretroviral therapy (ART) today which can help HIV patients lead a normal life. But this requires lifelong care. What’s more ARTs are expensive and compliance with the drug remains an issue for many patients. Besides medications that can control the virus, the case of the “Berlin Man” or Timothy Brown encourages researchers. In 2007 Brown went for leukemia treatment. He received a transplant of hematopoietic stem cells. These are all the cells associated with blood. But the donor these cells came from had a rare genetic disorder, which proved to make Mr. Brown HIV resistant. To date there is no sign of HIV in Brown’s body. He no longer has to take antiretroviral drugs. Despite this, there are still many challenges in curing HIV.  In fact, the task is more complex than researchers first imagined.

An HIV Cure is Still a Long Way Away

Though scientists are able to halt the virus’s replication, it continues to be able to hide out in the body, in what are known as HIV reservoirs. It can attach its DNA to a cell’s genome, and continue on in long living cells, such as CD4+T cells found within the immune system. One recent study suggests that the HIV virus can be kicked out of their hiding places and neutralized. Another study found a way to snip HIV’s DNA out of a cell’s genome.

A recent John Hopkins University study found that these latent reservoirs are 60 times more prevalent than previously thought.  ARTs are not only a method of controlling the virus but also preventing it. Many health experts say ARTs should be more widespread to prevent the virus, particularly amongst at-risk populations. Now that researchers understand the challenges they face more clearing in locating HIV reservoirs, extracting the virus and it’s DNA, they can now develop better methods and someday a cure.

Death Rate for African-Americans with HIV Declined Significantly

For African-Americans living with HIV, the mortality rate took an impressive nosedive between 2009 and 2012 according to the CDC.

In a recent report, the agency revealed that the mortality rate fell somewhere between 21-28% depending upon how it is calculated, while the number of actual deaths for blacks dropped 18%. Still, the mortality rate and number of deaths remains elevated over other races, the CDC finds. Though only 14% of the population, African-Americans account for 50% of all new HIV cases.

Among certain subgroups such as black men who have sex with men (MSM) the number of cases has actually risen. Still, the drop in death rate and mortality rate made greater strides for black people, more than any other race.  Data from the U.S. Census was cross-referenced with the National HIV Surveillance System in order to arrive at these results.

Death Rate for African-Americans with HIV Declined Significantly

Two rates were calculated from this data, the rate of those living with HIV per 1,000 and per 100,000. It is estimated that 8,165 African-Americans lost their lives to HIV in 2012, compared with 5,426 whites and 2,586 Hispanics. African-Americans were 48% of the total. They were 1.5 times more likely to die of HIV than whites and 3.2 times more likely than Hispanics. Still, deaths among African-Americans between 2008 and 2012 dropped 18% according to the report. Among all of those living with HIV, a 28% decline was observed. For African-Americans, mortality rates fell from 28.4 per 1,000 in 2008 to 20.5 per 1,000 in 2012. Those who were older and living with HIV had a higher death rate.

Transmission method had considerable influence, as those who contracted HIV through intravenous drug use had the highest mortality rate. This is because they are more likely to have other serious health problems that increase their risk. MSM had the lowest mortality rate from HIV. Researchers note that the way the study was conducted, looking at all deaths associated with HIV, rather than HIV-only related deaths, it is impossible for them to determine any differentiation in care among the races.

Researchers wrote that overall the situation has improved for all of those living with HIV and differences between races has narrowed.  Moreover, minority focused treatment and care programs may see further declines.

MSM Remain Most Affected by HIV

The Center for Disease Control and Prevention (CDC) has confirmed through new research that gay and bisexual men are still the most affected by HIV, as the rate of infection has gone up in the past few years.

Two studies were presented by the CDC at the annual Conference on Retroviruses and Opportunistic Infections (CROI). The studies dealt with HIV and its impact on men who have sex with men (MSM) and the impact on groups within the MSM community.

According to the CDC, each year MSM account for two thirds of newly diagnosed cases of HIV. Despite the fact that overall, the number of HIV diagnoses went down between 2003 and 2012, certain areas of the US saw an increase in numbers, particularly in the MSM population, between 2008 and 2012. Data analyzed by the CDC from the National HIV Surveillance System (NHSS) shows that these Metropolitan Statistical Areas (MSA) are usually cities with populations over 500,000, such as New York, Washington D.C., Miami and Dallas.

The overall rate of HIV diagnoses decreased on an average of 3.7 percent, out of the 105 MSAs that were analyzed. There was a notable decrease in nearly two-thirds of MSAs. But, the HIV rate among MSM in these MSAs increased by over 10 percent, between 2003 and 2007. The rate evened out and decreased between 2008 and 2012, yet the rate was less than that of the national average. Between 2008 and 2012, HIV rates for MSM only declined 2.2 percent.

MSM Remain Most Affected by HIV

During that last four year period, MSM between 13-24 had an HIV diagnosis rate increase by 15 percent, while older generations saw unchanged rates.

A separate study looked at more than just age as a separate factor–it included an examination of the correlation between MSM, their ethnicity, and diagnosis rate. Results showed that African American men were diagnosed at a higher rate than others. There is an overwhelming disparity between both HIV infection rate and awareness between white and African American MSM.

Despite the fact that African American MSM did not report a higher rate of sex without a condom, it was shown that they were less aware of their infections and those under 40 were “significantly more likely to be HIV-positive compared to all other racial/ethnic groups”.

It’s obvious that this data from the CDC shows where HIV prevention needs to focus: younger MSM, particularly African American MSM. This is a day and age where sexual health information is incredibly accessible, especially with Internet resources available.

Condoms are the number one way to prevent HIV transmission during sex. Plus, now that Pre-exposure prophylaxis (PrEP)/Truvada is available from many health plans, it’s important to speak with a doctor about your possibilities. It’s also vital to be tested for your status regularly. If you do test positive, you’ll want to take medication as soon as possible to make the best quality of life with HIV that is possible.

 

Bugchasing Becoming a Dangerous Trend

A well-known sexual act within the gay male population is, for many, a perplexing and scary idea.

It is considered extreme sexual taboo by those who engage in it.  It’s called “bug chasing”, which means one intentionally seeks to have sex with those infected with HIV (known as a “Gift giver”).  They seek to receive the “gift” of HIV.  Bug chasing is becoming more popular globally and, even though a minority seek this, the effects of it are felt by many more.

Bug chasing is associated with unprotected sex (barebacking), but extends to something much more dark.  HIV is no longer the death sentence it used to be, but it’s still not something most can come close to imagining they would want.  It would mean a lifetime of taking medications, visiting hospitals, getting blood drawn and very likely getting AIDS and dying.  Why would anyone choose this?

Bugchasing Becoming a Dangerous Trend

There are different reasons people claim to chase the “bug”.  Some say that they are self-harming and have suicidal ideations.  The most popular reason is that they are trying to avoid a lifetime of fear that revolves around possibly contracting HIV.

Even with protection, there’s still a chance to contract HIV.  To avoid this, some gay men take on the philosophy that avoiding this life of paranoia with regard to contracting HIV can be eased by “beating it to the chase”.

After all, they believe they’ll probably get it anyway, so why not have some control over the situation and not have to worry about catching it afterwards?  It’s a sad and unfortunate way to believe you must live.  After all, the majority of gay men do not abstain from sex and still live without contracting HIV. They are healthy and happy.

Other gay men who are “bug chasers” claim that they are turned on by the fact that they might become infected.  This dangerous, risk-taking chase excites them.  If one wants to get their bug-chasing needs met they can seek out a ‘conversion party’ that often involves those with and without HIV participating in unprotected sex with anyone.  The HIV status of all of the attendees are unknown, so you’d leave the party with your own status a mystery.  Internet apps are also tools that can be used to meet with people who want to chase the “bug” or give the “gift”.

It’s impossible, even after being given explanations, for many to wrap their heads around this phenomenon.   An obvious question that might arise is: Once you’ve been given the gift, do you still want it?

New Aggressive HIV Strain Discovered in Cuba

An aggressive, new strain of HIV has been discovered in Cuba.

One which has the ability to develop into AIDS within three years of infection. There is worry that this particular strain’s accelerated progression is so rapid that antiviral treatment may come too late, according to researchers. This study was prompted by the fact that Cuban doctors were reporting an ‘increasing trend’ of AIDS cases that were rapidly progressing.

Without any form of treatment, it usually takes HIV approximately 5 to 10 years to advance to AIDS. This happens more quickly if a patient has an already suppressed immune system. In the case of patients in the study in Cuba, there was a significantly faster advancement. The study found that within three years, patients with the mutated strain developed AIDS. It is often the differences in patients pre-existing immune system differences, not the subtype of HIV, that plays a role in AIDS development. Yet, it was obvious in this study that the specific type of HIV played a major role in the quick advancement.

New Aggressive HIV Strain Discovered in Cuba

When the researchers took a closer look, they found that the patients with quick advancing HIV were linked by their variant type of HIV. This new variant-HIV was discovered to be a new recombinant subtype made up of subtypes A, D, and G. It has been named CRF19. One researcher in the study, Prof. Anne-Mieke Vandamme of Belgium University-Leuven, explained how this variant accelerates the AIDS process:

“There are two types of co-receptors that HIV can use: CCR5 or CXCR4. And, in the normal progression of the HIV to AIDS it often happens that the virus switches co-receptor. It almost always starts with using CCR5 and then it switches to CXCR4 after many years. And once it switches the progression to AIDS goes very fast”.

The inclusion of subtype D may be a key in the CRF19 strain’s aggressiveness, according to researchers. Subtype D has an enzyme that allows HIV to produce in higher numbers and uses proteins that it takes from other subtypes, in new virus particles.