Tag Archives: United States

Why are we afraid to get tested for HIV?

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For some people the idea of being tested for HIV is as simple as making a note in a calendar, an entry which sits comfortably beneath a dentist appointment and above a mother’s birthday. For others, the idea of making that appointment, or taking that long walk to the clinic, is one of the most nerve-wracking experiences they can imagine. However, in an age where the numbers of people diagnosed with HIV are increasing, has our natural fear of the unknown become a luxury we simply can’t afford?

Many years ago it was a scary disease. We called it AIDS and it became a name associated with sin and death. The massive number of infections, particularly in the gay community, were staggering, and as the death toll slowly crept up, nations across the world panicked. It’s impossible for any society to come through such a dark time and emerge unscathed, and so the fear of a silent killer left a scar on our cultural memory which has never really healed, and the mere mention of HIV and AIDS still has a way of stopping conversations.

Thankfully, things have changed since then and treatment for HIV and AIDS is better now than it has ever been. People who have the condition are now finding that their lives have not changed completely, and they are still able to live as long and do all the same things they could before. It’s true that they now have a few additional concerns to think about but with the help of medication, HIV is now manageable. However, it seems that attitudes have not moved on as much as the treatment, with people still finding themselves afraid, ashamed and worried that their lives will never be the same again.

HIVTo try and get a better understanding of the feelings and attitudes behind the diagnosis, I spoke with Sona Barbossa, a counselling team leader with the GMI Partnership. Over the course of our conversation, Sona revealed that the anxiety surrounding being tested and anxiety about the results is something which does prevent people from being tested regularly. ‘I don’t think it’s so much a fear about the test itself, but more fear of what the results might be and having to deal with that. There is still a stigma around it and I see many guys who have not been tested for years because they’re afraid of finding out the results and having to make decisions upon learning their results. Also, there’s still a lot of thinking around where people believe that it won’t happen to them, so they don’t see the point in being tested.’ When I asked Sona if she thought attitudes have changed much since HIV first came to public attention, she told us she didn’t think so. ‘People still connect HIV with promiscuity, the gay scene and with drugs. There’s also still a lot of shame and guilt that surrounds the condition, which I think plays a large role in whether people want to be tested or not and can prevent people from making those all important first steps to be tested.’

The fear of the condition is more than understandable. Even with new treatments being developed every day, HIV is still a lifelong condition which also has lifelong consequences. There’s also a very real stigma still attached, which has always been associated with homosexuality, promiscuity and intravenous drug use. This forces a lot of people who have HIV into a double life to keep it a secret from their friends and family. Sona herself pointed out during our conversation that a lot of people still feel like they will be shunned by their loved ones. ‘The fear of being judged and being looked at differently does form a large part of why people may keep this condition from their loved ones. They think that people may change towards them, and worry that their friends won’t accept them any more, and obviously the worry that their families won’t accept them any more. With this kind of attitude pervading society, it’s little wonder that people would be put off from learning their status, as it forces people to think about a lot of things before they even go to have the test done.’

According to statistics gathered by the gay men’s health charity GMFA, 59,000 gay men were tested for HIV last year. While this seems like a large figure, I was later informed by Carl Burnell, the CEO of GMFA, that this figure may only make up 15-25% of the estimated gay population. This becomes all the more worrying when GMFA’s recent statistics uncovered that 82% of new HIV infections are actually passed on from people who have not been checked themselves. The organisation has consistently fought to encourage people to learn their status and  to be checked at least once a year, however in the course of their work, they find that anxiety about HIV is having a definitive effect on preventing people from being checked. When they examined the reasons for not going to be tested, they found that 30% of those asked noted that nerves about their results were a factor, with a further 10% going on to say this was the main thing stopping them from taking the test. Burnell also noted that though people are still keen to avoid becoming HIV positive, their awareness that the condition is all around them is decreasing, and this can potentially lead people to take risks with their sexual health. He also commented that there is still a popular misconception among young gay men that HIV is not something they need to worry about, as it’s still considered by some to be a disease that only harms older people.

However, it isn’t just methods of treatment which have moved on, but also methods of detection. Time was, that if you wanted to have an HIV test you would have to go to your GP and ask for the test specifically and then be referred to have your blood taken and examined. The process would take anywhere between 3 days and 2 weeks depending on the area, and the very idea of waiting for the results could be described as hell-on-earth for people who were brave enough to be tested in the first place. Now people are able to walk in and be tested within half an hour and have their results the same day, sometimes within minutes. Similarly, thanks to the work of organisations like the Terrence Higgins Trust (THT), people are now able to order and administer the test in the privacy of their own home, send off a small vial of blood and have their results sent to them via email or even text. The sad fact is that even with all these different ways to be diagnosed, not enough people are going out and being regularly checked.

An HIV test in progressHere at So So Gay we like to practice what we preach, so when it came to writing a feature that dealt with being fearless and going to get tested, I decided to go out and take the test myself. Having been in a long-term relationship and suddenly single again, it seemed like the right time to know my status, since I was back on the dating scene. I picked the 56 Dean Street clinic in London for its walk-in service and quick results. The staff were amazing and they made me feel reassured every step of the way. They made me feel like, even though I may have been nervous to be there, I was doing the right thing by being tested. I must admit I was scared – after all the idea of drawing blood at the best of times is scary, especially for a needle-phobe like me –  but I felt that whatever the result, it would all be OK. It’s impossible to be in that situation and not wonder about what happens if you get a bad result and I was no different as I sat in the waiting room. However, I was seen by the nurse extremely quickly and within a few minutes of me sitting down in the private room, we were ready to draw blood. The nurse was a saint and kept me calm, and reminded me that even if I was HIV+, then I would still be the same person I was when I walked in, and that there are services out there to help me every step of the way. When my result came back, I was thankfully HIV-. Although I was relieved, I also knew that being tested was only half the battle, so I went and made an appointment to come back in 6 months to be checked again. I felt like it was a responsible thing to do, not just for my own health, but also for the benefit of anyone I might come to know in the future.

The truth is that it’s very easy to get ‘caught short’ in life and sometimes that leads us to take risks when we know we shouldn’t. The true test is when we make these mistakes, we have to make sure that we take the time to know our own status, since it doesn’t just affect us, but also the people we care about. HIV is no longer the death sentence it used to be and people are able to live normal, healthy and happy lives like they did before. However, this is thanks to the amazing progress we have made in treating the condition and we can only begin to do that when we make the decision to get tested and keep on top of our health. It’s a scary prospect to some and no one takes that for granted, but by taking the chance to be tested, you could be buying yourself years of life. Speaking to Carl at GMFA, he even proclaimed that we could well see the cure to HIV in our lifetimes, so let’s all make sure we are all there to see it.

Some key facts to remember:

  1. HIV is a disease which is transmitted by the sharing of bodily fluids, i.e. blood and semen. It does not discriminate against people who are older, more sexually active or people who use drugs.
  2. There is currently no cure for HIV, so people with the condition have it for the rest of their lives.
  3. With an early diagnosis people are able to live long lives. If it is left untreated, then it becomes harder to fight.
  4. People who have HIV are still the same people they have always been, and it is wrong to judge people or treat them differently because of their status.
  5. Condoms are not 100% effective. There is still a chance you can get HIV if you are safe, so you need to get tested at least once a year to know if you have the condition or not. The only ‘safe’ sex, is no sex.

Above all, remember that we have a responsibility to care for each other as well as for ourselves because, regardless of positive or negative, we are still united as a community. Be brave, go out and get tested so you know your status. There is an old saying which says ‘knowledge is power’, but in this instance it would be more accurate to say ‘knowledge is life’, whatever your status may be.

Via So So gay

HAVE YOU EVER HAD A HIV TEST?

If you’re interested in having a HIV test, we offer a completely free and confidential rapid HIV test and you’ll get the results within 60 seconds from a simple finger prick test. We use the Insti HIV test produced by BioLytical laboratories. The test is 99.96% accurate from 90 days post contact for detecting HIV 1 and 2 antibodies. We also have a mobile testing van which is often out in communities providing mobile rapid HIV tests. Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995

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FREE Training: HIV & Culture

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Delivered in collaboration with people from a wide range of communities and cultures in Leicester, we will explore how culture affects perspectives and experiences of HIV.

  • Date & Time: Thursday, 13th December between 13:00-16:30 hrs.
  • Venue: The Michael Wood Centre, 53 Regent Road, Leicester, LE1 6YF.

The session will also look at ways of providing knowledge and empowerment about HIV to people with different cultural needs.”

Spaces are very limited, (only 10 available).  If you would like to attend, please contact us on 0116 2559995 and speak to our team who are happy to help.

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Gonorrhea Is Now One Antibiotic Away from Being Untreatable

A close-up illustration of the Gonorrhea bacteria on a petri dish

Back in October, we told you that Gonorrhea could possibly become untreatable, well, unfortunately, the disease is closer to untreatable than it has been since doctors devised a way to treat it in the first place.

We’re down to just one antibiotic that can effectively fight the disease!

The cause for alarm comes from the CDC’s cheerily named “Morbidity and Mortality Weekly Report,” which has reported this month:

Gonorrhea is a major cause of serious reproductive complications in women and can facilitate human immunodeficiency virus (HIV) transmission. Effective treatment is a cornerstone of U.S. gonorrhea control efforts, but treatment of gonorrhea has been complicated by the ability of Neisseria gonorrhoeae to develop antimicrobial resistance.

In everyday terms, gonorrhea has gradually grown resistant to nearly every antibiotic we’ve created over the past several decades to destroy it. Nowadays, our last stand against the disease is injections of the antibiotic ceftriaxone, which then need to be be followed up with oral doses of either zithromycin or doxycycline.  According to a statement from the CDC’s Director of STD Prevention, Dr. Gail Bolan, it is now “only a matter of time” until gonorrhea is resistant to our final, antibiotic regimen. After that, we’ll have nothing to stop it, which is not good news considering that gonorrhoea is a common STI in the UK.

It was diagnosed in over 16,500 people in 2010 and there are likely to be many more people who remain undiagnosed, because up to half of women and one in 10 men have no symptoms of gonorrhoea so don’t seek advice from a doctor.

So, in line with our advice in protecting yourself from contracting HIV, if you’re not using condoms already—(and, really, you should be using condoms if you’re having sex with people) maybe you should start now, there are other dangers out there besides HIV.

More information about gonorrhoea is available from the NHS and Bupa from the following links:

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Victory for HIV-Positive Teenager As Pennsylvania Boarding School Reverses Its Decision to Ban Him

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A HIV-positive 9th-grader from the Philadelphia area is celebrating victory against a private boarding school after it reversed its decision to ban him because of his HIV status.

A lawyer for the boy, who uses the pseudonym Abraham Smith, said he was considering the Milton Hershey School‘s offer of admission.

Mr Smith is an honour roll student who controls his HIV with medication.

Climb-down: Milton Hershey School has reversed its policy and offered the teenager a place

Climb-down: Milton Hershey School has reversed its policy and offered the teenager a place

The AIDS Law Project of Pennsylvania had filed a lawsuit against the school on the boy’s behalf, saying its policies violated the Americans with Disabilities Act.

The school, which is supported by the Hershey chocolate company, has now announced a new policy under which HIV-positive applicants will be treated the same as others.

School president Dr Anthony Colistra issued a statement defending the school’s previous decisions regarding the teenager.

He said the admissions offer, and an apology, were issued to him last month.

Apology: The school's president Dr Anthony Colistra said it now hoped to welcome the teenager

Apology: The school’s president Dr Anthony Colistra said it now hoped to welcome the teenager

‘Although we believed that our decisions regarding Abraham Smith’s application were appropriate, we acknowledge that the application of federal law to our unique residential setting was a novel and difficult issue,’ Dr Colistra said.

‘The U.S. Department of Justice recently advised us that it disagrees with how we evaluated the risks and applied the law. We have decided to accept this guidance.’

Dr Colistra added: ‘I publicly extend a heartfelt apology to [Abraham Smith] and to his family for the impact of our initial decision, as I did privately in my July 12 letter. We hope to welcome this young man to our school family in the near future.

‘The Milton Hershey School staff are among the most loving and caring people anywhere. I have witnessed the great work they do providing not only an education but nurturing to our students. As they always do, our staff will enthusiastically welcome all students, and continue to transform their lives.’

The boy’s lawyer, Ronda Goldfein, said recent developments did not end the lawsuit, and that her client was still assessing the school’s climb-down.

‘We’re certainly delighted that the school understands their obligations under the law and intends to follow them,’ Ms Goldfein said. ‘This case is not settled. This is one very important piece of it.’

The lawsuit was filed late last year in U.S. District Court in Philadelphia, and a judge last week scheduled a pre-trial conference for September.

‘We couldn’t be happier that they’re doing the right thing, but if you turn a blind eye to a law, you’re responsible for the harm caused while you were turning that blind eye,’ Ms Goldfein said.

Protests: The decision to ban the pupil sparked demonstrations from campaigners including these students from the University of Nevada, Las Vegas

Protests: The decision to ban the pupil sparked demonstrations from campaigners including these students from the University of Nevada, Las Vegas

Dr Colistra said the private boarding school is developing training on HIV-related issues for its employees and students.

In Washington, Justice Department spokeswoman Nanda Chitre welcomed the school’s decision and noted that federal law protects people with HIV from discrimination.

Milton Hershey School officials previously said the boy was denied admission in February 2011 because a chronic communicable disease would pose a threat to the health and safety of the students.

Their stance sparked a wave of protests from AIDS advocates in Hershey earlier this year.

The school for lower income and socially disadvantaged students is financed by a trust that holds the controlling interest in chocolate manufacturing giant The Hershey Co.

heroryanwhiteIt is shocking that we are still facing similar stores of prejudice and discrimination relating to HIV infection.  27 years after hero Ryan Whitewas banned from school and over 3 decades of campaigning establishments STILL don’t get the message.  A victory for Abraham Smith indeed, but a blow to the efforts of HIV positive people and organisations such as LASS who work tirelessly to combat stigma.

During the course of his short young life Ryan White changed the face of HIV and AIDS as we knew it, forever. He is, to this day, an inspiration and hero for many people living with HIV/AIDS. This is his story.

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I Am Living Proof That There Could Be a Cure For AIDS!

Timothy Ray Brown, known as the “Berlin Patient” and the only person to have been cured of AIDS, holds a press conference to announce the launch of the Timothy Ray Brown Foundation at the Westin City Center hotel on July 24, 2012 in Washington, DC. “I wouldn’t wish this on my worst enemy,” Brown said of the treatment process that eventually cured him. Planned to launch during the International AIDS Conference being held in Washington, the foundation will work to focus efforts on finding a cure for HIV and Aids. — AFP Photo

The only person believed to have been cured of HIV infection through a bone marrow transplant said Tuesday he feels wonderful and is launching a new foundation to boost research toward a cure.

Timothy Ray Brown, 47, an American from Seattle, Washington, rose to fame as the so-called “Berlin patient” after doctors tried a novel technique to use an HIV-resistant donor for a stem cell transplant to treat Brown’s leukemia.

Since 2007, he has had two high-risk bone marrow transplants and continues to test negative for HIV, stunning researchers and offering new pathways for research into how gene therapy may lead to a more widely acceptable approach.

“I am living proof that there could be a cure for AIDS,” Brown told AFP in an interview. “It’s very wonderful, being cured of HIV.”

Brown looked frail as he spoke to reporters in Washington where the 19th International AIDS Conference, the world’s largest meeting of scientific experts, policymakers and advocates is taking place.

The bone marrow transplant he received carried significant risks and may be fatal to one in five patients who undergo it. But he said his only complaint these days is the occasional headache.

He also said he was aware that his condition has generated some controversy, but disputed the claims of some scientists who believe he may still have traces of HIV in his body and may remain infectious to others.

“Yes, I am cured,” he said. “I am HIV negative.”

Brown said he fully supports more aggressive efforts toward finding a universal cure, and has met with a number of top scientists in recent days who have treated him “like a rock star.”

He said he hopes to harness some of that fame to encourage donors to fund more research, and noted that Europe and China spend far more on cure research than the United States.

“There are thousands of very able researchers who cannot get funded for research, so I want to change that. And there are a lot of researchers who are willing to work to find a cure for HIV.”

Brown was a student in Berlin, Germany, when he tested positive for HIV in 1995 and was told he probably had about two years to live.

But combination antiretroviral therapy emerged on the global market a year later, and eventually transformed HIV from a death sentence into a manageable condition for millions of people worldwide.

Brown tolerated the medications well but due to persistent fatigue he visited a doctor in 2006 and was diagnosed with leukemia. He underwent chemotherapy, which led to pneumonia and sepsis, nearly killing him.

His doctor, Gero Huetter, had the idea of trying a bone marrow transplant using a donor who had a CCR5 receptor mutation.

People without that receptor appear to be resistant to HIV because they lack the gateway through which the virus can enter the cells. But such people are rare, and are believed to consist of one percent of the northern European population.

It would be an attempt to cure cancer and HIV at the same time.

Brown’s leukemia returned in 2007, and he underwent a bone marrow transplant using stem cells from a CCR5 mutation donor, whom he has never met in person. He stopped taking antiretrovirals at the same time.

He soon had no HIV detectable in his system. His leukemia returned though, and he underwent a second bone marrow transplant in 2008, using stem cells from the same donor.

Brown said his recovery from the second operation was more complicated and left him with some neurological problems, but he continues to be free of leukemia and HIV.

Asked if he feels like his cure was a miracle, Brown was hesitant to answer.

“It’s hard to say. It depends on your religious belief, if you want to believe it’s just medical science or it was a divine intervention,” he told AFP. “I would say it’s a little bit of both.”

Original Article

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Related article

Another view on Angels in America

The drama in Angels in America seems like a nightmare from a long time ago, but still stands as a challenge to change our attitudes to HIV.

In Angels in America, HIV is the spur that causes the truth to come out. The original play by Tony Kushner is set in 1980s New York at the height of the Aids epidemic. Not only does HIV reveal the truth about all the characters and their sex lives, it also (through each person’s attitude to the disease) tells us a huge amount about society in general.

It’s a complex story. Louis leaves his gay lover Prior, who has been diagnosed with Aids, because he can’t cope with it all. In a separate strand, Roy, an apparently rightwing lawyer, is gay yet extremely homophobic. He is dying but he won’t let what’s killing him be called Aids; he euphemistically terms it “liver cancer”. And Prior is bullied by angels, who tell him to be a prophet – but he rebels, retorting that all people with HIV and Aids want is to be “citizens”.

The play has now been turned into an opera by Péter Eötvös. When I saw it recently at London’s Barbican, I wasn’t convinced that the music brought much to the party. But the opera did successfully depict the complex and often messy reality of living with HIV. The shift between grim reality and leaps of fantasy echoes the double perspective of HIV: it is a terrible disease, but it is also a call to arms, prompting debate over gay identity and liberation.

In the 1980s, HIV challenged gay sufferers in two ways – with the threat of death, and with having to reveal their sexuality. Nowadays, treatment is widely available, so much of the drama in Angels seems like a nightmare from a long time ago. But the stigma surrounding HIV remains: I still get calls from people with HIV whose families have abandoned them, or who are excluded from jobs, healthcare or school.

The opera’s penultimate line, “we will be citizens”, stayed with me. It’s a fitting tribute to those who endured the first terrible onslaught of the HIV epidemic. It stands as a challenge to change our attitudes to the disease.

Original Article

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Even without a cure, the end of the AIDS pandemic is in sight

A very bold statement to make in the run up to AIDS 2012, none the less, this is the view of Dr. Anthony Fauci, director of the National Institute of Allergy and Infections Diseases (NIAID )

NIAID director Dr. Anthony Fauci addressing the United Nations General Assembly special session on HIV/AIDS on 10June 2008.

Dr. Fauci was appointed Director of NIAID in 1984. He oversees an extensive research portfolio of basic and applied research to prevent, diagnose, and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on transplantation and immune-related illnesses, including autoimmune disorders, asthma and allergies.  Dr. Fauci serves as one of the key advisors to the White House and Department of Health and Human Services on global AIDS issues, and on initiatives to bolster medical and public health preparedness against emerging infectious disease threats such as pandemic influenza.

Dr. Fauci has made many contributions to basic and clinical research on the pathogenesis and treatment of immune-mediated and infectious diseases. He has pioneered the field of human immunoregulation by making a number of basic scientific observations that serve as the basis for current understanding of the regulation of the human immune response. In addition, Dr. Fauci is widely recognized for delineating the precise mechanisms whereby immunosuppressive agents modulate the human immune response. He has developed effective therapies for formerly fatal inflammatory and immune-mediated diseases such as polyarteritis nodosa, Wegener’s granulomatosis, and lymphomatoid granulomatosis. A 1985 Stanford University Arthritis Center Survey of the American Rheumatism Association membership ranked the work of Dr. Fauci on the treatment of polyarteritis nodosa and Wegener’s granulomatosis as one of the most important advances in patient management in rheumatology over the previous 20 years.

AN END TO NEW INFECTIONS?

Three decades into the AIDS pandemic an end to new infections is in sight, according to Dr. Fauci.

“We don’t even know if a cure is possible. What we know is it is possible that we can end this pandemic even without a cure,”

Fauci told AFP in an interview ahead of the International AIDS conference 22nd -27th July in Washington DC, America.

Some 34 million people around the world are living with human immunodeficiency virus, which has killed 25 million since it first emerged in the 1980s.

The theme of this conference, which is held every two years, is “Turning the Tide Together,” and is based on experts sharing knowledge of the latest advances and how to best implement them in order to halt new cases of HIV/AIDS.

“We have good and effective treatments but we have to keep people on the treatments indefinitely in order to keep them well,” said Dr. Fauci, referring to antiretroviral drugs which have transformed a deadly disease into a manageable condition.

“When you have a very marked diminution of the number of new infections then you reach what we call and AIDS-free generation.”

Dr. Fauci said he did not expect any staggering breakthroughs to be announced at the conference, but that the gain would come though collaborating on ideas to speed progress by using the tools that practitioners have already at hand.

Otherwise, if progress continues at the present rate of reducing new infections worldwide by about 1.5 percent per year, the goal becomes too distant, he said.

Recent studies that tested antiretroviral drugs in healthy people as a way to prevent getting HIV through sex with infected partners have shown some promise, though getting people to take their medication daily had proven a challenge.

“The important thing is you have to take your medication,” Fauci said, noting that average HIV risk reduction in a study of men who have sex with men was just 44 percent.

The approach of treating healthy people with antiretrovirals is known as pre-exposure prophylaxis, and “is not for everyone,” Fauci said. “We have to selectively use it.”

The US Food and Drug Administration on Monday approved the first pill for HIV prevention, Truvada, despite concerns by some in the health care community that it could encourage drug resistance and risky sex.

Novel ways to boost testing are also good news, particularly with the recent US approval of the first at-home HIV test.

“It is so important in the quest to ending the AIDS pandemic to get as many people tested as possible. You can link them to care and get them on treatment. Anything that makes that goal easier would be an important advance.”

As far as an AIDS vaccine, Fauci said researchers have made “good progress” but “still have a long way to go.”

Experts are examining a trial done in Thailand that showed in 2009 modest efficacy of just over 30 percent, but is still considered a breakthrough and offers clues for future study into why some were helped and others were not.

Dr. Fauci also said he did not expect much concern to be raised over upcoming reports of the extent of drug resistance to antiretrovirals.

“People may think I am taking it lightly but quite frankly it is not a serious problem,” Fauci said.

He added that overall, AIDS research is “going well” even though “funding is restricted right now.”

And he expressed pride in the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR), “which has really transformed how you can get people in low income countries to get on treatment care and prevention.”

The United States provides almost half the world’s funding for international HIV assistance, according to UNAIDS.

The International AIDS Conference is returning to the United States after more than two decades away due to a ban on travel and immigration by people with HIV that was lifted in 2008 and signed into law in 2009.

Fauci called those restrictive laws “unfortunate” and “embarrassing.”

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PEP: THE BASICS

PEP: THE BASICS

PEP stands for Post Exposure Prophylaxis and is a treatment that may prevent HIV infection after the virus has entered the body.

Post = After
Exposure = A situation where HIV has a chance to get into someone’s bloodstream, like unsafe sex.
Prophylaxis = A treatment to stop an infection happening.

PEP Treatment: 

  • Involves taking anti-HIV drugs for four weeks
  • Must be started as soon as possible after unsafe sex or a condom not working, straight after exposure or within 24 hours is best and no later than 72 hours (three days)
  • Has side effects
  • Is likely to stop HIV but isn’t guaranteed to work

Where do I get PEP?

  • Sexual Health clinics (GUM clinics) – at Leicester Royal Infirmary or the one in your city / town
  • Hospital Accident & Emergency department (A&E) – be prepared to ask for PEP as soon as you can after you book in.
  • Not all of these places in every part of the country will have PEP or be able to prescribe it

PEP – Post Exposure Prophylaxis

How soon?

  • It is best to start PEP straight after exposure or within 24 hours and no later than 72 hours (three days later). The longer you wait there is less chance it will work, after 72 hours PEP isn’t usually given as it’s unlikely to work by then.

But if HIV is in my body doesn’t this mean I will now be infected?

  • No. After HIV gets into your bloodstream it takes from a few hours to a few days before it permanently infects you. If you act in that short time you stand a chance of stopping HIV before the infection takes hold.

How does PEP work?

  • Taking anti-HIV drugs every day for four weeks might stop the HIV before it gets a permanent hold in your body. PEP is not a ‘morning after’ pill that’s taken just once, it’s one month of drug treatment.

So if someone takes PEP they won’t become HIV positive?

  • Research shows PEP makes infection with HIV a lot less likely. But PEP doesn’t always work, some people who take it still end up with HIV after treatment. PEP can fail because some anti-HIV drugs don’t work against some strains of HIV. It’s more likely to fail if it’s not taken properly or soon enough.

Are the drugs the same as the ones taken by people with HIV?

  • Yes, you take three drugs which are also used in ‘combination therapy’ taken by HIV positive people.

Is PEP a cure for HIV?

  • There is no cure for HIV. PEP can only stop the HIV infection if it’s taken very soon after it has entered your body and before the infection takes hold. Once the HIV infection becomes permanent then anti-HIV drugs can’t get rid of the virus. This is because it is not in parts of the body the drugs can’t reach. Once HIV permanently infects someone the drugs can usually control the HIV in their body but can never get rid of it completely.

Does PEP have side effects?

  • Yes, it can cause diarrhoea, headaches, nausea and vomiting. Because of the side effects, you may need time off work or study and some people have to stop taking it. Side effects go once you stop taking the drugs. One Australian study showed that among people taking PEP, side effects were mild to moderate for two out of three people and severe for one in four.

What are the chances someone will get PEP?

  • New guidelines have been given to Sexual Health Clinics that help doctors decide if PEP should be given. A doctor will need to ask questions about:
  • Who you had unsafe sex with, to identify the likelihood of you having HIV.
  • What kind of sex you had, when it happened, whether it was oral, vaginal or anal sex and whether either of you came inside the other.
  • Doctors might sometimes give PEP after oral sex, depending on the circumstances.
  • It’s worth thinking about PEP if you or someone you had anal or vaginal sex with didn’t use a condom or something went wrong with the condom and it’s not later than 72 hours (3 days) since it happened.
  • They will also talk to you about having an HIV test. Before you are given PEP you must have a test to check you don’t already have HIV. You must also agree to be tested after taking PEP to see if it’s worked. PEP won’t be offered if you refuse to be tested.

What if I can’t get to a place that has PEP within 72 hours?

  • After 72 hours PEP won’t usually be offered so if it’s not possible to get to a Sexual Health Clinic in time it is advisable to go to a hospital Accident & Emergency department because they never close.

If I take PEP can I become resistant to HIV drugs so they won’t work if I get HIV later?

  • No, it’s HIV, not your body that can become resistant to the drugs. If PEP works it gets rid of the virus – and the virus can’t become resistant because it’s not there anymore. So if you were to become HIV positive later and needed drugs if wouldn’t make any difference that you took PEP in the past.
  • But if PEP doesn’t work and you become HIV positive, there may be problems with the HIV in your body being resistant to some drugs, including ones used in PEP.

If I’m taking PEP does that make me immune to HIV while I’m on it or when I’ve stopped taking it?

  • No. Unsafe sex while taking PEP could let more HIV into your body, making PEP much more likely not to work.
  • If, after taking PEP you have stayed HIV negative and then you have unsafe sex again, you can become infected just like any other HIV negative person.

Now we have PEP does it matter so much if I don’t use condoms?

  • PEP doesn’t change the need for condoms, here’s why:
  • Using a condom is more likely to stop HIV being passed on than PEP is.
  • Condoms don’t make you ill with side effects, which PEP can.
  • You need a condom for as long as the sex lasts – but PEP lasts for four weeks.
  • Condoms are everywhere. PEP can be hard – sometimes impossible – to get.
  • You control getting hold of condoms but doctors decide if you should get PEP and they may say no.

How many times can I have PEP?

  • Doctors decide who gets PEP and they’re unlikely to give these expensive and powerful drugs to the same person time after time. So if you keep having unsafe sex you will usually be offered help with having safer sex rather than being given PEP lots of times.
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A History of HIV & AIDS – 1997

As we prepare to enter our 25th year, we are reflecting on the global HIVevents from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

For the first time since the AIDS epidemic became visible in 1981, the number of deaths from AIDS had dropped substantially in the developed world due to the advances of anti HIV medicine and combination therapy.  Within two years, death rates due to AIDS will have plummeted in the developed world. (See 1996 for why)

In New York City the decline was even more dramatic, with the number of people dying from AIDS falling by about 50 per cent compared to the previous year. The number of babies being born HIV positive had also declined dramatically.

In May, President Clinton set a target for the USA to find an AIDS vaccine within ten years.

In August UNAIDS estimated HIV/AIDS cases in India, Myanmar (Burma), Bangladesh and Nepal at 3 million, 350,000, 20,000, and 15,000 respectively.

Worldwide, 1 in 100 adults in the 15-49 age group were thought to be infected with HIV, and only 1 in 10 infected people were aware of their infection. It was estimated that by the year 2000 the number of people living with HIV/AIDS would have grown to 40 million.

September 2, “The most recent estimate of the number of Americans infected (with HIV), 750,000, is only half the total that government officials used to cite over a decade ago, at a time when experts believed that as many as 1.5 million people carried the virus.” article in the Washington Post.

Based on the Bangui definition the WHO’s cumulative number of reported AIDS cases from 1980 through 1997 for all of Africa is 620,000. For comparison, the cumulative total of AIDS cases in the USA through 1997 is 641,087.

December 7, “French President Jacques Chirac addressed Africa’s top AIDS conference and called on the world’s richest nations to create an AIDS therapy support fund to help Africa. According to Chirac, Africa struggles to care for two-thirds of the world’s persons with AIDS without the benefit of expensive AIDS therapies. Chirac invited other countries, especially European nations, to create a fund that would help increase the number of AIDS studies and experiments. AIDS workers welcomed Chirac’s speech and said they hoped France would promote the idea to the Group of Eight summit of the world’s richest nations.”

At the end of the year, UNAIDS reported that worldwide the HIV epidemic was far worse than had previously been thought. More accurate estimates suggested that 30 million people were infected with HIV. The previous year’s estimate had been 22 million infected people with an estimated 3.2 million cases of new HIV infections.

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A History of HIV & AIDS – 1994

As we prepare to enter our 25th year, we are reflecting on the global HIV events from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

We focus on 1994 today, when The Centre for Disease Control (CDC) released 13 hard hitting AIDS advertisements which was a significant move from their more subdue approach. The prevention method was the use of condoms, which were rarely seen or even mentioned on television.

“One of the television ads, entitled Automatic, features a condom making its way from the top drawer of a dresser across the room and into bed with a couple about to make love. The voice-over says, ‘it would be nice if latex condoms were automatics. But since they’re not – using them should be. Simply because a latex condom, used consistently and correctly, will prevent the spread of HIV.’ (Library Reference)

In February, Secretary Shalala announced the eighteen members of the National Task Force on AIDS Drug Development, which includes experts in AIDS drug development issues from academia, industry, medicine, the HIV/AIDS-affected communities, and Government.  The Chairman of the Task Force is the Assistant Secretary for Health. The FDA (Food & Drug Administration in America) provides administrative and managerial support for the Task Force.

In March, the actor Tom Hanks won an Oscar for playing a gay man with AIDS in the film Philadelphia.

Philadelphia was was the first big-budget Hollywood film to tackle the medical, political, and social issues of AIDS.  Tom Hanks plays Andrew Beckett, a talented lawyer at a stodgy Philadelphia law firm. Andrew had contracted AIDS but fears informing his firm.  The firm’s senior partner, Charles Wheeler (Jason Robards), assigns Andrew a case involving their most important client. Andrew begins diligently working on the case, but soon the lesions associated with AIDS are visible on his face.

I won’t tell you more in case you’ve not seen it yet, (spoilers are never nice)! Suffice to say it’s all about prejudice and discrimination in legal setting in the early 90’s.  It’s nice to see that laws have since changed but today, 18 years on we still have a long, long way to go in order to stop the ignorance and stigma left behind!

On March 29, The FDA asked condom manufacturers to begin using the air-burst test on all brands of latex condoms. This new test measures a condom’s strength, and may be an indirect indicator of its resistance to breakage during use.

By July 1994 the number of AIDS cases reported to the WHO was 985,119. The WHO estimated that the total number of AIDS cases globally had risen by 60% in the past year from an estimated 2.5 million in July 1993 to 4 million in July 1994.

It was estimated that worldwide there were three men infected for every two women, and that by the year 2000 the number of new infections among women would be equal to that among men.

At the end of July, it was announced that the WHO’s Global programme on AIDS would be replaced. The UN Economic and Social Council approved the establishment of a new “joint and cosponsored UN programme on HIV/AIDS”.  The separate AIDS programmes of the UNDP, World Bank, UN Population Fund, UNICEF and UNESCO would have headquarters with the WHO in Geneva.  Later in the year it was announced that Dr. Peter Piot, the head of the research and intervention programme within the Global Programme on AIDS, would be the head of the new UN program.

Official statistics for Brazil, with a population of about 154 million, indicated that some 46,000 cases of AIDS had been recorded, but estimates put the actual number at anywhere between 450,000 and 3 million cases. Two thirds of the known cases were in Sao Paulo state where AIDS was the leading cause of death of women aged 20-35.

In early August 1994, the Tenth International Conference on AIDS was held in Yokohama, Japan. It was the first of the International Conferences to be held in Asia.  No major breakthroughs emerged, and it was announced that in future the international conference would be held every two years.

An exciting study, ACTG 076, showed that AZT reduced by two thirds the risk of HIV transmission from infected mothers to their babies.  It was the most stunning and important result in clinical acquired immunodeficiency syndrome research to date because it was the first indication that mother-to-child transmission of HIV can be at least decreased, if not prevented. And it will provide a real impetus for identifying more HIV-infected women during pregnancies so that they could consider the benefit of AZT treatment for themselves and their children.”

Meanwhile in the Russian Federation, deputies in the Russian Parliament, the Duma, voted at the end of October to adopt a law making HIV tests compulsory for all foreign residents, tourists, businessmen and even members of official delegations.

India by this time had around 1.6 million people living with HIV, up by 60% since 1993 (identical to the global figure). Local and state governments were accused of underusing and misusing HIV prevention funds.

In December, President Clinton asked Joycelyn Elders to resign from the post of US Surgeon General, following a remark during a World AIDS Day conference that children could be taught about masturbation.  She was asked whether it would be appropriate to promote masturbation as a means of preventing young people from engaging in riskier forms of sexual activity, and she replied, “I think that it is part of human sexuality, and perhaps it should be taught.”

This remark caused great controversy and resulted in Elders losing the support of the White House. White House chief of staff Leon Panetta remarked, “There have been too many areas where the President does not agree with her views. This is just one too many.”

Elders was fired by President Clinton as a result of the controversy in December 1994.

Perhaps this unfolds unhappy memories if you experienced this discrimination first hand but to our younger audience who may not have lived during these times, it’s important to understand that prejudice, stigma and discrimination remained significant obstacles for sex education, HIV prevention and AIDS awareness throughout the 1990s and into the new millennium.

In closing today, someone recently told me that Tim Radford (A freelance Journalist) wrote a special report “the progress being made in the fight against the cleverest and most malevolent virus scientists have ever seen”.  The report also examines issues of stigma, discrimination, and the effect HIV/AIDS has on families. – I’m afraid I can’t link to it, but if anyone has a copy, please get in touch!

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