Monthly Archives: May 2016

California lawmakers approve bill allowing HIV-positive organ transplants

Photo by Dmitry Kalinovsky/Shutterstock

Photo by Dmitry Kalinovsky/Shutterstock

California’s state government moved with a quickness Friday that may save a life by approving a bill allowing HIV-positive people to donate organs.

Both houses of the California legislature approved a bill that will allow an HIV-positive person to donate a liver to an HIV-positive patient in need, the L.A. Times reports.

California Gov. Jerry Brown announced through a spokesperson that he would sign the bill as soon as it reaches his desk after lawmakers managed to get both houses to vote to allow the surgery in less than an hour.

“Right now there is a felony associated with that donation,” State Sen. Ben Allen after introducing the bill for a vote. “We can save a life this month.”

Senate Bill 1408 was written this week after Dr. Peter Stock met with lawmakers about a patient requiring a liver transplant he could not perform, despite an HIV-positive healthy person willing to donate a part of their liver, because the donation is felony under state law, the Sacramento Bee reported.

“I am deeply concerned for these patients because their health is failing, and I am concerned that, by the time the Legislature is able to act in the ordinary course, the patients will be unable to receive a transplant due to deterioration or unavailablity of a donor,” Stock, a professor of surgery at the University of California San Francisco, wrote in a letter to legislators.

Despite federal law changing in November to allow transplants between HIV-positive people, and the first transplants already conducted at Johns Hopkins University in March, California, as well as several other states, still prohibited the procedures.

“This is a life-saving matter that aligns California with federal law and the governor will sign this bill as soon as it arrives,” Brown’s spokeswoman Deborah Hoffman said in a statement.

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UK Research Project: Experiences of diagnosis & living with HIV in past 5 years.

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Colleagues at Hull University have approached a number of sexual health organisations regarding a research project currently taking place at the University of Hull.

Their “Positively Different” study is exploring the experiences of young people (in the age range 18-35) who have been diagnosed with HIV in the past 5 years.

The research will explore people’s experiences of diagnosis, and living with HIV: this includes the challenges and difficulties people experience, as well as the things that help people live well with HIV.  We hope that the study will help to understand whether, as medical approaches to HIV have evolved, the lived experience of HIV has also evolved and changed.

The findings of this research should be of interest to people living with HIV, support organisations, and agencies providing health and social care, education and information.

You can take part in the research through taking part in a confidential online survey. This can be accessed at https://positivelydifferent2015.wordpress.com/. The survey includes questions about receiving a diagnosis, telling other people, whether people have received support, whether people’s feelings about living with HIV have changed over time.

In addition, people can take part in the research by taking part in an interview. The survey will be available until 30th April 2016.

The research is being carried out by Liz Walker (E.Walker@hull.ac.uk) and Caroline White (C.White@hull.ac.uk) at the University of Hull. They welcome the involvement of all members of the community, and are interested in hearing about people’s experiences, both positive and negative.  The research project has been approved by the relevant University of Hull Ethics Committee.

If you have any questions about any aspect of the research, please contact either of the researchers working on the study.

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Hospital will ‘automatically’ test emergency patients for HIV under Elton John partnership

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Sir Elton John has launched a new hospital initiative at a London hospital which will see all patients in the Emergency Department routinely tested for HIV.

107,800 people are living with HIV in the UK ,and of these 24% are undiagnosed – with higher rates in Greater London

Story via Pink News
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Under a new scheme at King’s College Hospital, every patient over the age of 16 who is having their blood tested will be tested for HIV at the same time, unless they choose to opt out.

It is hoped that including HIV tests in routine blood screening will help to identify the large number of people with HIV who are unaware of their status, who would not otherwise be tested.

Sir Elton John and David Furnish visited King’s yesterday to launch the initiative, which aims to reach 34,000 Londoners in its first 12 months of operation, in partnership with the Elton John Foundation.

Similar procedures have been implemented in other London hospitals, including Chelsea and Westminster Hospital and St Thomas’ Hospital – though the practise has not been taken up outside London.

Sir Elton John said: “Twenty-three years ago it was my privilege to open the Caldecot HIV Treatment Centre at King’s College Hospital.

 “At the time, there was so little that could be done to prevent the sickness and death caused by HIV/AIDS, or to ease suffering and prevent infection.

“It was heartbreaking. So it’s incredible to think that today King’s can introduce something which not only stops people becoming sick needlessly, it prevents new infections and saves precious resources.

“I’m deeply proud that my Foundation has been able to support King’s in this endeavor and to see a British hospital leading the kind of innovation that will get us to an AIDS free future.”

Dr Cyril Noel, Consultant in Emergency Medicine said, “We’re extremely grateful to the Elton John AIDS Foundation for the grant that has allowed us to implement universal HIV testing.

“Lambeth and Southwark have some of the highest levels of HIV in the UK. There’s no reason why people should get sick or die from HIV, and one of the most common reasons they do is because they don’t know they have the infection. Universal testing is a significant step in addressing this.”

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HIV activism: ‘It feels more like social work than my day job in adult services’

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Photograph: Niall Carson/PA

Story by Nathan Fox, via The Guardian
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I want people with HIV to live free from oppression, & for the NHS and social services to become HIV-neutral in their activities

I was diagnosed with HIV in 1994, a time of moral panic about the condition. The stigma I had internalised about HIV, combined with that of sex and sexuality, made me to hide the diagnosis from family and friends for six years. Consequently, and despite physically managing the condition well with antiretroviral medications, I have battled with depression since. While in mental health recovery, I realised I wanted to work in a helping profession and qualified as a social worker in 2010.

I won’t be the first person from a disadvantaged group who has been motivated to do social work. But having worked in a range of adult health settings since qualifying, it has failed to satisfy me, so in July 2015 I founded Live HIV Neutral – an activists’ working network. Its focus is challenging HIV stigma and it aims to broaden the dialogue about HIV prevention to the mainstream arena; only in such forums will stigma be overcome. It is closer to the type of work that inspired me to become a social worker in that it aims to bring about change in society. As the job did not exist, I had to create it. It is unpaid, so I manage it alongside my day job in adult social care.

Many people ask me why I want to do unpaid activism on top of a stressful job in statutory adult services. The honest response is that if I only did the paid work, I would probably no longer be a social worker. The ever-narrowing definition of social work to include primarily legally indicated tasks, such as safeguarding adult investigations and best interests assessments, is not enjoyable. There is little emotional succour in this work, so I try to redress the balance elsewhere. The faultline between social work and community work is debatable. But, to me, this activism feels more like social work. It is what makes the day job bearable.

The shift from traditional social work roles toward a more refined definition of tasks was catalysed by a desire to define the professionalism of the sector. There is certainly a need to distinguish between social work and other professions. But I am uncertain whether it’s wise or possible to draw clear lines between social work and community work. I consider much of third sector activity to be social work, which is shown by the growing dependence of social services on this sector to provide essential services: for instance, adult social care’s working relationships with Age UK and carer’s centres.

Live HIV Neutral aims to empower people to make changes in their lives, to live free from discrimination and oppression, and to have an equal voice in society. If that is not a social work role then I am not a social worker. And there is a dire need for community capacity building in this area at a time of harsh local authority cuts. HIV services are linked to sexual health services and these remain the responsibility of local authorities in England. Many people fear losing essential resources as ill-informed commissioners decide the future of services they do not understand.

Further local authority cuts are inevitable. Rather than directly fighting them, I believe it is time for HIV and other blood-borne viruses, such as hepatitis C, to be redefined as the responsibility of the NHS. This would ensure essential health services are funded from budgets with more protection. In addition, it would contribute to challenging stigma. Not everyone who has HIV or hepatitis C got it through sex. And many people who did acquire infections via sex report the experience of attending sexual health clinics as oppressive. Some people with HIV choose to abstain from sex rather than negotiate relationships, yet when they attend blood tests they are routinely asked how many sexual partners they have had.

Another casualty of the cuts in many regions is HIV specialist social worker posts. This is concerning many people who have relied on this specialism to overcome the stigma they face. The cut means social workers in generic care teams are now engaging with people with HIV. This risks people with a lack of specialist knowledge trying to negotiate a stigmatised health condition.

I don’t doubt that some people will say things in ways that others experience as stigmatising. But, despite this, enabling a wider social work cohort to develop knowledge about HIV is a good thing. As people with HIV age and manage co-morbidities such as strokes or diabetes, this knowledge base will increasingly be secondary to another specialisms. Perhaps it is via the education of a wider health and care cohort that HIV stigma will begin to be challenged in these professions, in a similar way as we have seen with mental health stigma.

And that is where the network comes in. We aim to take the conversation about HIV beyond the bubble of the HIV sector. We want mainstream organisations, such as the NHS and social services departments, to consider how they can become HIV neutral in their activities. As a social worker in an integrated health and care landscape, this is the challenge I need to take on. So we have developed the Live HIV Neutral pledge and, for World Aids Day 2016, we want to see organisations taking the pledge and telling society what living HIV neutral means to them. We do not want symbolism, we want meaningful action.

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Three things you think you know about gay men and HIV

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Critics of PrEP, the daily pill that stops people getting HIV, say that gay men just need to change their behaviour, not take a preventative medicine. Here is why that alone is not the answer

When the Pill was introduced, there was an immediate backlash, as people felt it would encourage promiscuity. We managed to overcome that stigma, and over 50 years later we are on the cusp of something similarly revolutionary in regards to HIV.

Article via 
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PrEP, a daily pill that stops people getting HIV, could soon be provided on the NHS. For gay men, the demographic most at risk, there is the very real possibility that they too will be able to have sex without life-changing consequences.

Yet like the Pill, PrEP is not without its critics – we are seeing many of the same arguments, often made by heterosexuals with a low HIV risk, being rolled out to deny gay men PrEP.

It’s important to remember that it’s not just gay men who get HIV, but often the main arguments against it are based on judgements about their behaviour.

1. “Just stop sleeping around”

Shaming anyone’s sex life isn’t an effective way to prevent HIV and whilst it stands to reason that the less people you sleep with the less chance you have of getting HIV. It’s not that simple.

For gay men the odds are stacked against them from the off. One in 20 gay men in the UK has HIV. This compares to 1 in 1,000 straight people.

If you are a sexually active gay man, you have a high chance of sleeping with someone with HIV.  If he is one of the 14 per cent of gay and bisexual men who aren’t aware that they have HIV, there is a real risk you will acquire it from them.

People who have diagnosed HIV and are on effective treatment areessentially non-infectious.

2. “Use condoms”

People say that giving gay men PrEP will mean they are less likely to use condoms. The UK-based PROUD PrEP trial, which was designed to understand how PrEP would be used in the real world,showed that this wasn’t the case.

Condoms used perfectly are 98 per cent effective, but this isn’t a realistic scenario. They can break or come off – this brings overall effectiveness to 85 per cent. This is without factoring in the times people are just too drunk or turned-on and decide to chance it.

Let’s face it: people do make bad decisions in the heat of the moment.

Clearly condoms have been, and will continue to be, vital to the fight against HIV.  Scientists have concluded that if gay men had given up on condom use entirely between the years 2000 – 2010, we would have had 400 per cent more new infections.  With around 2,500 gay and bisexual men acquiring HIV a year though, condoms have clearly not managed to crush the epidemic single-handedly.

3. “Just pick a partner and stick with them”    

In reality, more men get HIV from their boyfriend or regular partner than from casual sex – promoting monogamy isn’t a catch all solution.

Clearly, what we have been doing hasn’t stopped HIV or even slowed it down amongst gay men (each year a record number get diagnosed with HIV).

But we have something that works – PrEP.

PrEP is at least as effective as condoms in preventing transmission. In the three major studies on PrEP, there were no instances of someone who was taking PrEP, in the correct manner, acquiring HIV.

By all means if condoms work for you, keep doing what you’re doing – but if that was enough, we would have stopped HIV in its tracks a long time ago.

We need to keep the options open for everyone, and level the playing field for populations facing an unfair burden of HIV, meaning they can have the privileges that so many of us take for granted – the chance to have sex without fear.

 

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HIV+ and worried about cancer? – You should be, read this and find out why.

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Breakthroughs in medicine made it so a HIV diagnosis is no longer a death sentence; staying well with the illness is way less complicated than it used to be. That is, unless you are HIV-positive and get cancer.

Article via NewsWeek

A study conducted by researchers at the University of Utah, the National Cancer Institute and the American Cancer Society and published earlier this week says HIV patients in the U.S. are much less likely than the general population to receive treatments for cancer, whether it has affected the gastrointestinal system, lungs, cervix, prostate, breast or blood.

Patients with HIV have a significantly higher risk for certain cancers, known clinically as AIDS-defining cancers. These include Kaposi sarcoma (a soft tissue cancer that causes lesions in the lymph nodes and mucous membranes), cervical cancer and non-Hodgkin lymphoma. The diagnosis of any of these cancers for someone who has HIV is considered a clinical sign that the infection has progressed to AIDS.  (Don’t know the difference between HIV & AIDS? – Click here to read more).

According to the National Cancer Institute, people with HIV are several thousand times more likely than people without the disease to develop Kaposi sarcoma. They are 70 times more likely to develop non-Hodgkin lymphoma. HIV-positive women are five times more likely to be diagnosed with cervical cancer. In addition, HIV increases the risk for most common cancers, including those in the breast, prostate and lungs and colorectal cancer.

HIV is also often associated with other viruses that can cause or are related to certain cancers. For example, patients diagnosed with HIV may test positive for the human papillomavirus, which causes cervical cancer and some other types of cancers of both the male and female reproductive systems. HPV is also the cause of some head and neck cancers. Other viruses often diagnosed in people with HIV are Epstein-Barr and hepatitis B or C, all of which are linked to certain cancers.

To better understand how cancer specifically affects the HIV-positive community, researchers looked at data from the National Cancer Data Base on non-elderly adults diagnosed with several common cancers from 2003 to 2011, comparing 10,265 patients with an HIV diagnosis and 2,219,232 without. The researchers looked at rates of common types of cancer treatments across both populations, including chemotherapy, surgery, radiation or any combination. The result were published in the medical journal Cancer.

After adjusting for factors such as whether patients had health insurance, the researchers found that across the board, HIV-positive cancer patients were still significantly less likely to receive standard oncology treatments. For example, 32 percent of HIV-positive patients with lung cancer weren’t receiving treatment, versus 13.6 percent of lung cancer patients without HIV. HIV-positive patients with cancer of the upper gastrointestinal tract were more than twice as likely to go without treatment than those who didn’t have HIV. These disparities still existed for HIV patients who were privately insured, but those on Medicare or Medicaid, or uninsured, were even less likely to get cancer treatments.

However, the authors say the study shows health insurance isn’t the only cause behind the cancer treatment disparities. One finding indicates race and ethnicity could contribute to limited medical care: HIV patients who were black tended to fare worse. The authors also suggest the disparities could be driven by the lack of research on the relationship between cancer and HIV—for example, whether certain chemotherapies and cancer drugs are safe to use on HIV-positive patients.

“HIV-infected patients with cancer have historically been excluded from cancer clinical trials, thereby limiting the applicability of clinical trial results for this population,” the researchers write in the conclusion of their study. Oncologists often feel less confident when treating these patients, which results in poor survival outcomes.

Rates of cancer mortality among patients with HIV/AIDS have decreased significantly since the introduction of antiretroviral drugs. These drugs lower the amount of virus circulating in the blood, which boosts immune system function, preventing the HIV virus from progressing to AIDS. The introduction of these antiretrovirals in the marketplace in the 1990s also significantly reduced the rates for Kaposi sarcomas and non-Hodgkin lymphoma.

But antiretroviral drugs don’t fully restore immune system function, and their efficacy slowly diminishes over time, leaving HIV patients susceptible to cancers later in life. Additionally, many of these drugs are still relatively new, and no one knows for sure what the long-term impact may be for patients who take them for the full duration of their life. Regardless of these factors, the older a person is, the higher his or her risk for cancer.

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Talking sex, drugs and emptiness with a chemsex playwright.

Dionysis Livani

Dionysis Livani

A Soho bender ends in sex, G and crystal meth
A club night poster boy ends up at Old Mother Meph’s with a pornstar
Fag Hag Cath is definitely not doing drugs tonight
A sexual health worker goes to his first chillout
Rob’s snorting mephedrone off a photograph of his parents

The Chemsex Monologues

The UK’s gay community is in a state of flux. While some of us dream of same-sex marriage and settling down in a house in the suburbs, others demand that an anti-assimilationist agenda prevails – we must reject the desire to conform at all costs, and continue to “be” in our own queer way.

Article via DAZED
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In the 80s, at the height of the AIDS crisis, a queer identity was formed and fiercely contended with, but today’s sanitised British gay scene has pushed this debate to the fringes of our community. Super clubs like G-A-Y and Heaven are thriving while dingy, dirty queer bars quietly disappear. Pride in London has become a corporate-sponsored street party, not a boundary-pushing radical protest.

Same-sex marriage was all well and good, but there’s an all too deafening silence when another HIV crisis gets going, when trans people of colour are murdered, when the Home Office demands queer asylum seekers prove that they’re not straight. Some gay men want to keep their heads down, to quietly fit into the heterosexual word that engulfs us, and others simply don’t. To put it simply, there’s a “good gay vs bad gay” divide.

Debate in any community is healthy. But it feels like these discussions are often muted, and it’s dangerous. Men are cast out for presenting as “femme” and refusing to adhere to expectations of masculinity. When we talk about the life-saving HIV-prevention drug PrEP, it’s often fraught with accusations of promiscuity. The chemsex scene can in many ways be seen as the heart of silenced battle. Long, drug-fuelled sex sessions are rife in the UK and beyond, with gay men partying for days on end with bodies charged on a concoction of powders, pills and liquids.

At first glance it would be easy to think that those who take part in these parties are rejecting normal modes of being, but the reality is much more complex. The lines of division in this strange “good gay vs bad gay” rift are blurred. Chemsex sessions aren’t just populated by anti-assimilationist queers who’ve made an active decision to reject the norms society imposes on us.

The Chemsex Monologues, a new play by Patrick Cash, might well provide an opportunity for us to start talking. Patrick’s script tells the stories of five fictional characters each navigating their way through the complex and confusing chemsex scene.

“We get perspectives in the monologues from sexual health workers, a female friend of a guy on the scene, as well as three men making their way inside it,” he says to me, when we meet outside56 Dean Street.

The Chemsex Monologues might well be the desperately needed conversation starter we’ve been waiting for, because as a phenomenon it transcends the usual boundaries of ‘homonormativity’ v aggressively queer. “What’s interesting on the chemsex scene is that the good v bad divide morphs”, Patrick explains.

“A lot of these guys are practising ‘good gay’ in the week: in their 20s and 30s, holding down good jobs as lawyers, dentists, recruiters in the city.” Only last week Henry Hendron, a well-respected city lawyer, was sentenced to 140 hours of community service for buying the mephedrone and GBL his 18-year-old boyfriend took before tragically dying in their bed.

That veneer of respectability was stripped away. Grindr and private Facebook groups allow for these parties to be organised in secret, with no need to be seen queuing and resurfacing at a visible public club. It took a dire accident to pull the issue to the surface, and yet still the headlines were judgemental. The Chemsex Monologues opened in London this week, and Patrick hopes it’ll provide a catalyst for gay men on the scene and outside it to talk openly about what’s really going on.

“With drama and creating characters you can show the emotional empathy in an arc”, Patrick says, “with no need for snippets of articles or docs. Therefore, you can make an audience feel more connected, make the character identifiable and provide a fuller view.” Chemsex has become a phenomenon – a spectacle that those outside the scene seem desperate to comment on. But beneath the judgemental headlines and voyeuristic depictions on screen lies a debate that needs to be raging amongst the gay community. And right now it’s not.

“I see the play as a springboard to explore how chemsex has become a spectacle for those outside the gay community”, Patrick tells me. “It’s a chance to look at how it’s being used by some to judge and comment on the gay community. I was interested in the people beneath the drugs. Chemsex has become a buzzword that people talk about constantly – featured in films and articles, and it’s become a storm – there’s a polarisation of the good gay vs bad gay, and I wanted to take that away and see who these people are taking the drugs.”

“I was interested in the people beneath the drugs….there’s a polarisation of the good gay vs bad gay, and I wanted to take that away and see who these people are taking the drugs” – Patrick Cash

Patrick’s interest in the scene comes from his own personal experience. As a student in London he worked in a Soho bar, just around the corner from our little meeting, to make ends meet. “The guys who I worked with were pretty much my age, and we’d head to Vauxhall after work together.” Patrick had taken drugs since 16 – but it was in here he first took G.

“I took a shot of G in a pint – even though you’re not meant to mix it with booze. I said ‘put it in here’, and the guy did as I asked”. Half an hour later he woke up in the medics room. Just a short while later Patrick saw a post on Facebook, a man had died from a lethal concoction of drugs and alcohol in a club down the road.

After a year or two out of the city, Patrick returned and soon found himself immersed back in the scene.

“I started going to chill outs after nights out, and sure there were parts of it that were fun”, he says, smiling. “Going out and dressing up and having fun.” He said to himself at the time that as long as he enjoyed himself while on mephedrone and G, and could carry on with his job during the week, then what was there to worry about?

“The trouble was the Tuesday come down, the irritability, which was a nightmare at work. It got dark, cyclical and I felt trapped. I’d come home and start thinking it wasn’t fun, a little bit sad, lonely, I was taking drugs to express an emotional need through physical intimacy.” He’d go home and never see these people again, it started to feel dangerous and hollow.

“I realised I was chatting between sex about my fears and desires – it’s why I set up Let’s Talk About Gay Sex and Drugs. It’s why I wrote the monologues.” He’s right. Instead of sticking up our communal noses, we need to be talking frankly about why it is that gay men are so often looking for community and emotional connection with strangers in the heady downtime between sex. Instead of bemoaning the fact that some within our community want to take drugs and have fun, we need to do all we can to ensure people are safe – ensuring we know the reality of the dangers of certain substances.

And yes, sexual liberation maybe shouldn’t be celebrated whatever the cost. We’re in the midst of a sexual health crisis, and reckless sexual interactions – however fun – have consequences beyond your own gratification. Drugs like GHB might do wonders for your libido, but at the expense of your inhibitions meaning that unprotected sex becomes increasingly commonplace.

We need to talk about chemsex, and the divide it’s so often accused of representing. There’s a sexual health crisis sweeping the gay community, and a mental health pandemic too. Patrick’s experiences, and those of many others, are of finding a sense of belonging and community on the scene, and with the closure of charities, venues and support spaces it should hardly come as a surprise. We’re taking drugs and mixing them dangerously, and our messed up drugs laws and education policy encourage it.

And no, that doesn’t mean that taking drugs and having sex is the morally reprehensible cause, or that if you want to make connections with people while having sex and doing lines you’re somehow a lesser person. It simply means that we need to be talking. As Patrick put it to me, if you want to build relationships on substances then that’s up to you, but there needs to be space to build relationships with substance too.

The Chemsex Monologues is running from May 17th-21st (7pm) at the King’s Head Theatre, 115 Upper Street, N1 1QN. Tickets £18, £15 concs (£10 previews 17th) Click here to book tickets.

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