Tag Archives: CDC

10 things you need to know about the pill to prevent HIV

The Magic Pill

It’s been called, simultaneously, a medicine to “end the HIV epidemic” and a “party drug:” Pre-exposure prophylaxis, or PrEP for short, refers to a daily antiviral treatment that prevents HIV.

That’s right: People who don’t have the virus can take a pill a day to save themselves from getting infected.

Haven’t heard about PrEP? You’re probably not alone. The drug-maker, Gilead, doesn’t advertise Truvada (its brand name) for prevention, and the Centres for Disease Control and Prevention only endorsed it this past May—two years after it hit the market.

Want to learn more about PrEP, (click here).

Going forward, however, you’ll be hearing a lot more. On Friday, the World Health Organization backed the antiviral, recommending all HIV-negative men who have sex with men consider taking it as part of a strategy to reduce the global incidence of the disease. But there’s a lot more to the story. Here’s what you need to know:

1) Public health officials aren’t recommending this pill for “all gay men,” despite what the headlines say

The pill is “for people who do not have HIV but who are at substantial risk of getting it,” according to CDC guidance. “At substantial risk” means you regularly have unprotected sex with partners of unknown HIV status. This can include men who have sex with men, heterosexual men and women, injection drug users, sex workers, and people in couples with an HIV-positive partner. In other words, not simply “all gay men.”

The latest headlines about Truvada were so misleading that the WHO had to issue a clarification noting that they support PrEP “as an additional choice”—again, not for all men who have sex with men.

“We know from surveillance that condom use is not as high as is necessary to control the epidemic”

2) Truvada is not a condom replacement

Public-health officials are not endorsing Truvada as an alternative to other forms of protection. “We are suggesting that for people who are already not using condoms, we have another option to help protect them from HIV infection,” says the CDC’s Dawn Smith, biomedical interventions implementation officer. “It’s part of being practical and realistic.” So the hope is that those who get prescriptions are folks who just aren’t using anything to protect themselves. “We know from our surveillance systems that condom use is not as high as is necessary to control the epidemic,” Smith added.

3) We don’t yet know exactly how the drug will be used in real life

Still, this public-health message hasn’t stopped some activists and AIDS campaigners from worrying aloud that the pill will undermine traditional advocacy messages about condoms—especially at a time when HIV infections are on the rise among gay men. And the truth is, we don’t yet know what kind of impact PrEP will have on people’s behaviour.

To find out, there are now “demonstration trials” being run around the world. These will look at how Truvada works outside of clinical trials, the impact of non-daily use of the drug, and whether the antiviral encourages more risky sexual behaviour or leads to an increase in other sexually-transmitted infections.

4) We do know Truvada only works effectively when taken every day

A three-year clinical trial of PrEP in HIV-negative men who have sex with men found that users got much more protection when they took the drug every day. Participants who took the drug less than half the time had a 50 percent reduction in HIV acquisition; daily users cut their risk by more than 90 percent. These results have been supported by other studies in a range of populations—from injection-drug users to heterosexual men and women. The trouble is, most people don’t take their medications as their doctors prescribe.

Drug-resistant strains of HIV have emerged when people with acute, undetected infection were given Truvada

5) Truvada can cause drug-resistant HIV infection

Drug-resistant strains of HIV have emerged when people with acute, undetected infection were given PrEP. This means they were positive when they started the medicine, but levels of the virus in their blood were hardly detectable because their infections were so new. They hadn’t made enough antibodies to show up in a test and so they were prescribed the drug anyway.

There’s some question about how serious this risk is for individuals and public health. For now, doctors are asked to confirm the HIV status of patients and to do follow-up and re-testing throughout treatment.

When asked how much of a concern drug resistance is, Smith of the CDC said, “We don’t know yet. That’s one of the things we’ll learn as the first few demonstration projects begin telling us.”

6) Besides that, it’s pretty safe

Though Truvada for the prevention of HIV was only licensed by the Food and Drug Administration in 2012, it was first authorized in 2004 to treat HIV positive patients. That’s right: the same drug used for these two purposes. Since it has been on the market as a treatment for over a decade—with very minimal side effects and harms—doctors are pretty confident in its safety profile for preventative use. There seem to be few side-effects with Truvada for prevention, the most common one being nausea.

People have been slinging the term ‘Truvada whore’ around, and the head of the aids healthcare foundation called the pill a ‘party drug’

7) “Truvada whores” are a thing

Because of the questions about whether PrEP will cause people to have risky sex and ditch condoms, there’s some related stigma in the gay community. People have even been slinging the term “Truvada whore” around, and the head of the AIDS Healthcare Foundation called Truvada a “party drug.” In response, one PrEP activist created a #TruvadaWhore t-shirt campaign to reclaim the word.

Many have pointed out that this divide parallels the early days of the birth control pill and suggestions that the medication would encourage promiscuity.

8) Uptake has been slow—but that’s not the full story

According to data from the drug maker Gilead, by March 2013 there were approximately 1,774 people in the US taking the drug. But it’s important to put this number in context. First of all, these findings were not published and peer-reviewed; they were presented at a scientific conference last year. When studied, we’ll have a better picture of the PrEP landscape and it may look quite different.  Secondly, Truvada has only been on the US market for prevention since 2012, a year after these numbers were gathered. It often takes decades for innovations to penetrate a market, especially in the conservative field of medicine.

9) The drug is expensive

Without insurance, Truvada can cost up to $14,000 a year, according to the CDC. But for most people, it is covered in their insurance programs and there’s only a co-pay. There are also medication assistance programs across the US for the uninsured that will cover the entire cost of the medication.

10)  HIV remains a socio-economic crisis around the world

Globally, men who have sex with men, prisoners, injection-drug users, and sex workers are still the groups most affected by HIV.

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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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Aging & HIV

There’s no denying the life-extending benefits of antiretroviral therapy. While it has allowed many people living with HIV to plan for their golden years, it has also meant preparing to face age-related health problems. According to the CDC, 25 percent of those living with the virus are over 50 years old.  In turn, there’s a growing need for comprehensive  care to prevent and manage typical age-related maladies, such as heart disease, cancer, diabetes and osteoporosis—all of which can be complicated by HIV and its treatment.
You can find comprehensive information about treatment options from your GP and the people over at http://www.aidsmeds.com have written an excellent report into HIV & Ageing covering:
  • What is aging, and why do we become ill as we get older?
  • How does HIV affect the aging process?
  • Are people with HIV aging more rapidly?
  • Is it possible to slow down the aging process?
  • Are there experimental treatments to slow aging in people with HIV?

The good news is that most HIV-positive people can do quite a lot to slow the aging process and guard against the onset of age-related illness. So why not head over there and understand how aging works in the first place, and what you can do to help yourself..

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A History of HIV & AIDS

Welcome to our new Twitter followers and Blog subscribers! – Thank you for following us, many of you have arrived from our recent news, Archbishop Emeritus Desmond Tutu honours LASS in his role as International Patron of LASS and we hope you enjoy this site.

The Red ribbon is a symbol for solidarity with...

The Red ribbon is a symbol for solidarity with HIV-positive people and those living with HIV. (Photo credit: Wikipedia)

We are here to to respond to the challenges of HIV, and over the next next few weeks, as we prepare to enter our 25th year, we’d like to take a moment to reflect on the past 25 years as HIV and AIDS have 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.

On 5 June 1981, the US Centres for Disease Control (CDC) published a report describing cases of a rare form of pneumonia among five gay men in Los Angeles. Soon after, there are a number of reports of a rare skin cancer, Kaposi’s sarcoma, increase among gay men living in California and New York.

In 1982, the term A.I.D.S. (Acquired Immune Deficiency Syndrome) is used for the first time. Prior to this, it was called G.R.I.D. (Gay Related Immune Deficiency) and was associated with homosexuality because it was first documented among gay men in New York and California.  It was only in 1983 we began to get evidence that AIDS is caused by a virus (sic), this emerges from the Pasteur Institute in Paris. The US reports that more than 1,200 Americans have been affected by AIDS and more than one-third of them have died.

The number of cases doubles each six months, it is officially an epidemic and the deadliest since swine fever ravaged the US at the end of the first world war.
In Geneva, the World Health Organisation convenes the first meeting to discuss the international implications of AIDS, which has so far been found in dozens of countries, and has now been found in both women and men.

The Human Immunodeficiency Virus was isolated by scientists in the US and France (though it was not formally named as HIV until 1986). Later, a public controversy erupts over who first discovered HIV, and eventually over who would get the Nobel Prize for it.

Along with the discovery of the virus, the first diagnostic blood test, known as the Elisa test, is developed to screen for HIV infection.

This photo of Ryan White was taken by me (Wild...

This photo of Ryan White was taken in the spring of 1989 at a fund raising event in Indianapolis, Indiana. (Photo credit: Wikipedia)

Ryan White, a haemophiliac teenager who contracted HIV from contaminated blood products in 1985 is barred from school.  He soon becomes one of the most bravest, and well-known advocates for AIDS research and awareness in America.

1985 also marks the year that Hollywood actor Rock Hudson dies of an AIDS related illness. He had recently publicly disclosed his AIDS diagnosis.

The first international Aids conference is held in Atlanta, Georgia and 1986 marks the discovery of a second type of HIV, eventually named HIV-2, it’s discovered by US and French research teams. Jon Parker, a former drug user, starts the first needle-exchange programme in the US to combat HIV among intravenous drug users and The World Health Organisation launches the Global Programme on Aids. The programme will later end and be replaced by UNAids, the UN Aids agency.

Stay tuned over the next few days for more information as we reveal more, of the history of HIV and AIDS.

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