LGBT Health Education Blog
The International AIDS Conference continues in Washington, DC, with many of our faculty, colleagues and collaborators participating. The full conference schedule is available at this link: www.aids2012.org. Also, follow Fenway Health’s live tweets from the IAC at @FenwayHealth.
Here is a run down of sessions for the rest of the week featuring researchers from The Fenway Institute, our parent organization.
WEDNESDAY, July 25
- Differences in psychological, social, substance use and HIV sexual risks between urban Black Men who have Sex with Men Only (BMSMO) and Black Men who have Sex with Men and Women (BMSMW) (Ken Mayer)
- When Worlds Collide: Differential Concerns of IRBs Reviewing a "Buy Study" Protocol (Julia Gaggin, Patricia Case)
- An RCT of an intervention to reduce HIV sexual risk and increase self-acceptance among MSM in Chennai, India (Steve Safren, Ken Mayer, Matthew Mimiaga
- Knowledge of and attitudes toward PrEP in a New York City sample of MSM. Sean Cahill.
THURSDAY, July 26
- Leadership Institute for Black Gay & Bisexual Men. Biomedical HIV Prevention Research: A Bridge to the End of AIDS. Ben Perkins, Charlie Gregor.
- From promise to Programmes: Treatment as Prevention. Patients in routine HIV clinical care at-risk for potentially transmitting HIV in the "test-and-treat" era of HIV prevention. Ken Mayer, Matthew Mimiaga, Steve Safren.
- Out in the World: Global MSM HIV Epidemics. Non-adherence to HIV testing guidelines and late HIV diagnosis is common among U.S. black men who have sex with men (MSM); Effect of early versus delayed initiation of antiretroviral therapy (ART) on clinical outcomes in the HPTN 052 randomized clinical trial. Ken Mayer.
- Satellite Health Sector Partnerships: Creating Local Clinical Service Networks for MSM in Diverse Global Settings. Rodney VanDerwarker, Ken Mayer.
- HIV-infected Men Who Have Sex with Men (MSM) who report Very High Rates of HIV Sexual Transmission Risk Behavior: Developing a Context for Novel HIV Prevention Interventions. Connal O’Cleirigh, Ken Mayer, Wade Taylor, Steve Safren.
- The Global Picture: Transgender Health and Rights. Ken Mayer.
FRIDAY, July 26
- The cost-effectiveness of treatment as prevention: analysis of the HPTN 052 trial. Ken Mayer.
Our parent organization, The Fenway Institute, held a pre-conference satellite event yesterday, entitled Pre-Exposure Prophylaxis (Prep) For HIV Prevention: Maximizing Success. The panel, which included advocates, policymakers, funders, clinicians and researchers, examined how PrEP implementation might vary geographically and by population, and how to minimize barriers to implementation. Sean Cahill, Director of Health Policy Research at The Fenway Institute co-moderated the panel with Lisa Diane White, Director of Programs for Sister Love.
Programs today and tomorrow involving our faculty, colleagues and collaborators include:
MONDAY July 23, 2012
- Health Disparities and the U.S. MSM HIV Epidemic. Ken Mayer, HPTN 061 Protocol Team. An evolving concentrated epidemic: comparison of socioeconomic, behavioral and biological factors among newly diagnosed, previously diagnosed and HIV-negative black men who have sex with men in six US cities. Also, correlates of HIV incidence among black men who have sex with men in 6 U.S. cities.
- Treatment as Prevention: A Work in Progress. Ken Mayer. Sustained Treatment as Prevention: Continued Decreases in Unprotected Sex and Increases in Virological Suppression after HAART Initiation Among Participants in HPTN 052.
- Bridging Session Treatment as Prevention: Is It Time for Action? Ken Mayer.
TUESDAY July 24, 2012
- Implementing PrEP: Current Progress and Future Challenges. Ken Mayer.
- Antiretroviral Prophylaxis: Attitudes And Implementation. Anticipated Risk Compensation With Pre-Exposure Prophylaxis Use Among North American Men Who Have Sex With Men Using An Internet Social Network. Ken Mayer, Matthew Mimiaga.
- The Lancet 2012 Special Theme Series: Men Who Have Sex with Men and HIV. Ken Mayer.
In addition many of our Fenway Health and Fenway Institute colleagues have posters at the conference. The full conference schedule is available at this link: www.aids2012.org. Follow Fenway Health’s live tweets from the IAC at @FenwayHealth.
National HIV Testing Day (NHTD) is this week, June 27, 2012. This is the 19th year for NHTD. The CDC estimates that 1.2 million people in the United States are living with HIV and that 1 in 5, or about 240,000 individuals are unaware they are HIV positive. HIV continues to disparately impact gay and bisexual men, and particularly gay and bisexual men of color.
The U.S. Centers for Disease Control and Prevention (CDC) recommends routine HIV screening as part of primary care adolescents and adults, and repeat screening at least annually for those at high risk. High risk behaviors include injecting drug use, unprotected sex with men who have sex with men, sex work and diagnosis and/or treatment with hepatitis, tuberculosis or STIs, and unprotected sex with anyone who falls into one of the above categories, or with some someone whose history is unknown.
Health centers across the country are getting folks in their communities tested, offering free walk-in testing events that coincide with cookouts, free haircuts, and consciousness-raising walks. The CDC’s listing of events is here: link.
Check out our website resources pages for links to many additional HIV testing and treatment resources (link). Also, our colleagues at the National Association of Community Health Centers have developed numerous tools and guidelines for incorporating HIV screening into primary care. Their tools have been tested and evaluated by health centers (link).
The Centers for Disease Control and Prevention (CDC) recently updated their fact sheet on HIV among gay, bisexual and other men who have sex with men (MSM). The news, unfortunately, is not good. In the US, HIV continues to affect gay and bisexual men more severely than any other group. Among MSM, Black/African American men bear the most disproportionate burden of HIV and young men of color continue to represent increasing proportions of new infections. The fact sheet is available on our resource page (link).
Check out Urbanite Baltimore's noteworthy profile of openly lesbian health care provider Tonia Poteat, PhD, who was recently appointed Senior Technical Advisor for Most At Risk Populations by the Office of the U.S. Global AIDS Coordinator. As a physician assistant at Chase Brexton Health Center (a LGBT-focused health center in Baltimore) Dr. Poteat cared for at-risk transgender patients at Poteat's coming out story was told in the 2007 documentary For The Bible Tells Me So, which profiled Christian families’ struggles to accept lesbian and gay children. Dr. Poteat also did a stint with the CDC and the World Health Organization monitoring and evaluating HIV treatment programs in sub-Saharan Africa. It is inspiring to read about a provider so dedicated to reaching the most vulnerable populations.
Our director, Dr. Harvey Makadon, was the keynote speaker at the third annual LGBT Health Student Symposium, a gathering of medical, nursing and social-work students from around the country. The symposium was organized by Howard Brown Health Center, Center on Halsted and the University of Chicago Medicine. The Windy City Times reported on the conference.
Dr. Makadon stressed the importance of asking patients about their sexual orientation and gender identity, and discussed transgender health care in depth. Speaking about how transgender patients may seek health care providers’ assistance to transition, he stated, "Someone once said, 'The source of identity is in your soul.' It's not so much a transition, but an affirmation of what has always been."
Also at the conference, representatives from Chicago Black Gay Men's Caucus (CBGMC) discussed the disparate impact of HIV on Black men who have sex with men (MSM). Other speakers discussed stigma and discrimination; transgender health; LGBT inclusion in medical school curriculum; and LGBT mental health.
Morehouse School of Medicine
Thursday, April 19, 2012
Last week, the White House Office of National AIDS Policy (ONAP) held a one day conference at Morehouse School of Medicine to highlight the issues of HIV/AIDS in the LGBT community. Former Surgeon General David Satcher stated in his speech that there is no greater health disparity than the impact of HIV on gay men.
Also of importance were discussions introduced by the ONAP Director Grant Colfax and CDC's Kevin Fenton on the growth of the epidemic among men who have sex with men (MSM) and transgender women, in particular young black MSM. According to recent statistics from the CDC, MSM accounted for 64% of new cases of HIV in the United States in 2009, and alarmingly there was almost a 50% increase among young black MSM. When considering this, it is important to keep in mind CDC researcher Greg Millett’s meta-analysis of HIV risk factors shows that black MSM do not engage in higher rates of risky behavior but that they do experience lower rates of testing, a higher prevalence of HIV in their community, and barriers to care. Recent evaluation of HIV among transgender women showed HIV rates as high as 27% (Herbst et. al). Regarding our understanding of the epidemic, David Malbranche, MD from Grady Hospital and Emory University presented an eloquent discussion on how we might think of intersectionality and the MSM community, raising interesting new perspectives on how intersectionality, long considered a source of LGBT health disparities, can also be viewed as a reason for resilience. The conference was a particularly good opportunity to develop an agenda; a great deal of work remains to create interventions that will make a difference regarding HIV and LGBT people.
On that note, Sean Cahill, the Director of Health Policy at the Fenway Institute has just written on this topic. His essay follows.
HIV funding and programming targeted at gay and bisexual men in the U.S.: Reasons for hope, and cause for concern
By Sean Cahill
Over the past few years we have witnessed a number of advances in science-based HIV prevention and care policy and LGBT health policy in the U.S.
We have a first-ever National HIV/AIDS Strategy that prioritizes reducing the disparity affecting gay and bisexual men—who were 64% of new infections in 2009, although just 2% of the adult population. We repealed a number of counterproductive policies dating back to the dark days of the 1980s and Senator Jesse Helms, such as ending the HIV entry ban, ending the ban on using federal funds for syringe exchange, and ending funding for abstinence-only-until-marriage education. Unfortunately, the latter two changes were short-lived. And we’ve seen long overdue increases in funding for Ryan White care, the AIDS Drug Assistance Program, HIV prevention through the CDC, and research at NIH, including promising biomedical prevention research.