US: Promoting the PrEP pill for HIV prevention among Latinos

Latinos are disproportionately affected by HIV, making up about 21% of new infections nationally, though they represented about 17% of the population. Latinos are more likely than non-Hispanic whites and blacks to get diagnosed later in the course of their illness, raising the risks to their health and the likelihood of transmission to others.

In California, New York, Texas and elsewhere, health workers are trying to get more high-risk Latino men to use the pre-exposure prophylaxis drug, Truvada--shown to be more than 90% effective when used correctly. But health workers are encountering barriers among many Latinos.

Among them are a lack of knowledge about the drug and the stigma attached to sleeping with men or perceived promiscuity. Many Latinos also have concerns about costs and side effects. For instance, a study with gay and bisexual Latino men in Texas, finds 58% of those surveyed see themselves as good candidates for PrEP, compared to 82% of non-Hispanic whites, according to preliminary data. Read More

US: Obama signs Executive Order for new National HIV/AIDS Strategy

Updated to 2020, a new HIV/AIDS details principles and priorities to guide the collective national work to address HIV in the US over the next five years. Director of the Office of National AIDS Policy, Douglas Brooks said that the level of HIV infection in the U.S. is “stable overall, but the risk to gay men remains severe. We still have an HIV epidemic, especially for young black men.”

Brooks said HIV “remains a major health crisis for the United States.” Despite successes in treatment and prevention, certain groups, highlighted by Brooks, remain a priority in the new strategy. This includes gay, bisexual, and other men who have sex with men of all races and ethnicities, black women and men, Latinos and Latinas, people who inject drugs, people between the ages of 13 and 24, people living in the Southern United States, and transgender women.

Brooks noted the particularly high burden of HIV among black transgender women and black gay and bisexual men, especially among young men. Read More

Egypt: The untold stories of Egypt’s transgender community

Ever since realizing he had Gender Identity Disorder (GID), Bassem has been receiving professional psychiatric support, though mostly “kinda useless.” But Bassam's new treatment is “amazing!” His treatment now is indeed unique and advanced for a country like Egypt, where most psychiatric professionals are uncomfortable with dealing with transgender patients, often not even willing to acknowledge the existence of GID as a medical condition.

Even more unexpected is that this treatment is neither expensive nor private, but is free and provided by a government hospital. Moreover, it is headed by one of Egypt’s most experienced and leading psychiatrists on transgender therapy, Dr Hashem Bahary. 

Dr Bahary, who has been working with transgender patients for 25 years, has been at Al-Hussein Hospital for nearly 10 years now. For almost half of his career, gender reassingment operations were prohibited in Egypt. In 2003, they were allowed only for cases of intersex. However, in 2013, in what is considered a major landmark moment for the transgender and transsexual community, the Egyptian Medical Syndicate issued a new Code of Ethics, which essentially recognised GID as a medical condition and permitted transgender patients, who could prove they have GID, to have gender reassignment surgery in Egypt. Read More

UK: The dangers of trans broken arm syndrome

Accessing healthcare is another item on the long list of things that are harder when you’re trans. Transition-related healthcare is notorious for long-waiting lists, unnecessarily strict requirements and a lack of local services. But general healthcare is fraught with difficulties too. Trans people are frequently subject to poor standards of care due to prejudice or plain ignorance. Then there’s the phenomenon known as Trans Broken Arm Syndrome. It’s when healthcare providers assume that all medical issues are a result of a person being trans. Everything – from mental health problems to, yes, broken arms.

The  more a person’s trans status is blamed for a person’s unrelated health problems, the less likely they are to bring it up – even when it is relevant. J summed it up, saying: “It’s a calculated risk on our part: The 1% chance that it is relevant and you make it worse by hiding, versus the 99% chance that it’ll be used to push you out of the clinic with no diagnosis, and ending up made worse by that. I take that 1% risk every time, it’s safer. But if I didn’t have to take that risk then I wouldn’t.” 

While it’s always important to be honest with healthcare providers, with attitudes as they are it is understandable than many trans people find it hard to trust staff. That will only change when workers are fully informed on trans issues.  Read More 

Black market for Truvada PrEP may undermine treatment adherence in marginalised people living with HIV

The increasing demand for pre-exposure prophylaxis (PrEP) is likely to increase the likelihood that some marginalised individuals living with HIV interrupt their own treatment to sell some of their prescribed medication to pill brokers and drug dealers, according to a study presented to the Conference of the Association for the Social Sciences and Humanities in HIV in South Africa last week.

Dr. Steven Kurtz said that several reports have documented street markets for diverted antiretrovirals (ARVs) in the US. In his study of men who have sex with men, people who didn’t sell their drugs also reported being approached by traders. Less frequently, ARVs were sold or given to individuals who would use the pills themselves, sometimes in exchange for recreational drugs or sex.

There was little evidence that individuals purchased ARVs from the black market for self-treatment of HIV infection, but that the illicit use of Truvada for prevention purposes has been documented. Many HIV-negative people who are at high risk of HIV infection do not have health insurance, perhaps making them more likely to turn to the black market.  “The potential intersection of widespread ARV street markets and misinformed at-risk populations about the effective use of PrEP is a major public health concern,” Kurtz concluded. Read More 

Serbia: Fake condoms flood region

The Serbian Agency of Medicines (Agenciji za lekove) has confirmed that counterfeit condoms have flooded local markets of Belgrade and Novi Pazar. The condoms carry names from prominent manufacturers, but carry false expiration dates, serial numbers, and country of origins. In a local interview, Doctor Nevenka Dimitrijevic warned that these condoms would not provide protection against sexually transmitted diseases or pregnancy. Read More

UK: Nobel scientist calls for HPV vaccination for boys

The UK should vaccinate all boys against the cancer-causing human papilloma virus, Professor Harald zur Hausen, the Nobel Prize-winning scientist who discovered the link between HPV and cancer has said. There is now a wealth of evidence that HPV also causes cancers in men, including anal, penile and throat cancer. Professor zur Hausen added that there was now a chance to “eradicate” HPV viruses altogether if the world developed global vaccination programmes for all children.

Since 2008 the UK has offered free vaccinations against HPV to girls aged 12 to 13 – a programme that had an almost 87% uptake from 2013 to 2014 and has led to falls in the number of pre-cancerous abnormalities of the cervix, according to research. Scientists say changes in sexual behaviour – with more couples having oral and anal sex – may be the cause of increased cases of anal and throat cancers in both men and women in recent decades. Read More  

Canada: British Columbia to fund HPV vaccine for boys & gay men under 26

After years of requests from gay health advocates, BC’s Ministry of Health announced that it will offer free HPV vaccines for boys and young men who have sex with men, beginning this September.

“The human papillomavirus virus is the most common sexually transmitted infection,” BC Health Minister Terry Lake said. “Our vaccination program will help protect all young British Columbians from cancers and other diseases caused by HPV infection.” The vaccine is currently offered to all girls in Grade 6 as part of the province’s routine school-age immunization schedule. 

“We know if you get above 60% of the women vaccinated you get a herd immunity effect in which heterosexual men are protected as well,” says health officer Perry Kendall. “But we are not offering protection to men who have sex with men.”

Infectious disease expert Joel Palefsky says the vaccine may also help prevent oral cancer in men. “Many people in our field believe universal vaccination is warranted even if a high percentage of girls are vaccinated,” he explains. “They will get prevention for most anal cancers and most genital warts as well as the likely but as of yet unproven prevention of oral cancer.” Read More 

US: Bisexuals have worse health than gay, lesbian, or straight people

Professors of Sociology at Rice University have found that bisexual Americans face higher health disparities than their gay, lesbian, and straight counterparts. A variety of these health issues stem from systemic socioeconomic vulnerability in the bisexual community, according to the new study.

“As a group, bisexual men and women have higher rates of a variety of factors that can lead to poor health — things like poverty or involvement with lifestyle activities that can lead to poor health, ” lead author Bridget Gorman said. Bisexual respondents also reported a higher propensity for smoking and using alcohol than straight or gay counterparts — health risks that can be amplified by the higher rates of poverty among the bisexual community compared with other peers. Among gay, lesbian, and straight counterparts, researchers found members of the bisexual community were the least likely to be educated at a university level.  Read More 

Jamaica: Bisexuals accounted for 40% of new HIV infections in 2012

The Minister of Health Dr Fenton Ferguson yesterday disclosed that men who have sex with both men and women accounted for almost 40% of new HIV infections in 2012.

“While we have a prevalence rate of 1.8% among the general population, female sex workers have a prevalence of 4.2%, young men under 25 years who have sex with men are at 24.3% as at 2013,” the health minister explained.

“I want to further note that MSM who reported being involved in sex work, reported an HIV prevalence of 41%, transgender women 45%, and transgender populations in sex work reaching as high as 56%.”

Insisting that the prevalence rate among these groups are “way too high”, Dr Ferguson said that much of the efforts must be concentrated on these vulnerable groups, adding that there is the ever present challenge of implementing mechanisms to effectively deal with the issue of stigma and discrimination. Read More

Nigeria: Gay, bisexual men report more fear in healthcare after law

Gay and bisexual men in Nigeria are reporting increased reluctance to access healthcare. While consensual sexual relationships between men were already illegal in Nigeria, the Same-Sex Marriage Prohibition Act, signed into law in January 2014, prohibited participation in organizations supporting gay people or attempts at any kind of civil same-sex relationship.

There were reports of arrests and torture following the enactment of the law, according to a paper published in The Lancet HIV. Since the law took effect, men who have sex with men may fear that the benefits of medical care don't outweigh the risks. The study suggests "that they think the (benefit) of HIV prevention care isn't worth remaining in a system that could potentially out them," she said.

Schwartz and her colleagues analyzed data from 707 gay and bisexual men in Nigeria who were receiving HIV prevention and treatment services from a community-based clinic in 2013 and 2014. Read More