Canada: Worried about PrEP-resistant HIV? The Doctor who discovered it has some advice

Last week, David C. Knox, a physician and researcher based in Toronto, caused a small earthquake in the world of queer sexual health. He revealed the first known case of a patient contracting HIV despite confirmed adherence to PrEP—the HIV prevention strategy that currently comprises taking a daily pill (Truvada) that blocks the virus from taking hold after an exposure. Although PrEP has been proven to prevent the transmission of HIV with 99 percent efficacy, this particular case has been discussed as the unfortunate one percent: The highly uncommon strain of HIV the patient encountered showed various levels of resistance to many drugs, including those in Truvada.

But is the one percent figure—and the relative confidence it still affords—totally accurate? What variables are in play? And if the percentages are not as simple as they seem, how would that information help PrEP users take further control of their sexual health? I spoke with Knox to find out.  Read more via Slate 

Switzerland: Deferred Hep C therapy in MSM with HIV increases risk for mortality

Hepatitis C (HCV) is a leading cause of morbidity and mortality in people who live with HIV. In many countries, access to drugs to treat HCV is restricted to individuals with advanced liver disease. Using the Swiss HIV Cohort longitudinal study, the research goal was to estimate the long term impact of deferring HCV treatment for men who have sex with men (MSM) who are coinfected with HIV and often have multiple risk factors for liver disease progression.

The study found that early treatment of Hepatitis C could reduce replication of the disease, thereby reducing the risk of transmission. Additionally they determined that delayed treatment increased liver-related morbidity and mortality. Read more via Journal of Hepatology  

Ireland: Rates of LGBT self harm, suicide are horrific, says McAleese

Former president of Ireland Mary McAleese has described the findings of a new report which reveals high rates of suicide and self-harm among gay teens as “horrific”. While Ireland revealed itself to be a country committed to equal rights in last year’s same-sex marriage referendum, she said it was clear that the “long-standing architecture of homophobia” will take years to dismantle.

The largest study to date of the lesbian, gay, bisexual and transgender (LGBT) community in Ireland shows gay teens experience elevated levels of suicidal behaviour and depression.

Speaking at the launch of the of the report, she said: “This scholarly report is as essential and revealing as it is horrifying. The ongoing damage is undeniable. That it involves so many young people is tragic. That it is solvable is the good news,” she said. Read more via Irish Times

UK: PrEP policy in disarray after NHS U-turn

Activists, individuals at risk of HIV, and clinicians have reacted with anger to an official U-turn on provision of HIV pre-exposure prophylaxis (PrEP). NHS England officials have refused to allow a draft policy on PrEP to go forward for further consideration.

“By denying full availability of PrEP we are failing those who are at risk of HIV,” commented Ian Green of Terrence Higgins Trust. “PrEP has already been approved in the US, Kenya, South Africa, Israel, Canada and France. And yet, our own government refuses to take responsibility for PrEP.”

Although the stated reason for blocking PrEP was that NHS England should not be paying for it, officials did not present a clear path for a way forward. “Today’s statement makes it no clearer who is responsible – is it the Department of Health, local authorities, the NHS or Public Health England?” said Ian Green. “We need answers, we need access, and we demand both.”  Read more via AIDSmap

Venezuela: Safe sex is a luxury where a pack of condoms costs nearly $200

 Venezuela's economic crisis has caused unprecedented shortages of of basic goods—making contraception nearly impossible to find, and even harder to afford. As a result, teen pregnancy, illegal abortion, and HIV are all on the rise.

"The situation is critical," said Belmar Franceschi, head of PLAFAM, a Venezuela-based sexual and reproductive health advocacy group. "For over a year now, there have been shortages across the board. It is almost impossible to find condoms and other contraceptive methods, and when you do they are astronomically expensive."

In Venezuela's pharmacies, a pack of three condoms can cost as much as the equivalent of $169 USD, says Jhonatan Rodriguez, head of NGO StopVIH—which is roughly five days' salary for the average worker in the country. "We either eat or we buy other products. The minimum wage doesn't stretch far enough. It doesn't even cover basic groceries," he said.

On the country's flourishing black market, the price of condoms doubles or even triples. When products become available, many struggling Venezuelans buy them and sell them on at inflated prices that most can't afford. The practice has become so common that a new word has entered Venezuelan lexicon: "bachaquero," named after a leaf-carrying ant. "Bachaqueros buy contraception and then sell it to people at whatever price they want," said Freddy Ceballos, president of the Venezuelan Pharmaceutical Federation. "People are desperate. They are taking anything they can get hold of." Read more via Broadly 

Canada: Third country to approve PrEP

Canada followed in the footsteps of the US and France by becoming the latest country to approve HIV-prevention medication pre-exposure prophylaxis (PrEP). The approval of PrEP is expected to lead to lower prices for the drug in Canada, as well as a potential increase in prescriptions.

The US has had PrEP since 2012 while France only had it approved last November. The World Health Organisation has also endorsed it. In Australia, doctors can prescribe the medication to patients but it is only available to those who can afford to import it from online pharmacies.

Following Canada’s approval of the drug, the Greens last week on the Federal Government to fast-track its approval in Australia.

“There is now a strong evidence base and consensus amongst Australian non-government organisations working in this area that PrEP, along with rapid HIV tests and home self-tests are vital to add to the prevention tools currently available, so the government should be doing all it can to speed up availability,” South Australian Greens Senator Robert Simms said.  Read more via Star Observer

Transgender people are at high risk for HIV, but too little is known about prevention and treatment

Transgender women have among the highest rates of HIV infection but little is known about HIV prevalence among trans men, Tonia Poteat of Johns Hopkins said in a plenary lecture on transgender health and HIV at the recent Conference on Retroviruses and Opportunistic Infections (CROI 2016) in Boston – the first ever on this population at CROI. A growing number of studies and prevention and treatment programmes are addressing transgender populations, but more research is needed.

Dr Poteat noted that while mainstream knowledge about transgender men and women is relatively new in the US and Europe, people outside the male-female gender binary have long existed in many cultures, such as the hijra in India. Yet traditional ‘one-step’ data collection approaches can make it difficult to accurately identify trans people in HIV research.

One worldwide meta-analysis of 39 studies from 15 countries found that transgender women had an HIV prevalence rate of 19% – 49 times higher than that of the general population. In high-income countries the prevalence was 22%, with the highest rate among trans women of colour. 

A number of biological and social and structural factors may make transgender people more susceptible to HIV infection or less likely to use prevention methods or access treatment if they become infected.  Read more via AIDSmap

Lebanon: Op-ed, How public health can affect LGBT Rights

When I think about LGBT rights in Lebanon, a swinging pendulum comes to mind. Slow progress met with backlash and arbitrary detention. A recent study showed that 81% of a representative Lebanese sample believed homosexuality was not normal. Nevertheless, LGBT activists stood fast in this environment and fought the institutional discrimination facing this community. LGBT health advocates even managed to stir up conversation on sexuality among their peers and the broader community.

Arguments rooted in public health principles supported many LGBT rights issues. Until 2012, forensic doctors performed anal tests, humiliating and torturous acts conducted on gay men and transgender women to ‘prove’ that they had anal intercourse. LGBT health activists successfully pressured the Lebanese Order of Physicians to ban them. As a consequence, the Order started investigating physicians who performed these tests and publically threatened to suspend their medical license.

The Lebanese experience proves that public health can be a tool used in fighting against discrimination based on sexual orientation and gender identity. But reflecting on these successes also highlights that health care disparities still persist in Lebanon and other countries where LGBT communities face stigmatization. 

Read more via Center for Transatlantic Relations Equality Blog 
 

UK: This is what domestic violence is like when you’re LGBT

Sam was three months pregnant when her girlfriend Lynn raped her. They were at home. Sensing that Lynn wanted sex, Sam decided to tell her that she did not. “She suddenly got nasty,” says Sam, flatly. “She was physically a lot bigger than me. She pinned me against a doorway and said, ‘I’ll have what I fucking like if I fucking want it.’ She assaulted me.”

Sam is in her early thirties. It is only in the last few months she has felt able to talk about the events of her early twenties. She looks up briefly, as we sit talking in a half-empty restaurant, and asks, “How do you say to your friends, ‘My girlfriend rapes me’ when their only mental definition of rape is a man forcing his penis inside a woman’s vagina? How do you say you were assaulted when it comes back to the idea of ‘that doesn’t count’? Well, it does count.”

It is a story that not only Sam finds difficult to tell, but one that many lesbian, gay, bisexual, and transgender people struggle to disclose. BuzzFeed News spoke to both LGBT survivors of domestic abuse and an organisation trying to help them – amid a backdrop of cuts to funding.
As the accounts of violence, rape, bullying, coercion, and control surfaced, sometimes for the first time, two questions began to form: What prevents LGBT people in particular from speaking out? And, what external forces are stopping them from finding safety?  

Read more via Buzzfeed
 

US: Black and latino queer men face a public health emergency with HIV

Sobering news came from the CDC Tuesday: According to a major new study that covers all 50 states and DC, about 1 in 2 black and 1 in 4 Latino men who have sex with men are projected to be diagnosed with HIV in their lifetime if current trends hold. As a comparison, the study found that white MSM face odds of 1 in 11, while members of the MSM community as a whole are looking at a 1 in 6 chance.

The new study, which used diagnoses and death rates from 2009-13 to extrapolate into the future, also looked at geography and found that individuals living in the South encounter more risk than those in other regions of the country. Washington, D.C., saw the highest rate at a 1 in 13 chance of an HIV-positive diagnosis.

That’s a lot of numbers, but the takeaway is this: Black and Latino MSM, in facing a risk of HIV infection that’s wildly disproportionate to other populations, are embroiled in a genuine public health emergency. Of course, this won’t come as news to advocates already working on HIV/AIDS among those groups; but it reiterates the need for education, community-specific messaging, and, above all, access to prevention tools in the effort to stem the tide.  Read more via Slate 

Asia: Social media app Hornet invests in gay men's health

Hornet is committed to HIV health innovation and is investing in its Health Innovation Group with a new officer for SE Asia. Data shows that HIV prevalence among men who have sex with men in this region continues to increase while prevalence among the general population has been in decline. Very few gay men are knowledgeable about PrEP or the benefits of effective HIV treatment for improved health or prevention. Additionally, gay men continue to encounter significant barriers when accessing treatment or prevention. 

"I want to see more gay men getting tested and accessing appropriate treatment or prevention services following their test," said Lieu Anh Vu, Hornet's new Health and Innovation Strategist for Southeast Asia.  Vu joins Hornet from United Nations Development Programme UNDP where he worked as an LGBT social justice and health advocacy.

Hornet recognizes the unique opportunity that social networking apps present in ongoing efforts to improve the health and wellness of gay men around the globe. The endeavors in Southeast Asia is part of an ongoing investment in the lives of gay men and fostering of stronger community relationships.  Read more via PR Newswire 

Malta: Prime Minister 'immensely disappointed' by Church committee report on conversion therapy for gay people

Prime Minister Joseph Muscat said today that he was immensely disappointed by comments by the committee which advised the Church on conversion therapy for gay people. It was unbelievable, he said, that in this day and age, some people thought that sexual orientation was something that could be healed by medication and therapy.

This was an offence to the gay community and all those who wanted to live in a European society which respected the people's freedom. It was a similar offence to link homosexuality with child abuse. 

Dr Muscat said he would defend the right of the Church to speak out, but the government would carry on with its legislation against such conversion therapy. He could never accept a situation where any Maltese was called a sick or a pedophile because of a particular sexual orientation.  Read more via Times of Malta