PRE-EXPOSURE PROPHYLAXIS TRIAL SHOW REDUCED RISK OF HIV INFECTION
HIV DRUG REDUCES LIKELIHOOD OF INFECTION WHEN PART OF A COMPREHENSIVE PREVENTION PROGRAM
The results of the Global iPrEx Study were published Tuesday, November 23, 2010, in the New England Journal of Medicine. Results showed that a daily dose of an existing HIV medication in combination with counseling and condom use greatly reduced the risk of HIV infection. On average, risk was reduced by 44%, and among those who adhered most closely to the daily regimen, risk was reduced by nearly 73%.
The study is being lauded by Drs. Kevin Fenton and Jonathan Mermin of the US Centers for Disease Control and Prevention as "a significant advance in HIV prevention research." Mitchell Warren, Executive Director of the AIDS Vaccine Advocacy Coalition, or AVAC said, "This is a great day in the fight against AIDS... As we move towards potential PrEP implementation, it is critical to remember that millions of HIV-positive people around the world, including thousands in the United States, lack access to the HIV treatment they need, which is often the same drug used in this trial."
Researchers selected 2499 HIV-negative men and transgender women who have sex with men who received either Truvada (a combination of two HIV anti-viral drugs) or a placebo once daily. All subjects received monthly HIV testing, risk-reduction counseling, condoms, and management of sexually transmitted infections. Comparing the number of new infections among these two groups yielded the reduced risk of 44%. You can read the full study here and watch an introductory video about the study here.
While these results are encouraging, the National Institutes of Health still advises that "correct and consistent condom use and a reduced number of sexual partners remain the most effective ways for gay and bisexual men to protect against HIV infection." CDC also advises that "anyone considering using PrEP should first speak with their doctor," and that "PrEP should never be seen as the first line of defense against HIV."
In the next few weeks, the CDC will be developing and releasing its guidance for clinicians and public health officials on PrEP. In the meantime CDC suggests the public follow these guidelines to reduce their risk for HIV:
- Use condoms correctly and consistently
- Get tested to know your status and that of your partner(s) for certainty
- Get tested - and treated if needed - for other sexually transmitted infections that can facilitate
- HIV transmission, such as syphilis and gonorrhea
- Get information and support to reduce drug use and sexual risk behavior
- Reduce your number of sexual partners
A&PI Wellness Center offers free HIV testing every Wednesday and Friday. Call (415) 292-3400 to schedule your appointment.
In the coming days, we will be updating this section to include information on a community forum happening at the SF LGBT Center on December 9 at 6:30. Details coming soon!
READ MORE ABOUT PrEP, THE STUDY, AND THE FUTURE OF PrEP:
1 IN 5 MEN WHO HAVE SEX WITH MEN IN 21 CITIES HAS HIV, NEARLY HALF DON'T KNOW IT
On September 23, 2010, Centers for Disease Control and Prevention (CDC) released new data showing that among 21 major cities that 19% of men who have sex with men (gay, bisexual or otherwise) are living with HIV while 44% don't know they are living with HIV. The study is based on a data analysis of the 2008 National HIV Behavioral Surveillance System and reported in the Morbidity and Mortality Weekly Report.
Among Asians, the study found an 8% HIV prevalence rate, and among Native Hawaiians and Pacific Islanders, the rate was much higher at 18%. Of those that tested positive, nearly half of both Asians and Pacific Islanders did not know their status (43% and 45% respectively). For Asians and Pacific Islanders, the data could be inconclusive due to low recruitment of Asian and Pacific Islanders (A&PI) in the sample of the study where only 2% were Asian and less than 1% were Native Hawaiian or Pacific Islander.
This low recruitment of A&PIs into the study is disappointing because the study did include seven metropolitan areas where large populations of A&PI MSMs reside. These cities included Chicago, Houston, Los Angeles, New York, Philadelphia, San Francisco and Seattle. At this point, we do not have a clear understanding why such low recruitment rates of A&PIs occurred for this study.
A&PIs have the lowest testing rates of all races and ethnicities. A comparison of San Francisco Department of Public Health data and US Census Bureau data show that A&PIs test at a significantly lower rate compared to their population. In 2008, A&PIs made up over 30% of the population, but of all HIV tests given in the city, only 10% were to A&PIs. Yet, data shows from 2004 to 2010, A&PI MSM HIV rates have gone from 4% to 10% of the city's epidemic. Nationally, two-thirds of Asians and over half of Pacific Islanders have never been tested for HIV.
Here are ways to find out more about this study:
Read Dr. Kevin Fenton's blog post. Dr. Fenton is the Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.
Read the Morbidity and Mortality Weekly Report. [September 24, 2010, Prevalence and Awareness of HIV Infection Among Men Who Have Sex with Men-21 Cities, United States, 2008. 59(37);1201-1207.]
NATIONAL HIV/AIDS STRATEGY
UPDATE ON THE NATIONAL HIV/AIDS STRATEGY: THIS WEEK IN DC
A&PI Wellness Center is pleased to note that some key concerns of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) are acknowledged in the National HIV/AIDS Strategy (NHAS), particularly around the need for stronger HIV data collection and surveillance methodologies to better understand the impact of HIV in our communities. The NHAS also expressly noted the need for AANHPI inclusion in comprehensive prevention strategies for men who have sex with men. These are important steps forward for our communities.
The fight is far from over, however, and we are busy advocating on behalf of all AANHPIs to ensure our voices are heard. Through our coalition work (with the Federal AIDS Public Policy and National People of Color HIV/AIDS workgroups), we are at the table helping to shape the implementation of the NHAS. We are prioritizing cultural and linguistic competency, with an eye toward the needs of AANHPIs. We also want to be sure the strategy is flexible enough to adjust to the needs of emerging populations affected by the HIV epidemic.
This week, we are traveling to Washington, DC to meet with key leaders to discuss the NHAS and move our policy agenda forward. Visits will include:
- Jeff Crowley (Director of the White House's Office of National AIDS Policy)
- Kate Moraras (Advisor on Health Policy and Community Engagement, White House Initiative on Asian Americans and Pacific Islanders)
- Christopher Bates (the Director of the US Department of Health and Human Services Office of HIV/AIDS Policy)
- Congresswoman Judy Chu
Stay tuned for more updates!
Read more about the National HIV/AIDS Strategy:
A&PI Wellness Center was one of nine leading national minority HIV organization who helped to convene a group of leaders representing over 30 national HIV/AIDS organizations serving communities of color. Together, this group worked in unison and formulated an urgent call to action to the presidential candidates. When we understand the epidemic from our perspectives, the HIV/AIDS epidemic is an epidemic of communities of color and we demand the attention, focus and resources to immediately stem this epidemic.
We developed a seven-point action agenda that works to do this. For Asian American, Native Hawaiian and Pacific Islander communities, this agenda addresses the most critical issues for us, including calling for more accurate surveillance data and for a National AIDS Strategy that specifically focuses on the epidemic in communities of color, demanding stronger and more resourced culturally competent HIV prevention programs, and insisting that health care access is a human right.
Recently, the CDC released alarming HIV/AIDS statistics related to our communities. Asian American, Native Hawaiian and Pacific Islanders were the only racial group with a statistically significant percentage increase in annual HIV/AIDS diagnosis rated from 2001 to 2004. And, between 2001 and 2006, Asian Americans, Native Hawaiian and Pacific Islanders had the largest proportionate increase (255.6%) in new HIV/AIDS infections among all racial and ethnic groups.
The following documents were produced:
“Impact of HIV/AIDS on Asian American, Native Hawaiian and Pacific Islander Communities”:
Produced with Asian & Pacific Islander Coaltion on HIV/AIDS, Asian & Pacific Islander American Health Forum, and Life Foundation, this document outlines the current problems with public policy as it relates to HIV/AIDS in the AANHPI community, including the need for more data collection and federal funds to properly respond to the HIV epidemic in these communities.
“Fighting AIDS in Communities of Color: An Action Agenda for the Next President”:
Produced by a coalition of 30 different HIV/AIDS organizations working with communities of color, this policy document lays out a seven-point plan for improving HIV/AIDS services and research for people of color. This document was circulated at both the Democratic and Republican National Conventions.
Click here to download the press release about “Fighting AIDS in Communities of Color” (PDF)
Past Events
Protect HIV Funding
Our
Cecilia Chung in the Advocate!
Vigil in Solidarity with the
Peoples of the Indian Ocean to be Held Tuesday, February 1 in
San Francisco, January 17 2005
A&PI Wellness Center
host HIV activists from Japan, November 16 2004
A&PI Wellness Center
signs on to fight discrimination within the LGBT community,
November 09 2004
Lance Toma’s Speech,
as given at the Asian & Allies Rally for Marriage Equality
Event on August 8, 2004
Testimony before the Senate
Budget Subcommittee, May 10 2004
A&PI Wellness Center Addresses
Same Sex Marriage, April 27 2004
Asian & Pacific Islander
Wellness Center Decries November Arrest of Gay Men in Vietnam,
December 23 2002
