Showing posts with label HIV Discordant. Show all posts
Showing posts with label HIV Discordant. Show all posts

June 27, 2017

The Evidence Has Been in On HIV Prevention! U=U (Undetectable=Untransmittable) U=U






I remember making enemies from some in the HIV community (not in NYC) back on 2009 when I posted information about PrEp (prophylaxis). Nobody wanted to believe it and the government did not want to emphasize it because it did not want to be seen to the religious right that it was encouraging gay sex, safe or not, because that incorrectly was thought as the thrid rail of politics.

PREP keeps an HIV- individual negative even when condoms are not use. We know the truth about condoms and how people lie about using them and how many people become HIV with the same lie ( sorry it must've come off).

Now we have something that works when the HIV+ individual takes the responsibility to use the meds correctly and becomes undetectable ( virus does not show in the blood with one of the standard tests used by different labs).

The responsibility comes back to the HIV individual to become undetectable and be ready to prove it when asked for the latest test (usually a blood test is given every 3 months), which will show if the virus is undetectable and if not it will show the viral load. A nine month or year old test is worthless. It has to be undetectable, not low and current; Otherwise, the parties involved have to go to condoms and or prep.

U=U is a new reality which is not new but now this month some states and city governments have been ready to inform people on this week's HIV prevention day (Wed 27).

I posted this at least a year ago and still, some people did not want to believe it. Why? I can only think that because it takes a little work to be undetectable or to stay HIV-  1. Take the HIV test and if proven positive starts meds as soon as possible, (Untransmissible, when undetectable) if meds are use correctly and your body works with them there will be a point on most people that they will become not able to transmit.
2. Keep your lab and Dr appointments 3. Take the meds as prescribed. 

Just last month in London one of the world famous gay bars kept a gay man from coming in because on a search for weapons they found a bottle of HIV meds.

Instead of congrats buddy! He was shame and kept from coming in, hopefully, he is able to financially recoup for this stupid mistake.


You can make this HIV prevention strategy work for you by taking your HIV treatment as prescribed and seeing your healthcare provider regularly. Your ongoing healthcare should include blood tests to check your viral load and ensure that it remains undetectable.
Wait until you have had at least two consecutive undetectable viral load test results before depending on this strategy.
To make this strategy keep working for you, adherence is key. If you have trouble taking your HIV medications every day, don't be afraid to ask for help from your doctor, pharmacist and/or peer counselor.
If your viral load does not become undetectable or if it becomes detectable again, this can increase the risk of transmission. In that case, you may need to use other prevention strategies, such as condoms, until your viral load becomes undetectable.

What About Other STIs?

Maintaining an undetectable viral load can prevent HIV transmission but it does not prevent the transmission of other sexually transmitted infections (STIs), such as chlamydiagonorrhea, and syphilis. However, condoms can reduce the risk of many STIs, so you might want to use HIV treatment and condoms.

What Is an Undetectable Viral Load?

Viral load refers to the amount of HIV in the blood of a person living with HIV. HIV treatment can reduce the amount of HIV in the blood to a level too low to be measured by a viral load test. At that point, a person's viral load is said to be undetectable. For most people, this occurs after taking HIV treatment for three to six months.
Having an undetectable viral load does not mean you are cured of HIV. The virus is still in the body. If you stop taking HIV treatment or miss too many doses, HIV will start replicating again and the viral load will once again become detectable.

What are the Benefits of Having an Undetectable Viral Load?

We now know that it's good for your health: Starting treatment as soon as possible after becoming HIV positive decreases a person's risk of developing serious illnesses and allows people to live long, healthy lives. Having an undetectable viral load can also prevent HIV transmission.

How Do I Know if I'm Undetectable?

The only way to know is to have regular viral load tests. If your viral load becomes detectable again, there may be a risk of HIV transmission. An ongoing detectable viral load may also indicate that your HIV treatment is no longer working properly. If your viral load becomes detectable, talk to your doctor.

How Can I Know That Maintaining an Undetectable Viral Load Prevents the Sexual Transmission of HIV?

A significant body of research has been accumulating over the years. In 2016, the final findings from two large international studies -- PARTNER and HPTN 052 -- were published. These studies showed that not a single HIV transmission occurred between serodiscordant sex partners when the partner living with HIV was on treatment and had an undetectable viral load.
As Dr. Myron Cohen, the principal investigator of HPTN 052, stated: "We now have 10,000 person years (of follow-up) with zero transmissions from people who are suppressed."
As a result, we can confidently say that when a person taking antiretroviral treatment maintains an undetectable viral load, they do not transmit HIV to their sex partners.
The Prevention Access Campaign -- an international coalition of HIV advocates, activists and researchers who are spreading the word that undetectable HIV is untransmittable -- has turned this scientific evidence into a simple message: U=U. Researchers from all the major treatment as prevention studies have endorsedit.

What Does U=U Mean to You?

I spent 21 years stigmatizing myself while trying to provide a positive front in my work with people living with HIV. I feel somewhat hypocritical because while fighting against stigma and discrimination, I perceived HIV as making me damaged goods, dirty and less than. I lived in fear of transmitting HIV and built walls to keep others out.
U=U has impacted me to my very soul. I am now aware that I am much more than a virus. I can look forward to meaningful relationships with others and opening my heart.
      -- Tom, Bonny River, NB
I am an HIV-positive woman. I have known for a long time, through consultations with HIV specialists, that I was not able to transmit the virus. This has given me a sense of relief when having condomless sex. The scientific proof makes me feel optimistic about stigma changing. It is an enormous move forward in normalizing people living with HIV, as we will no longer be marginalized. Through education, the public will respond to HIV in a more supportive manner and the quality of life for me and the HIV community will improve.
      -- Anonymous, Montreal
It took us too long to disseminate the findings of the PARTNER study. We were not simply cautious in our messaging regarding this transformative research, we were silent. Why did it take people with HIV and the organizations that represent us so long to get the U=U message out? Some thoughts: deep-rooted stigma against people with HIV; paternalism in our organizations and the alignment of ASOs with an under-informed government agenda, held in place through diminishing funding; and a disengaged, less scientifically literate National PHA movement that seems prepared to settle for the status quo in HIV.
      -- Darien, Toronto
This research is wonderful but many people are not aware that U=U. We need more education and we need to deal with the social stigma of HIV before the positive impacts of U=U can be widely felt. Despite all the research, the stigma is still there -- not just in serodiscordant relationships but also in society.
I am in a long-term relationship and I've been undetectable for three years, but many women with HIV are fearful of being criminalized for not disclosing their HIV status. We still have lots of work to do before we can fully enjoy the benefits of U=U.
      -- Madhuri, Calgary
[Ed's note: U=U has not yet had an impact on HIV laws in Canada. A person living with HIV in Canada still has a legal duty to disclose their HIV status to a sex partner before: (1) sex (vaginal or anal) without a condom; and (2) sex (vaginal or anal) with a condom unless you have a low viral load (less than 1,500 copies/ml). It is not clear how the law applies to oral sex.]
As an activist and as a person living with HIV who is privileged to have access to life-saving treatments and good healthcare, U=U is something I embrace and celebrate. U=U has presented people with HIV with even more reason to demand universal access to treatment and healthcare. As part of the North American U=U Steering Committee, I have connected with peers and activists across the globe to advance this important message locally and globally. As a member of the Canadian Positive People Network, it is my hope that our network can further explore how we can spread awareness of U=U -- among poz folks, within the HIV sector, and with public health, government and the general public.
      -- Christian Hui, Toronto
All of us here at CATIE, and indeed around the world, are celebrating the most significant development in the HIV world since the advent of effective combination therapy 20 years ago. The "fabulousness" of this news cannot be overstated. With or without a condom, if you're undetectable you won't pass along HIV! This is an absolute game-changer and those who live with HIV can proudly share this information.
      -- Laurie Edmiston, Executive Director of CATIE

February 21, 2017

Mr.Gay NZ Defends his View of Unprotected Sex with PrEp Partners

Charlie Tredway, 33, who was crowned Mr Gay New Zealand at Big Gay Out in Auckland on February 12, has received a backlash after being linked with websites about "barebacking".
Charlie Tredway, 33, who was crowned Mr Gay New Zealand at Big Gay Out in Auckland on February 12, has received a backlash after being linked with websites about "barebacking".
The new Mr Gay New Zealand, who is HIV positive, is defending having unprotected sex, saying he always informs sexual partners of his health status.
Charlie Tredway, 33, who was crowned Mr Gay New Zealand at Big Gay Out in Auckland on February 12, has received a backlash after being linked with websites about "barebacking" (a term used to describe anal sex without a condom).
Tredway, who works as a community outreach staffer for the New Zealand Aids Foundation, said he used condoms the majority of the time and always made sure that sex was informed, consensual and that he was looking after himself and his sexual partners.
He said he only had unprotected sex with HIV positive men or HIV negative men who he knew were on Pre-exposure prophylaxis (PrEP), which was a pill that reduced the risk of them getting HIV. 
He was also on anti-retroviral treatment which successfully lowers the level of HIV in the body to an undetectable viral load where the risk of passing HIV on was virtually non-existent.
An undetectable viral load is when there are less than 20 particles, called "copies", of HIV found in a person's blood.
"That combined with regular sexual health screening and monitoring my viral load is what safe sex looks like in 2017," Tredway told the Herald.
“We have lots of options to protect ourselves and others." Tredway, who contracted HIV from a partner he was entering a monogamous relationship with, said he was not endorsing sex without condoms, rather people's responsibility to look after themselves and use the tools available to them.
"We live in a time where there are scientifically proven and highly effective options and we need to be having these conversations without the scapegoating and misconceptions."
He said the only reason he entered Mr Gay NZ was to challenge the stigma that people living with HIV face regularly.
"That untrue notion that we are somehow less than the rest of the community. That we are unsafe to be around, or unclean and that we can't live our lives with transparency and dignity."
The online backlash was "difficult to take", but also validated his reasons for entering Mr Gay NZ, he said.
New Zealand Aids Foundation executive director Jason Myers said HIV prevention science had moved rapidly in the past two years and had shown that people with HIV and on treatment could reach an undetectable viral load which rendered them virtually non-infectious.
"And so, while in the good old days condoms are the only way to prevent the onwards transmission of HIV we are now in a space in 2017 where there are a number of tools that are equally as useful."
In addition to condoms, undetectable viral loads and Pre-exposure prophylaxis were also viable options to prevent HIV transmission.
The NZAF says it is legal to have sex without condoms if a person has disclosed their HIV status.
In an open letter, Mr Gay NZ producer Matt Fistonich said the organisation would continue to support Tredway as the 2017 Mr Gay New Zealand winner and his advocacy role for the community and HIV stigma and awareness.
"What Mr Tredway does in the privacy of is own home, is not an issue, and ironically any discussion around Mr Tredway's private life highlights and reinforces how as a community we need to continue to fight HIV-related stigma, and raise awareness of the damaging and hurtful attitudes of a vocal minority that need to change."

September 14, 2015

Man on Grindr - 'Oh you have HIV... I'm not ready for that kind of complication in my life'.

Tom Knight, a 28-year-old events manager and producer from London, has been HIV positive since 2013.
NullPicture: Facebook
He was chatting to a man on Grindr, the dating app, last week and revealed he was HIV positive.
Here's how their conversation went down:
His response raises an important point. 
In no way are flared jeans acceptable in this day and age.
HIV positive
(Photos: Getty)
No seriously, while the anonymous man was well within his rights to state his concerns, his response is symptomatic of the routine rejection HIV positive people face on the basis of their condition.
Knight told Buzzfeed:
It’s a kick in the teeth. Every time it’s a kick in the teeth. It’s not easy telling people I’m positive. You worry about what they’re thinking about you.
Nowadays, treatment is also far more effective than it used to be - HIV is more likely to get passed on if the HIV positive partner has what’s called ‘a high viral load’, which treatment can lower, reducing the risk of passing on HIV.
As Knight added:
People like him don’t have any knowledge about HIV and don’t know what 'undetectable' means [an undetectable viral load occurs when medication suppresses the virus to such low levels it doesn’t show up on lab tests], and don’t realise that it means you can’t pass the virus on.
HIV is spread through contact with blood (including menstrual blood and any blood in saliva, urine, and feces), semen, vaginal fluids, breast milk, and fluids around the brain, spinal cord, joints and a developing fetus.
HIV is not spread through contact with sweat, tears, saliva, feces or urine.
You cannot get HIV by touching or hugging someone who is HIV positive or by kissing someone living with HIV.
Every sexual act with someone who is HIV positive, oral, anal or vaginal, has an element of risk of transmission of HIV, but condoms remain the most effective barrier, as well as dental dams and latex gloves.
In addition, if a condom splits or you forget to use one – a HIV negative partner can take PEP (post-exposure prophylaxis), which helps prevent transmission of HIV. It needs to be taken within 3 days, but better within 24 hours.
For more information visit the NHS website.
Null
(H/T Buzzfeed)

July 21, 2015

New Study: Suppressive HIV Therapy Also Protects Discordant Straights by 96%


                                                                           


We now know that when one gay partner is HIV+ and the partner is HIV-(discordant couple), the negative partner (positive partner with suppressive therapy and with an undetectable viral load) is protected by at least 97%. The question emerged when we are talking about a straight couple; Does this answers the question about Straights? We now have an answer with very similar results as to the gay couple.

Antiretroviral treatment that consistently suppresses HIV is highly effective at preventing sexual transmission of the virus in heterosexual couples where one person is HIV-infected and the other is not, investigators report today at the 8th International AIDS Society Conference on HIV Pathogenesis, Treatment & Prevention (IAS 2015) in Vancouver, Canada. The finding comes from the decade-long HPTN 052 clinical trial funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and conducted by the NIH-funded HIV Prevention Trials Network (HPTN).
“For heterosexuals who can achieve and maintain viral suppression, the risk to their partners is exceedingly low.”
—Anthony S. Fauci, M.D.
NIAID Director 
In 2011, the HPTN 052 study investigators reported a breakthrough: Starting HIV treatment early, when the immune system is relatively healthy, reduced the risk of sexually transmitting the virus to an uninfected partner by 96 percent over 18 months. Based on additional data gathered since 2011, today’s finding unequivocally demonstrates the enduring power of HIV-controlling antiretroviral therapy to greatly reduce sexual transmission of the virus.
“The study now makes crystal clear that when an HIV-infected person takes antiretroviral therapy that keeps the virus suppressed, the treatment is highly effective at preventing sexual transmission of HIV to an uninfected heterosexual partner,” said NIAID Director Anthony S. Fauci, M.D. “For heterosexuals who can achieve and maintain viral suppression, the risk to their partners is exceedingly low.”
The HPTN 052 trial was designed to evaluate whether antiretroviral therapy reduces sexual transmission of HIV. Beginning in April 2005, the study enrolled 1,763 heterosexual couples ages 18 or older in Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States and Zimbabwe. Each couple included one partner with HIV infection and one without. Infected participants were assigned at random either to start antiretroviral therapy right away, while their immune system was relatively healthy, or to delay starting treatment until their immune system weakened or they developed an AIDS-defining illness, consistent with World Health Organization guidelines at the time. All participants received condoms and counseling on how to protect their partners from sexual transmission of HIV.
Once the investigators reported their landmark data in 2011, all infected study participants were offered the opportunity to begin antiretroviral therapy right away, and the trial continued for another four years, concluding this spring. At the end of the study, 1,171 couples remained in the trial.
Investigators report today that starting antiretroviral therapy early reduced HIV transmission by 93 percent over the course of the study. Only eight cases of HIV transmission occurred in uninfected partners of HIV-infected participants who received antiretroviral therapy. Four of these infections were diagnosed shortly after the start of treatment. In these cases, the virus most likely was transmitted just before antiretroviral therapy began or right after it commenced, before treatment had fully suppressed HIV replication. The other four infections occurred in study participants for whom treatment no longer was working and the virus was replicating. Treatment failure may have occurred because HIV-infected participants did not take their antiretroviral drugs as prescribed or had an HIV strain that was resistant to one or more of the drugs in their treatment regimen.
The lack of sexual transmission of HIV by virally suppressed individuals in this large study provides robust evidence that antiretroviral therapy started at any time in the course of infection can prevent heterosexual HIV transmission if viral suppression is achieved and maintained, the investigators note.
“Throughout our decade-long study with more than 1,600 heterosexual couples, we did not observe HIV transmission when the HIV-infected partner’s virus was stably suppressed by antiretroviral therapy,” said Myron Cohen, M.D., the study’s principal investigator. Dr. Cohen is Associate Vice Chancellor for Global Health at the University of North Carolina at Chapel Hill and director of the university’s Institute for Global Health and Infectious Diseases. “These findings illustrate that treatment is an incredibly powerful tool for HIV prevention.”
HPTN 052 investigators also are reporting findings today about relationships between viral load, viral suppression, treatment failure and drug resistance. The researchers found that having a relatively high level of HIV in the blood at the start of therapy was associated with a longer time to viral suppression, which, in turn, was associated with both the occurrence of treatment failure and a shorter time to treatment failure. Thus, having a relatively high viral load at the start of treatment could increase the risk for HIV transmission, the scientists suggest.
In addition, the investigators found that among the HPTN 052 participants who started antiretroviral therapy early but failed treatment before May 2011, those who had a higher viral load when they joined the study were likely to develop resistance to their antiretroviral drugs. Additional analysis is needed to clarify this association, according to the investigators.
The HPTN conducted the trial with funding from NIAID, the National Institute on Drug Abuse and the National Institute of Mental Health, all part of NIH, through grant number 5-UM1-AI068619. Additional support was provided by the NIH-funded AIDS Clinical Trials Group.



For more information about the HPTN 052 trial, please see Questions and Answers: The HPTN 052 Study: Preventing Sexual Transmission of HIV with Anti-HIV Drugs. Information is also available in ClinicalTrials.gov under study identifier NCT00074581.
NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available http://www.niaid.nih.gov
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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