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

January 11, 2019

Stigma is Keeping Delhi Men From Getting Tested for HIV

When the news broke that India’s Supreme Court had struck down a colonial-era law making gay sex illegal, the reaction in Delhi was jubilant, with public celebrations erupting across the capital.
Fast forward four months, and HIV/Aids charities are finding the old stigma and prejudice against members of the LGBT+ community are stubbornly refusing to go away.
Although attitudes towards gay relationships have softened in the past two decades, a 2016 survey found that even among young people, more than 60 per cent of respondents believed homosexuality was wrong.
That translates to “a lot of shame” among men who have sex with men (MSM), says Abhina Aher from the India HIV/Aids Alliance, a leading charity supported by the Elton John Aids Foundation (EJAF).
The Alliance has identified MSM as a key at-risk group being left behind in the country’s response to HIV, threatening India’s goal of meeting the UN’s “90-90-90” pledge by 2020. HIV prevalence rates are around 16 times higher in this group compared to the general public.
Intense societal pressure to get married at a young age makes the matter worse, Ms Aher says - Alliance estimates that 60 per cent of their MSM clients also have wives, making it very difficult to get them to open up about unsafe sex practices.
For many young men in India, anal sex is seen as harmless experimentation - the most common Hindi word for it is masti, literally meaning “fun”, or “mischief”. A complete lack of sex education means most people don’t realise it carries the same risk of infection as other forms of sex. 
“We get people who will say they f***ed a man but won’t admit that they liked it because it undermines their masculinity,” says Ms Aher. 
“If you don't want to acknowledge you are having sex with a man, you won't have conversations about STIs, you won't be careful about correct condom use. You don't want to talk about it - you just want to get it done!” 
Groups like the Alliance are having to come up with innovative ways to reach men having sex with men, to let them know that they are at risk of HIV and need to get tested. 
One option is to take advantage of the explosion of smartphone use in urban India. It is now thought that more than 50 per cent of all men in large cities like Delhi are online, and popular apps like Facebook, Grindr, WhatsApp and Instagram offer access to untapped communities that have never been subject to HIV outreach before.
Online trials have had very promising results. After a one-month test run with a social media consultant, the Alliance found the rate of clients getting tested at its Delhi clinic who heard about the service online rose from 6 per cent to 45 per cent.
Another agency using funding from EJAF has launched the website Safe Masti, which includes India’s first anonymous online chat service for MSM seeking more information about safe sex.
Programme manager Harsh Agarwal says the site has reached two million people in just 15 months. He believes government programmes, which exclusively rely on traditional methods of encouraging people to find out their HIV status, are increasingly out of touch.
“There has to be a shift to online, 100 per cent,” he says. “When you can meet anyone in the world from the comfort of your own home, no one in their right mind would want to keep cruising for sex [on the street].”
Safe Masti’s online chat service is manned by Vishwa Srivastava, a charismatic young doctor who says that - as a gay man who is also HIV+ himself - he can relate to shy and worried clients in a way counsellors at a public hospital never could.
Mr Srivastava described one case of a 21-year-old student from a poor family who was awaiting his initial HIV test results when he first reached out to the Safe Masti chatline.
“He hadn’t ever told anyone else about his sexuality, let alone about his HIV status. We talked, and when the test came out positive, he called me crying. He was feeling guilty and trapped. He felt like he was being punished by God because he is a sinner, for having gay sex.
“He didn’t know how he was going to inform his family. I helped him, I even sent him a little money to pay for travel to an NGO where he could start treatment. More than that, I could offer hope, and give him guidance for how he could go forward with his life.”
Despite the shift online, Delhi remains well-known in the LGBT+ community for its network of massage parlours, which are still among the most popular places gay men go to pay for sex.
Speaking at the Alliance’s Samarth clinic, former masseur Avinash says it will still be “some time” before attitudes shift in the wake of the September ruling of the Supreme Court striking down Section 377, a clause of the British-era Indian Penal Code that was interpreted as outlawing gay sex. 
Avinash is an HIV+ former masseur who now provides outreach work for the Samarth HIV/Aids clinic in Delhi. He says social media has huge potential to raise awareness of HIV testing, but can never fully replace one-to-one interactions with the LGBT+ community (Adam Withnall/The Independent)
“Many don’t understand what the 377 [ruling] is,” he says. “They think it means two kuthi (Hindi slang for an effeminate man) can get married, and that’s something they don’t think should be done.”
Avinash says he regularly experiences first-hand the stigma against gay men in Indian society. “You get used to being called names. But there have been times when it was physical abuse too.”
He was one of the first clients to be tested positive when the Samarth clinic opened in 2016, at a time when he was cruising for sex with multiple partners more or less every night.
His contacts within the massage parlour network have been invaluable to the Alliance, and he still believes there is a place for the traditional outreach worker in the battle against India’s HIV epidemic.
“The chunk of the population may stop using cruising spots to hook up, but social media has its limitations,” he says. “People may be using a smartphone, but a lot are less educated and they won’t understand what you are trying to say.
“If I’m trying to bring a person for a health check, that message will still require some explanation, and some kind of support [afterwards]. You need that one-to-one personal touch to get people to understand.”
Money raised from public donations through the AIDSfree appeal will be used to support the Elton John AIDS Foundation projects in six key cities around the world (London, Nairobi, Atlanta, Kiev, Delhi and Maputo). Through UK Aid Match the UK government will double public donations up to £2m to be spent across projects in Maputo and Nairobi.

November 29, 2017

Americans Are Getting HV Tested Faster But Not Fast Enough

 HIV Testing Kids Vending Machine located at a Bar

Americans with HIV are getting diagnosed faster than ever before, but most people who are infected carry the virus for years before they know it. 
On average, people infected with the AIDS virus go three years before they are tested and told about it, the Centers for Disease Control and Prevention reported Tuesday. 
That’s three years during which the virus is eroding away at their immune systems, leaving them vulnerable to other infections — and three years during which they can infect others without even knowing it. 
But it’s still an improvement, the CDC team said. In 2011, people went an average of three years and seven months before they got a test and diagnosis. 
Graphic: Time between HIV infection and diagnosis depends on risk group and race/ethnicity
Paul Cheung / CDC
“These findings are more encouraging signs that the tide continues to turn on our nation’s HIV epidemic,” said CDC Director Dr. Brenda Fitzgerald. “HIV is being diagnosed more quickly, the number of people who have the virus under control is up, and annual infections are down.” 
But three years is still too long and this gap between infection and detection is helping keep the virus in circulation, the CDC said. 
“Ideally, HIV is diagnosed within months of infection, rather than years later,” said Dr. Eugene McCray, director of CDC’s Division of HIV/AIDS Prevention.  
About 1.1 million Americans are infected with the human immunodeficiency virus (HIV) that causes AIDS. Thanks to better testing, about 85 percent of them know it, and nearly half, 49 percent, have the virus under control with drugs. 
There’s no cure for HIV and no vaccine on the market yet, but increasingly simplified drug cocktails – some as simple as a single daily pill — can control the virus so that it cannot be easily detected in the blood, doesn’t make people sick and makes it almost impossible to transmit to others
Some groups go even longer than three years. For heterosexual men, it takes on average five years to get tested and diagnosed, in part because straight men don’t think they are at high risk. 
“Fifty percent of persons with HIV infection diagnosed in 2015 had been infected for at least three years, and a quarter had been infected for more than seven years,” the CDC team wrote in their report. 
Whites are tested on average after two years, African-Americans get tested on average three years after infection and Asian-Americans don’t get diagnosed until they’ve been infected for four years on average. 
They’re not only missing out on treatment — they are often infecting others. 
“It’s 40 percent of HIV infections in the United States (that) are inadvertent, unknowingly being transmitted by persons who don’t know they have HIV,” the CDC’s Dr. Jonathan Mermin told reporters. 
“Nine out of 10 HIV infections are transmitted by people who are not diagnosed or not in care,” the CDC adds on its website. 
The way CDC calculates that is by looking at how much damage has been done to patients’ immune systems when they finally are tested. The virus attacks immune cells called CD4 T-cells, and blood tests measure both how much virus is in a patient’s blood and how many of these crucial T-cells have been destroyed. 
What’s helping get more people tested? Quick, on-the-spot tests have made a big difference, said Rama Keita, Community Health Educator at Washington, D.C.’s Whitman-Walker clinic. 
“We went from people having to wait 20 minutes to get their results to just having to wait 60 seconds,” Keita said. 
Clinics and advocacy groups have also stepped up active efforts to get people tested, Keita said. “We go where the clubs are,” she said. Mobile units offer quick testing in communities with a higher-risk population. 
But it will take more than that to reach straight men, Asian-Americans and others who may not realize they’re at risk. Straight men, for example, are less likely to walk into a mobile HIV testing van. 
“They think, ‘I don’t want to be labeled as a member of the LGBT community. I don’t want to go into Whitman Walker’,” Keita said. “That mentality will keep you from coming in and getting tested.” 
And that’s a shame, said Carl Corbin, a Whitman-Walker patient, and volunteer who tested HIV positive in the early 1980s, at the start of the HIV epidemic. “All of my friends were dying all around me,” Corbin said.  
“I was saying to myself, 'I am not going to live another year'. I have lived 30-some years.” 
But even though people lose hope when they hear they have an incurable disease, HIV can be managed with the many available drugs on the market. 
Now 61, Corbin is healthy and has no detectable virus in his blood. 
“I advise every human being to get tested. There is so much help out here for you,” he said. 
While some groups are at more risk than others, anyone could become infected. The CDC recommends that almost everyone be tested for HIV at some point. 
“If you are having sex you are at risk. It’s a sexually transmitted disease,” Keita said. 
“We know infidelity occurs. Sometimes things happen.” 
The best result would be if men and women alike were tested routinely as part of a doctor visit, said Mermin. But 70 percent of people at high risk who were surveyed by CDC and who had not been tested said they'd been to a doctor in the past year. 
"We don't want to burden people with having to think of themselves as being at risk of HIV," Mermin said. "It should be as routine as a cholesterol test." 
Those most at risk include gay and bisexual men, their sex partners, and injecting drug users. But any kind of sex can transmit the virus, as can the use of shared needles. 
“Get tested. Know your status,” advises Corbin. “Because getting tested and knowing your status will save your life. If you are sexually active in the world today, you are at risk, because it is not a gay disease.” 

August 16, 2017

In London An HIV Testing Vending Machine at Gay Sauna


In London, an innovative vending machine for HIV tests being piloted in Britain aims to help in the fight to end the epidemic by encouraging more people to find out whether they have contracted the virus as a first step to seek treatment, a doctor said.

Installed at a gay sauna in the southern seaside city of Brighton, the first-of-its-kind machine distributes free fingerprick self-testing kits that can be collected anonymously and used at home, providing results within minutes.

"(The aim) is to... encourage people who haven't tested so far to test," said doctor Gillian Dean, an HIV specialist at the Martin Fisher Foundation (MFF), the charity behind the project.

A vending machine dispensing free HIV tests is seen at the entrance of the Brighton Sauna in Brighton, Britain, August 10, 2017. Cormac O'Brien / Thomson Reuters Foundation
An estimated 14 percent of the more than 100,000 people living with HIV in Britain have not been diagnosed and are unaware they have the virus, according to government figures.

"If we can get to that 14 percent and get them tested and on treatment then they will essentially become uninfectious and the whole epidemic could then be drawn to a conclusion," Dean told the Thomson Reuters Foundation in an interview at the Brighton Sauna, where the machine was installed in June.

Currently many people are put off tests by the lack of anonymity and restricted working hours of sexual health clinics, MFF said.

A 2016 study of 281 men at the Brighton Sauna showed while about a third had never been tested, 93 percent were prepared to try self-testing or self-sampling, the charity said.

In the first six weeks since the machine was installed, it dispensed more tests than those collected by charity workers at the sauna in the preceding six months, it added.

Related: UnitedHealthcare Apologizes, Reverses Truvada Policy After HIV Activists Push Back

People living with HIV can take antiretroviral medication to lower the amount of virus in their blood, reducing the risk of transmission to their sexual partners.

Sauna customer Callum Stripp, 18, said heading to a clinic to get tested for the first time was an experience many gay men dreaded due to stigma surrounding the disease and homosexuality.

The kits dispensed by the touchscreen machine allow for more privacy and help reduce anxiety as traditional testing methods can take a few days to arrive, he said.

"You're left waiting and it nags that you might get a bad result. Having such a quick and easy kit eliminates all of that worrying," said Stripp.

The machine is accessible to anyone during the sauna's opening hours and staff have been trained to offer support and advice.Instructions on how to seek help are also included in the kit, which costs significantly less than in-clinic tests
Funded by a government grant, the machine, could also be used to collect data for research, Dean said.MFF said it planned to roll out 10 more machines at gay venues across Brighton, which has the second highest prevalence of HIV in Britain after London.

Of 6,095 people in Britain newly diagnosed with HIV in 2015, 54 percent were gay and bisexual men, according to Department of Health data.


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