This week in HIV/AIDS, is an ongoing weekly blog series where I highlight news or commentary about HIV/AIDS in an attempt to increase the dialogue about HIV/AIDS within the LGBTQ community.

Before I highlight anything for the week, I want to put out a call for anyone taking PrEP who is willing to talk to me/ answer some questions, please contact me. Looking to seek your experiences to include in some way within this blog series. Confidentiality/anonymity honored. Email interest to thomaswaters@mac.com.

I have three links I want to share this week regarding HIV/AIDS.

(1) The first is a link to a guest post at The Billerico Project that I write some about yesterday. David Mariner, Executive Director of the DC Center for the LGBT Community, posted some ideas about strategies for progress in 2015 which included the goal of “End New HIV Infections.” He writes:

In 2010, gay and bisexual men accounted for 63% of estimated new HIV infections in the United states. A sobering statistic, but the numbers are even more alarming when you look at gay and bisexual men of color.
While HIV/AIDS has not been a high-priority for many LGBT organizations, perhaps nothing would have a bigger impact on the lives of gay and bisexual men than ending new HIV infections, and New York State is making a plan to do exactly that. Better yet, it’s a plan you can replicate in your state.
The end of the AIDS epidemic in New York will occur when the total number of new HIV infections has fallen below the number of HIV-related deaths. Governor Cuomo and local HIV/AIDS activists have a three-point plan to get this done.

  • Identifying persons with HIV who remain undiagnosed and linking them to health care;
  • Linking and retaining persons diagnosed with HIV to health care and getting them on anti-HIV therapy to maximize HIV virus suppression so they remain healthy and prevent further transmission; and
  • Providing access to Pre-Exposure Prophylaxis (PrEP) for high-risk persons to keep them HIV-negative.

Learn more about the plan on the Housing Works blog, and take part in the campaign to #EndAIDS2020 in your state.

(2) The next post appeared on December 24th on science daily.com:

How llamas’ unusual antibodies might help in the fight against HIV/AIDS

Most vaccines work by inducing an immune response characterized by neutralizing antibodies against the respective pathogen. An effective HIV vaccine has remained elusive so far, but researchers have continued to make progress, often employing innovative methods. A new study reports that a combination of antibodies from llamas can neutralize a wide range of circulating HIV viruses. After initial disappointment that HIV vaccine candidates were unable to elicit neutralizing antibodies, researchers found that some HIV-infected individuals did produce such antibodies. The current challenge is therefore to find safe and effective vaccine formulations (as opposed to HIV infection) that trigger the development of neutralizing antibodies that can recognize and prevent infection with all or most circulating HIV subtypes.

This is a really interesting story about the use of a non-conventional research animal that has offered a methodology for the creation of antibodies in response to vaccination which has proven impossible in more traditional research animals. This is because of the size of the developed proteins in relation to the size and location where the HIV virus binds to the CD4 receptor. In llamas,  a smaller protein is produced.

Research is rarely very easy for the average person to understand, yet I believe that one thing that has pushed gay men away from being more engaged in HIV prevention efforts is that there is a sense that progress is really impossible in the efforts for a cure or vaccination. The more the community can understand about the work, the less fearful it all can seem.

(3) The last is a post that appeared on HuffPost Gay Voices on /December 12th (but I didn’t catch last week) written by John-Manuel Andriote.

Spike in Tiny Number of Gay Men on PrEP Abandoning Condoms Hardly Represents ‘All’ Gay Men

This is a must read post in my opinion, and speaks about one of the primary controversies regarding PrEP, a daily drug regimen used as a prophylactic against HIV infection. Here is a part of the set up for the post:

Leuty reported on a survey of men in a Kaiser Permanente AIDS-prevention program. More than 500 are taking Truvada once a day as pre-exposure prophylaxis (PrEP). Leuty called the 45-percent increase among men in the study not using condoms “eye-popping” — which it is. Clearly these men aren’t heeding the Centers for Disease Control and Prevention’s recommendation to use condoms in addition to taking the drug.

It is hard to condense Andriote’s lengthy and meaty post down to a few words, so I’m not really going to try. But I love the questions he puts forward:

We can argue all we want about whether PrEP provides cover for dangerous behavior. But we aren’t addressing the most important questions: Why do some gay men value high-risk sex more highly than they apparently value their own health? Why do some guys seem unable to value themselves apart from their willingness to engage in “anything goes” sex?

I don’t think he addresses this at all, and ends up moralizing and judging in an effort to defend PrEP and protect it from negative publicity that may hut its greater adoption. To be sure, I utterly agree that PrEP offers a valuable tool to help stop the spread of HIV, and steps ti increase use of it will be invaluable, but as a gay man who has been active since before there ever was such a thing as HIV/AIDS, I struggle with his assertion that a desire to have condom free sex equates to not valuing their own life. I think men have condomless sex for a wide variety of reasons, and simple condescending moralization will never address the important questions he puts forward.

I want to note that the CDC recommendation is for condoms to be used in addition to PrEP. This not only increase the ability to stop HIV spread, but also the spread of other STIs, although I haven’t yet seen research that shows what the actual amount of increased prophylaxis may be. How successful are condoms alone? Condomless with PrEP, and PrEP alone.

I really suggest reading his whole post and thinking about what he has to say– you may agree or not– but these are crucial issues for the gay male community to grapple with as HIV infection rates rise again after many years of decrease.

 

 

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