It's National HIV Testing Day

So notes the Centers for Disease Control:

The majority of the estimated 56,000 new HIV infections that occur each year are transmitted by those who are unaware of their infection. Effective HIV treatments now allow people living with HIV to live long, productive lives, yet nearly 17,000 people with AIDS still die every year in the United States. Despite these troubling statistics, the majority of Americans have still never taken an HIV test. Many people don’t recognize that they’re at risk for HIV infection, even if they engage in behaviors that put them at risk. Others may fear what a positive diagnosis could mean for them, despite the effective treatments now available. And many people don’t yet realize that testing today is quick, easy and confidential. On this National HIV Testing Day, don’t let fear or misinformation stop you from getting tested. I strongly encourage all Americans to get tested for HIV, and to text and tweet hivtest.org to your friends and family to encourage them to do the same. HIV testing is the critical first step to protect yourself and your loved ones from HIV, and to help end the HIV epidemic in the United States.

In addition to the LGBT community health centers, there are many locations in New York City which offer rapid same-day HIV testing. Know your status.

Comfort Levels Around Pozzers

Andrew Sullivan points out an updated survey just published by Kaiser. Even in 2011, more than half of the respondents say they aren't comfortable having their food handled by HIV+ people. Embiggen for details.

HIV Map Of America

Wired Magazine reports:

With HIV’s 30th anniversary around the corner, a new interactive map reveals U.S. data on the disease down to individual counties and, for some cities, even zip codes. The nonprofit mapping effort, called AIDSVu, isn’t a perfect representation of the disease in the United States. The visualization is based on 2008 data, some states didn’t contribute county or demographic information that others did, and the map shows only diagnosed rates and cases. An estimated 1 in 5 HIV carriers in the U.S. are undiagnosed. Despite these limitations, it may be the most thorough geographical depiction of HIV ever created.

(Tipped by JMG reader Nicholas)

HomoQuotable - Larry Kramer

"Please know that AIDS is a worldwide plague. Please know that no country in the world, including this one, especially this one, has ever called it a plague, or dealt with it as a plague. Please know that there is no cure. Please know that after all this time the amount of money being spent to find a cure is still miniscule, still almost invisible, still impossible to locate in any national health budget, and still totally uncoordinated.

"Please know that here in America case numbers continue to rise in every category. In much of the rest of the world — Russia, India, Southeast Asia, Africa — the numbers of the infected and the dying are so grotesquely high they are rarely acknowledged. Please know that all efforts at prevention and educations continue their unending record of abject failure. Please know that there is no one in charge of this plague. This is a war for which there is no general and for which there has never been a general. How can you win a war with no one in charge?" - Larry Kramer, from a letter handed to patrons attending the revival of his landmark play, The Normal Heart.

Read Kramer's entire letter.

CDC Responds To End Of African PrEP

The CDC writes us this morning to note their response to the early halting of an African HIV PrEP study, which I mentioned yesterday. Pre-exposure prophylaxis (PrEP) involves taking an HIV medication as a preventive to infection. The CDC expresses disappointment with the cessation of the African study, as "this approach has already been shown to be effective in reducing HIV infection among men who have sex with men."

While PrEP with FTC/TDF was not shown to be effective in preliminary analyses of these study results, it cannot yet be definitely determined whether this drug combination works, or does not work, to prevent HIV among women. FEM-PrEP study investigators will be conducting additional analyses in the coming months to better assess potential reasons for the results in this study – including examining factors such as adherence and differential risk behavior between the two trial arms -- that may account for the lack of demonstrated efficacy in this trial. Investigators from other PrEP trials, including CDC, will be working closely with FHI to review all available data and determine any implications for ongoing research. Given today's results, CDC cautions against women using PrEP for HIV prevention at this time. We will not know if PrEP is effective for women, couples, or injection drug users until the conclusive results of this and other trials are reported.

American Psycho

San Francisco: Earlier HAART Treatment Appears To Reduce New HIV Infections

According to a story posted on AIDSmap.com, San Francisco is seeing a decrease in new HIV infections because HIV+ people are going on medication sooner and therefore have a reduced period of infectiousness.

Dr Das presented more evidence from San Francisco to show a strong correlation between reductions in community viral load and the falling number of HIV diagnoses. The most recent CVL, defined as the average viral load of all HIV positive people being seen for care in the city, went down from approximately 25,000 copies/ml in 2004 to 10,000 copies/ml in 2009. Over the same time, new diagnoses of HIV decreased from 820 in 2004 to 500 in 2009. For CVL to decrease, a number of other things have to happen first, in a ‘cascade’ of events. Firstly, the frequency of testing in the at-risk population must increase; this must result in a lower proportion of undiagnosed cases; those diagnosed must be linked to care, and the majority must start treatment; and the time between diagnosis and viral suppression must reduce. Dr Das said all these indicators were strongly correlated. The average time from diagnosis to the start of treatment shrank from twelve months in 2004 to two months in 2009. The time between diagnosis and achieving an undetectable viral load went down from nearly three years in 2004 to eight months in 2009; and the percentage with an undetectable viral load within a year of diagnosis increased from 26% in 2004 to 82% in 2008.

Last April the San Francisco Department of Public Health adopted the controversial position that newly infected patients should immediately begin HAART therapy upon their diagnosis. Some AIDS activists strongly objected to that, citing the prevailing opinion that HAART treatment should be delayed as long as possible due to the long-term side effects of the medications. Many HIV specialists continue to recommend a closely-monitored delay in treatment, but the above result in San Francisco should not be discounted.

(Tipped by JMG reader Bill)

Mark King On Florida's ADAP Crisis

More than half of the nation's AIDS patients who are on waiting lists to get medications are in Florida. Last week Sen. Bill Nelson wrote both the president and Florida Gov. Rick "Medicare Fraud" Scott, warning of a catastrophic public health crisis over the lack of ADAP funding. In the below clip, South Florida AIDS activist Mark S. King lays out the situation and what can be done about it.

CDC Issues Interim PrEP Guidance

Last last year researchers announced some success in preventing HIV among gay men who were taking a daily dose of the HIV medication Truvada. The concept of warding off infection by pre-dosing with a medication is known as pre-exposure prophylaxis (PrEP.) But alarmed by the prospect for abuse, yesterday the CDC issued some interim PReP guidance as studies continue.

CDC says it wanted to fend off improper use of pre-exposure prophylaxis (or, more catchily, PrEP) as it and other agencies work on more detailed guidelines, which will take “several months.” It says that the drug should only be used in men who have sex with men, since studies in other high-risk groups such as IV drug users are still underway. And it should be used only in high-risk men (with multiple partners or partners from an area with a high prevalence of HIV infection), who are most likely to benefit. Also, the drug isn’t the equivalent of the morning-after pill for HIV; it’s meant to be taken daily. “Support for adherence to the prescribed medication regimen must be a routine component” of PrEP, the CDC says. (In the study, the risk of HIV infection was reduced just 21% in men whose adherence was less than 90%, compared to a 73% lower risk of infection for those with adherence of 90% or better.) And other preventive measures, such as condom use, should continue to be taken.

The wholesale cost of Truvada in the United States is $1000 for a month's supply, a cost unlikely to be covered by insurance when the drug is used as a preventive. In some countries, Truvada costs as little as $12/month.

AIDS Denialists: Science Under Attack

In the first half of this BBC Science Under Attack special aired Sunday night, Nobel Prize winner Sir Paul Nurse examines the mindsets of folks who deny the science behind global warming. Interesting stuff, but skip forward to 43:00 where Nurse takes on a New Yorker who blithely denies that HIV causes AIDS.

(Via -Atheist Media Blog)

Roberto Alomar Named To Baseball Hall Of Fame Despite HIV-Related Accusations

Superstar second baseman Roberto Alomar was elected to the Baseball Hall Of Fame today, surprising some observers who had predicted that the retired ballplayer's HIV-lawsuit peppered past would keep him from the sport's greatest honor. In October 2010, Alomar's estranged wife filed a lawsuit claiming he had unprotected sex with her even though he knows he is HIV-positive. In 2009 a former girlfriend sued Alomar on similar grounds, claiming that he told her he was raped by two Mexican men at the age of 17 after playing in a baseball game in a southwest U.S. state. The ex-girlfriend said that she stayed with him for almost three years after his 2006 positive HIV test, but that she no longer had unprotected sex with him after that. Alomar settled the girlfriend's $15M lawsuit out of court for an undisclosed amount. His wife's lawsuit is still pending. Neither woman has reported being infected and Alomar continues to avow that he is not HIV-positive. He retired from baseball in 2005, citing health issues.

FDA Approves One-Minute HIV Test

The FDA has approved an HIV test that provides results in one minute.

“We believe the speed, accuracy, and unique technology of our 60-second HIV test will make the testing and early treatment of HIV/AIDS more efficient in all patient settings, including hospital emergency rooms and public health clinics,” said bioLytical Laboratories president Philip Bligh in a press release. “Additionally, our high-volume, automated manufacturing capability makes INSTI one of the most cost-effective solutions available for providers of HIV rapid testing.”

Got a minute? Get tested.

CALIFORNIA: State OSHA Fines Gay Porn Studio For Allowing Barebacking

The California division of OSHA has fined the gay porn studio Treasure Island Media for workplace practices that exposed employees to potentially infectious agents such as semen. The company is appealing the fines, which total over $21,000 for three separate citations. Lyla Katz reports at Xbiz:

"On Nov. 5, 2009, Treasure Island Media had failed to write or otherwise establish, implement and maintain an effective exposure control plan,” the 23-page investigation report said. “Employees were exposed to semen and other potentially infectious materials, due to work activities during filming and set cleaning.” The second serious citation said, “Treasure Island Media does not observe universal precautions during the production of their films. They have not instituted engineering and work practices controls to eliminate or minimize contact with blood and semen, including, but not limited to, the use of barrier protection such as condoms.”

Treasure Island Media's general manager Matt Mason told XBIZ that the company has cooperated with the Cal/OSHA investigation and administrative process. "We have appealed the citations and participated in the informal conference process and expect to take the matter to a hearing in 2011 with an administrative law judge," Mason said. Treasure Island Media has recently signed HIV-positive performer James Roscoe and has been promoting scenes with other HIV-positive performers.

A spokesman for CAL/OSHA said the fines did not arise from the studio's practice of employing HIV-positive performers. "Anybody may be infected, therefore you have to treat everybody's blood and other potential infectious materials [such as semen] as though it can be infectious."

HIV Drug Effective In PrEP Study

A just-released pre-exposure prophylactics (PreEP) study reveals that taking the HIV drug Truvada once a day reduces the incidence of HIV infection by about 44%. The result was even better among men who were the most compliant about taking the drug every day.

The drugs tenofovir and emtricitabine, packaged as a once-daily pill and sold in drugstores as Truvada, reduced HIV infections by an average of 44% among gay and bisexual men who took the drug, compared with those taking a placebo. Men who reported being the most diligent about taking their pill each day reaped an even bigger benefit, reducing their risk by 73%. "This is a huge step forward," says lead researcher Robert Grant, at the J. David Gladstone Institute at the University of California-San Francisco, a non-profit research foundation that carried out the study. David Paltiel of Yale University says that his research shows that Truvada could be as cost-effective a prevention method as those used to combat heart disease diabetes and cancer, despite its $8,700 annual cost.

The findings have bred new enthusiasm in a field where, for years, optimism was rare. Over 30 years, HIV has infected 40 million people. But this year alone, researchers have demonstrated that a pill and a vaginal gel (containing a component of Truvada) can prevent HIV and shown, at least in concept, that a vaccine can work. This is a very exciting, dynamic time in HIV prevention research," says Alan Bernstein, head of the Global HIV Vaccine Enterprise, a non-profit effort to accelerate vaccine research. "It couldn't come at a better time. There's clearly a growing realization that we're not going to be able to treat our way out of this epidemic.

Read the full details of the study.

Wife Of Former Mets Player Roberto Alomar Sues Over HIV Exposure

The wife of former New York Mets second baseman Roberto Alomar has filed a lawsuit claiming he had unprotected sex with her even though he knows he is HIV-positive. A former girlfriend of Alomar filed a $15M suit on the same grounds last year. Alomar settled that case out of court.

"Prior to the marriage" in 2009, the suit says, Alomar assured his wife "he had been tested for sexually transmitted diseases and the tests were negative." At some point after their wedding, she discovered that wasn't true, the filing says. She "learned from conclusive proof" that he was HIV-positive, the court papers say. The discovery caused her to "suffer extreme emotional distress, fear and mental anguish," the filing says. She has "not contracted the virus to date but uncertainty still exists due to the delay in the onset of the virus." Lawyers for the Alomars did not return calls for comment. Rivera's filing says she wouldn't have agreed to "marry him if she had known of his true physical condition."

Alomar's wife, who had once denounced the claims of the former girlfriend as "vile lies" says she now wants a divorce. Alomar has consistently denied that he is HIV-positive. He became eligible for the Baseball Hall Of Fame this year, but narrowly missed induction. Some sports writers have speculated that the HIV issue may have cost him that honor as many consider him to be have been the greatest second baseman in the history of the sport. He remain eligible until 2024.

CDC Reports 1 In 5 Urban Gay Men Are Poz

According to a new report from the Centers For Disease Control, 19% of urban gay and bisexual men are HIV positive but one-quarter to one-half of them don't know it.

Researchers at the CDC studied 8,153 men who have sex with men in 21 U.S. cities. The men were taking part in the 2008 National HIV Behavioral Surveillance System, which looked at prevalence and awareness of the human immunodeficiency virus or HIV, the virus that causes AIDS. Overall, they found that 19 percent of gay men are infected with HIV. The study found that 28 percent of gay black men infected with HIV, compared with 18 percent of Hispanic men and 16 percent of white men. Black men in the study were also least likely to be aware of their infection, with 59 percent unaware of their infection compared with 46 percent of Hispanic men and 26 percent of white men. Age also plays a role. Among 18 to 29-year-old men, 63 percent did not know they were infected with HIV, compared with 37 percent of men aged 30 and older, the team reported in the CDC's weekly report on death and disease.

The CDC recommends at least an annual HIV test for all men who have sex with men.

POLL: Two-Thirds Of American Gay Men Support HIV Transmission Laws

According to a poll published today on AIDSmap.com, two-thirds of American gay men support laws that make it illegal for HIV-positive people to have unprotected anal sex without disclosing their status. The pollsters recruited 1725 gay men via social network sites.

“Believing that it should be illegal was associated with HIV-negative or unknown status, less education, having a non-gay sexual orientation, living in a state that was perceived as hostile towards GLBT persons, reporting fewer UAI [unprotected anal intercourse] partners…and feeling greater responsibility”, write the authors. Since 2008, at least 30 individuals in the US have been prosecuted for exposing others to HIV. Penalties vary between states and range from a small fine to a lengthy prison sentence. The impact of such laws on HIV prevention efforts are hotly debated. Moreover, there is uncertainty about the attitudes of the communities most affected by HIV about the criminalisation of HIV exposure. Overall, 65% of men believed that it should be illegal for HIV-positive individuals to have unprotected sex without disclosure, 23% thought it should not be illegal and 12% did not know.

Support for criminalisation was highest (79%) among men aged between 18 and 20, and lowest (56%) among those aged 41 to 70. The investigators note that younger gay men were significantly less likely to have been tested for HIV. Separate research has shown that untested men are more likely to adopt a disclosure-based HIV prevention strategy “that gains credibility by transmission laws.” The overwhelming majority (70%) of HIV-negative and untested men (69%) supported legal sanctions, but only 38% of HIV-positive men endorsed criminalisation. “These differences most likely reflect a shift in orientation toward criminal statues on HIV transmission following seroconversion”, comment the investigators. Men with the lowest educational achievements were most likely to support criminalisation (75%), and those with a degree least likely (58%).

Several notable recent cases have put the issue in the spotlight, including the arrest last month of a Canadian man who is accused of having infected two women after not disclosing his status to them. Also last month, German pop star Nadja Benaissa was convicted of "grievous bodily harm" for having sex without disclosure. Some have been arrested for non-disclosure even though no known infections resulted from their actions.

(Tipped by JMG reader Band)

China Hears First HIV Discrimination Case

For the first time in the nation's history a Chinese court will hear the case of a man who says he was denied a job because of his HIV status.

The man said he had passed written tests and interviews for the teaching post in Anhui province. But he warned down after medical screening revealed his HIV status, China Daily said. The newspaper reported that the case will be heard by a court in Anqing city, in Anhui province. The plaintiff, a recent graduate, was not asking for compensation but wanted to be given the job, it said. A lawyer for the plaintiff told the BBC that he would defend his client under existing Chinese laws. "The state already has laws and regulations forbidding discrimination against HIV carriers when they apply for jobs," Zheng Jineng said. "But the actual practise by some government departments and employers are in direct conflict with the laws. "The fact that the People's Court has accepted the case indicates that the rule of law in China is progressing."

Researchers Make HIV Breakthrough With Existing FDA-Approved Meds

Scientists at the University of Minnesota believe that two existing FDA-approved cancer medications may work jointly to eliminate HIV infections.

The two drugs, decitabine and gemcitabine -- both FDA approved and currently used in pre-cancer and cancer therapy -- were found to eliminate HIV infection in the mouse model by causing the virus to mutate itself to death -- an outcome researchers dubbed "lethal mutagenesis." This is a landmark finding in HIV research because it is the first time this novel approach has been used to attack the deadly virus without causing toxic side effects. Because decitabine and gemcitabine are already FDA approved, researchers believe that if their research is effective in large animal models, it will be much easier to expedite the development of the drugs for human use.

Researchers found that the drugs caused no cell toxicity and were effective against HIV in levels below "well below" those used for cancer. The drugs are now being reformulated for oral use.

Family Research Council: Repealing DADT Will Increase Male Rapes And HIV