HIV diagnosis rate down by a third in the U.S.

From USA Today:

There is some good news in the fight against AIDS: The rate of diagnosis for HIV infections has fallen in the United States by a third over the past decade, a study finds.

The report, released Saturday by the Journal of the American Medical Association, can be seen as a sign that the AIDS crisis, which first hit the U.S. in large numbers in the 1980s, is starting to subside.

“It means treatment is working,” says Thomas Coates, associate director of the AIDS Institute at UCLA, who wasn’t involved with the study by the federal Centers for Disease Control and Prevention. “It means people who are infected are getting into care and not progressing to AIDS.”

HIV is the virus that causes AIDS, which destroys the immune system. The World Health Organization estimates that 35 million people globally have the virus, which was once thought to be an immediate killer. But new medicines have been able to keep HIV in check — former sports superstar Earvin “Magic” Johnson announced in 1991 that he was HIV-positive and shows no signs of slowing down.

The report covers the years 2002-2011, when nearly 500,000 patients were diagnosed with HIV. “Statistically significant decreases” in diagnosis rates were found in nearly every demographic group, the study says, with the biggest changes for women and individuals 35-44 years old and persons of multiple races.

The findings show 16 out of every 100,000 people ages 13 and older were newly diagnosed with HIV in 2011, a steady decline from 24 out of 100,000 people in 2002.

There is bad news from the study: Infection rates among presumed gay men didn’t trend downward. “Increases were found among certain age groups of men who have sex with men, especially young men,” the study says. “Because of delays in diagnosis, temporal trends in diagnoses and variations among groups may reflect earlier changes in HIV incidence.”

The study blames unprotected sex as the chief culprit for the increase.

Coates says most of the young men getting infected are African-American. “Access remains a problem,” he says. “Even with the Affordable Care Act, this is a population not used to having access to care. We need to make sure health services are available.”

Additionally, the study points out that it only reports on people who have taken the time to be diagnosed. “Reports show that many at high risk do not test annually and the overall percentage of youth who had ever tested for HIV during the period of analysis was low compared to other age groups.”

The study is based on HIV diagnoses from health departments in 50 states, which get results from medical offices.

Contributing: The Associated Press

 

Obamacare Could Insure 171,000 People With HIV

From aidsmeds.com.

Nearly 47,000 people with HIV who are in care and an additional 124,000 who are not have the potential to gain insurance coverage thanks to the Affordable Care Act (ACA, or “Obamacare”), according to Kaiser Family Foundation. The nonprofit health research organization analyzed data from the Centers for Disease Control and Prevention’s (CDC) Medical Monitoring Project to provide this first-of-its-kind analysis of how the 2010 health care law likely affects the HIV population. The study does not take into account any actual enrollment into ACA-related health care plans that may have taken place since open enrollment began in October 2013.

Out of an estimated 1.2 million Americans who are living with the virus, nearly 407,000 are in care.  Eighty-seven percent of those in care have incomes below 400 percent of the federal poverty level (FPL), which is the cutoff for receiving federal subsidies to pay for the new insurance marketplace plans. About 40 percent of Americans with HIV who are in care are currently covered by Medicaid.

Read the rest of the article here.

Health Law Inspires Hope But Also Worry Among Those With HIV

From kaiserhealthnews.org.

Matt Sharp had high hopes for the nation’s health law. The self-employed health consultant is HIV positive and has been denied insurance in the past because of his illness, so he was relieved to learn that the law wouldn’t allow that to happen again.

But now, the 57-year-old San Francisco Bay Area resident is less sure that Obamacare will live up to his expectations.

He plans to enroll in coverage through the state’s insurance marketplace — but he still doesn’t know if his doctors will be included.  And although he will get help with premiums and medications through an existing program for HIV patients, Sharp worries he won’t be able to afford co-payments and other out-of-pocket expenses.

“I am apprehensive,” said Sharp, a former classical dancer. “There is a lot of unease with the whole rollout. But when you are talking about a person in my situation, there is even more unease.”

The complete article can be found here.

Computerised Counselling Offers Many Benefits for HIV Therapy Patients

From aidsmap.com.

Computerised counselling can achieve reductions in viral load and HIV transmission risk behaviour, investigators from the United States report in the online edition of the Journal of Acquired Immune Deficiency Syndromes. The counselling programme was associated with significant reductions in viral load, improvements in adherence to HIV therapy and reductions in risky sexual behaviour.

“The adherence effect was most pronounced among those whose plasma HIV-1 load was not suppressed at baseline,” comment the investigators. “This reduced viral load and fewer sexual transmission risk behaviors seen among those undergoing the intervention both may contribute to decreasing HIV transmission to sexual partners.”

Thanks to antiretroviral therapy, many people with HIV now have a normal life expectancy. The best outcomes are seen in individuals who adhere to their treatment. Good adherence also has a secondary benefit, as suppression of viral load is associated with a reduced risk of HIV transmission to sexual partners.

However, some people living with HIV have difficulty achieving and sustaining the levels of adherence associated with the best treatment outcomes, and a significant proportion of patients with HIV have sexual behaviour that involves a risk of HIV transmission.

Investigators in Seattle wanted to see if a computer-delivered intervention called Computer Assessment and Rx Education for HIV-positive people (CARE+) improved treatment adherence and reduced transmission risk behaviours.

Find out more about the study here.

Regular Clinic Attendance Especially Beneficial for People with HIV who have Low CD4 Counts

From aidsmap.com

Strong association between regular clinic attendance and achieving undetectable viral load

People taking HIV treatment who have a low CD4 cell count are especially likely to achieve an undetectable viral if they attend their routine clinic appointments, research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes suggests.

The US study showed that retention in HIV care had a stronger association with viral suppression for people with a low CD4 cell count than people with stronger immune systems.

Overall, people with higher CD4 cell counts were more likely to achieve an undetectable viral load. However, the effect of regular clinic attendance on the chances of viral suppression was greater for people with immune suppression.

“While it is well established that retention in care is important for all HIV-infected patients”, write the authors, “our data suggest that retention in care may be even more central to achieving optimal virologic outcomes for persons with advanced HIV disease.”

Read the entire article here.

HIV May Be Becoming Less Fit as it adapts to the Immune System

From aidsmap.com

HIV, at least in some parts of the world, may be developing a lower replicative capacity as it adapts to variations in the human immune system, studies in southern Africa and elsewhere suggest.

Philip Goulder of the University of Oxford told the AIDS Vaccine conference last month that competition between HIV and certain varieties of human HLA (human leukocyte antigen) genes may be contributing to a diminution in HIV virulence, a lower community viral load, and an increased proportion of ‘elite controllers’ in the population.

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Goulder remarked that these changes seemed to be happening surprisingly fast, and that in some populations the introduction of antiretroviral therapy would also tend to reduce the fitness of the HIV that was still circulating.

Continue reading here.

Alicia Keys to Host National Watch Party and Twitter Chat about Women and HIV/AIDS in America

From The Sacramento Bee.

Sunday, January 19th at 8-9 pm EST / 5-6 pm PST Streaming on VH1.com and GreaterThanAIDS.org

Live Chat #WeAreEmpowered

Fourteen time Grammy Award-winning artist and HIV advocate, Alicia Keys, is joining with Greater Than AIDS to host a National Watch Party and Twitter Chat about women and HIV/AIDS in America Sunday, January 19th.

Ms. Keys is urging women and their loved ones to come together on Sunday, January 19th between 8-9 pm ET (5-6 pm PT) and log on to VH1.com to watch “We Are Empowered,” an intimate and inspiring half-hour conversation that she had about friendship, love and strength with five women living with HIV in the U.S. Ms. Keys will be live tweeting throughout the hour at #WeAreEmpowered.

Clear Channel Radio will make available an audio version of the program for broadcast across its stations nationwide (check local stations for airtime). And Walgreens is helping to amplify the message through social media efforts by engaging popular bloggers to encourage their followers to take part and host their own watch parties.

More information on the broadcast can be found here.