END THE EPIDEMIC / DIGITAL

End the Epidemic, In Part by Digital Communication

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HIV TESTING IMPROVE

Frequency of HIV Testing and Time from Infection to Diagnosis Improve

 


 

WORLD AIDS DAY, FLORIDA HEALTH IN ST. LUCIE COUNTIES

November 30, 2017

ON WORLD AIDS DAY, FLORIDA HEALTH

IN ST. LUCIE CONTINUES FIGHT AGAINST

HIV/AIDS

Contact:

Arlease Hall Arlease.Hall@FLHealth.gov

772-370-1391

St. Lucie County, FL — As the Florida Department of Health in St. Lucie (DOH-St. Lucie)

unite with others in communities worldwide, we observe World AIDS Day by showing support for

people living with HIV and honoring those who have died from an AIDS-related illness. We also

take this time to celebrate the caregivers, families, friends, and communities that support them.

This year’s national theme is “Increasing Impact Through Transparency, Accountability and

Partnerships.”

“St. Lucie’s struggle with this infectious disease became a crisis, and we were highlighted in the

Silence Is Death Report in 2006; where severe racial and ethnic HIV/AIDS, disparities reached

epidemic proportion. Through community engagement, with strong leaders we addressed the

issue through a collective impact process. Now, more than 10 years later, we rank number 19

out of 67 counties, and we have the largest decrease in new HIV infections in the state. DOH –

St. Lucie continues to remain vigilant in addressing HIV/AIDS in St. Lucie, because we

understand the impact this disease has on families and a community”, said Clint Sperber,

Health Officer and Administrator of the Florida Department of Health in St. Lucie.

Over 1.1 million people in the US are living with HIV, and 1 in 7 of them don’t know it. The

department remains fully committed to fighting the spread of HIV in Florida and helping connect

individuals who are positive with lifesaving treatment and services.

Florida is a national leader in HIV testing. DOH and our partners throughout Florida have made

great strides in prevention, identifying infections early and getting people into treatment,

however there is still much work to be done. The department is focusing on four key strategies

to make an even greater impact on reducing HIV rates in Florida and getting to zero, including:

· Routine screening for HIV and other sexually transmitted infections (STIs) and

implementation of CDC testing guidelines;

· Increased testing among high-risk populations and providing immediate access to treatment

as well as re-engaging HIV positive persons into the care system, with the ultimate goal of

getting HIV positive persons to an undetectable viral load;

· The use of PrEP and nPEP as prevention strategies to reduce the risk of contracting HIV;

and

· Increased community outreach and awareness about HIV, high-risk behaviors, the

importance of knowing one’s status and if positive, quickly accessing and staying in

treatment.

With early diagnosis, individuals can begin appropriate treatment and care resulting in better

health outcomes. Studies have shown that providing antiretroviral therapy as early as possible

after diagnosis improves a patient’s health, reduces transmission and can eventually lead to

undetectable viral loads of HIV. This model has been successfully implemented in Florida and

there are currently 35 Test and Treat sites operating statewide.

As part of our strategic efforts to eliminate HIV in Florida, the Department of Health is currently

working to make Pre-Exposure Prophylaxis (PrEP) medication available at no cost at all of the

67 county health departments within the next year. PrEP is a once-daily pill that can reduce the

risk of acquiring HIV in HIV-negative individuals. PrEP should be used in conjunction with

other prevention methods like condoms to reduce the risk of infection. According to the

Centers for Disease Control and Prevention (CDC), taking PrEP daily reduces the risk of getting

HIV by more than 90 percent. DOH-St. Lucie is a Test and Treat site and we are now offering

PrEP.

PrEP will be made available through CHD STD and Family Planning Clinics and patients can be

provided with up to a 90-day supply of medications. Some CHDs may offer PrEP through a

specialty clinic. Visit floridahealth.gov to locate the CHD in your county.

Every CHD also offers high-quality HIV testing services. Testing can be completed at your local

county health department or you can locate HIV counseling, testing and referral sites by

visiting http://www.KnowYourHIVStatus.com or texting your zip code to 477493.

PLEASE JOIN US

World AIDS Day Candlelight Vigil: Friday, December 1, 2017 – 5:30 p.m.

Location: Fort Pierce City Hall -100 US Highway 1, Fort Pierce, FL 34950

World AIDS Day Celebration: Saturday, December 2, 2017

Location: Lawnwood Stadium – 1302 Virginia Ave, Fort Pierce, FL 32982

Games, activities for children, fun vendors, community resources, free HIV/STD testing and

“LIVE RADIO REMOTE”

For more information, call the Florida AIDS Hotline at 1-800-FLA-AIDS or 1-800-352-2437; En

Espanol, 1-800-545-SIDA; In Creole, 1-800-AIDS-101.

About the Florida Department of Health

The department, nationally accredited by the Public Health Accreditation Board, works to

protect, promote and improve the health of all people in Florida through integrated state, county

and community efforts.

Follow us on Facebook, Instagram and Twitter at @HealthyFla. For more information about the

Florida Department of Health please visit http://www.FloridaHealth.gov.

HIV and Our Youth

KEY FINDINGS

1. HIV hits close to home for many young people of color.

Due to a combination of social inequities and where the disease initially took hold, HIV has disproportionately affected Black and Latino populations. The uneven impact of HIV is reflected in the starkly differing views and experiences reported by those of different races.

About three times as many Blacks and Latinos, as whites, say HIV today is a “very serious” issue for people they know.

National Survey of Young Adults on HIV/AIDS chart: How serious of a concern is HIV for people you know?

Almost twice as many Blacks, as whites or Latinos, say they know someone living with or who has died of HIV. One in five Blacks have a family member or close friend affected by HIV.

National Survey of Young Adults on HIV/AIDS 15

About a third of Black and Latino young people say they worry about getting HIV; approximately half as many whites express concern about their own risk.

National Survey of Young Adults on HIV/AIDS 16

2. Many are not aware of advances in HIV prevention and treatment.

In the five years since PrEP, the pill to protect against HIV, was approved by the Food & Drug Administration, only about one in ten young adults know about the prevention option.

When taken as prescribed, PrEP is highly effective in protecting against HIV. PrEP is also a significant advance in that it provides women with the first HIV prevention tool that they can control themselves.

National Survey of Young Adults on HIV/AIDS 17

There are also gaps in understanding of how the medications used to treat HIV work. While most young adults are generally aware of the health benefits of antiretrovirals (or ARVs), many understate their effectiveness and few know they also prevent the spread of the virus.

ARVs work to reduce the viral load to levels undetectable by standard lab tests. Studies show that when the viral load is less than 200 copies of virus per milliliter of blood, long-term health is greatly improved and sexual transmission of the virus is extremely unlikely, if not impossible.

National Survey of Young Adults on HIV/AIDS chart: How effective are current HIV treatment options

3. Stigma and misperceptions about HIV persist.

Most young people today say they would be comfortable having people with HIV as friends or work colleagues, but when it comes to other situations, the stigma of the disease is evident.

National Survey of Young Adults on HIV/AIDS chart: How comfortable would you be

Providing insight into what may be behind the stigma, the survey also reveals a lack of understanding among some about how HIV is and is not transmitted.

National Survey of Young Adults on HIV/AIDS 20

4. HIV testing is occurring less than generally recommended. 

The CDC recommends HIV testing as part of routine health care, yet more than half of young adults say they have never been tested.

Black young adults are more likely – and more recently – to report having gotten an HIV test.

National Survey of Young Adults on HIV/AIDS chart: Have you ever been tested for HIV

5. The Internet is a go-to resource for HIV information.

After school, searching online is one of the most often named sources of HIV information by young adults (multiple responses possible). Almost as many cite some form of media as doctors for at least “some” information.

National Survey of Young Adults on HIV/AIDS chart: How much information about HIV have you gotten from

Four in ten say they would like more information about at least one basic HIV topic asked about. More Black and Latino young people indicate they want to know more about HIV, across all topics, as compared to whites.

National Survey of Young Adults on HIV/AIDS 24

National Men’s HIV/AIDS Awareness Day

HIV.gov Shares Communication Tools for Gay

USCA: 2017 “See You in DC!”

 

 

 

 

 

Dear Eric,
This is the final communication prior to seeing everyone at the United States Conference on AIDS. The 2017 meeting has already surpassed the registration numbers from both the 2015 and 2016 conferences. In other words, there will be lots of people. Please be patient and use your time standing in line to meet your colleagues from across the country.

If this is your first time attending USCA, you may be surprised by the diversity of attendees. Typically, 60% of the participants are people of color, 55% are women, 30% are people living with HIV, 75% of the men attending are gay men, and there is a significant delegation from the trans community. USCA strives to have representatives from all 50 states and the territories. In other words, this is a community conference that reflects the full scope of the epidemic. If you’ve never been to USCA, you will quickly see the difference from other conferences. We are proud to offer a safe space for people to be themselves without judgement or discrimination. The 2017 meeting will be a USCA Family Reunion and our family values are built upon diversity, inclusion, and acceptance.

It’s been a challenging time in Washington. I believe that is why this year’s meeting is so important. People are fearful about the future. Between healthcare reform and the possibility of cuts to the federal HIV budget, attendees are seeking answers and community. While we may not have all of the answers, we will definitely have community. This year’s USCA is structured to not only train, but also to remind us why we do the important work that must be done. For many of us, this movement is more than just a job; it’s our life and the lives of our communities. In a world that can be very mean to people who are different, USCA celebrates our strange and wonderful family.

Latest Conference Information
To get the latest information on the meeting, download our smartphone app. It is a virtual portal of session descriptions, social media engagement, and logistic updates you will need to make the most of your conference experience.

Houston & SE Texas
USCA will have a moment during the Opening Plenary to stand-up for Houston and SE Texas. Six weeks after Katrina, NMAC brought a group of donors to New Orleans to see the devastation. As soon as Houston is ready, we intend to work collaboratively with other national organizations to support people living with HIV and HIV services in the region.

Recently, I received an email from Deondre Moore who lives in Houston and I wanted to share a small portion:

“USCA, for me, will hopefully be a time to heal and where I can refocus and get back on track. More importantly, during USCA it will be my first time seeing my mother since before the storm, and I cannot wait.”

After Katrina, we brought a small group of HIV leaders from New Orleans to DC to begin the planning process of moving forward. I remember how grateful they were for the meeting because it was the first time they could take a hot shower. This is another tragedy that we must and will overcome.

Hashtag
Use the hashtag #2017USCA. We’re not looking for stories about NMAC. We want you to tell the stories of people you meet at USCA, people who have committed their lives to ending the epidemic. Help expand the discussion about HIV on social media. Remember to post your photos!

Travel
Most people will arrive at either National Airport or Union Station. The quickest way to the hotel is via metro. The closest Metro stop to the Marriott is Convention Center on the GREEN and YELLOW lines. The Yellow line goes directly to the airport.

Hotel
The 2017 host hotel is the Marriott Marquis, 901 Mass. Ave NW. All of the workshops and plenary sessions and the exhibit hall are here. Unfortunately, the Marriott along with three other conference hotels are sold-out at the conference rate.

 

Registration
Registration starts on Wednesday, September 6th at 4 PM. It will be on the mezzanine level of the Marriott. To be greener and to save money, USCA only prints a “limited” number of program books. However, the full content can only be found online. The conference will have free Wi-Fi so remember to bring your laptop or smartphone.

Other Events
When putting your schedule together for the meeting, think about adding the Opening Reception, Film Screening, and the House Ball by Casa Ruby to your things to do. These are great ways to network with fellow attendees and celebrate the diversity of our movement.

The Opening Reception is on Wednesday, September 6th from 6 PM to 8 PM. It is at the Library of Congress in the James Madison Memorial Building, 101 Independence Ave. SE. The closest subway stop is the Capitol South metro located on the Orange and Blue lines. Congresswoman Maxine Water, Congresswoman Barbara Lee, and Congresswoman Ileana Ros-Lehtinen will be our special guests.

There will be a special screening of Nothing Without Us: The Women Who Will End AIDS on Friday, September 8th at 7 PM in Shaw (meeting level 3 of the Marriott). This 70-minute film reveals that no plan to end the HIV epidemic will be complete until it addresses the complex realities of all women’s lives.

Finally, there is a House Ball produced by Casa Ruby on Saturday, September 7th. The Ball starts at 8 PM in the Marquis Ballroom at the Marriott. It is free for conference attendees, although there is a $25 cover for everyone else. All funds raised go to benefit Casa Ruby. This is a special opportunity to experience the culture and glamour of DC’s trans community.

Thank you for being part of my strange and wonderful family. I look forward to seeing you in DC.

 

Yours in the struggle,

Paul Kawata

 

A Special Note from USCA Media Sponsor FHI 360
Hello USCA Partners,
We are excited to be partnering with FHI 360 again this year to provide you and USCA conference attendees a curated live coverage of experience through their Crowd360 web platform. Through Crowd360, FHI 360 will leverage the 2017 USCA social content being shared over multiple platforms (Twitter, Facebook, Instagram, Blogs, Conference Mobil App, etc.) and curate it into three different delivery vehicles. As in the past, these vehicles include:

2017 USCA Hub – The home for digital content being shared at 2017 USCA.
2017 USCA Daily Delivery – A HTML-based recap of the digital content and conversations taking place the previous day.
2017 USCA Live Social Blog – A crowd-sourced live blog created from live coverage being shared on social media (Twitter, Facebook, Instagram, Conference Mobile App, etc.).

Viral load as low as 400 copies/ml six months after starting ART is associated with a significant ten-year mortality risk

Michael Carter
Published: 05 July 2017

A viral load as low as 400 copies/ml six months after starting HIV therapy is associated with a substantial ten-year mortality risk, investigators from the United States report in the online edition ofAIDS. People with a viral load between 400 and 999 copies/ml had a 20% mortality risk, similar to the 23% risk observed in people with a viral load between 1000 and 4 million copies/ml. In contrast, the mortality risk was only 14% for individuals who rapidly achieved complete viral suppression – a viral load below 20 copies/ml.

“A single viral load measurement collected six months after initiating ART [antiretroviral therapy] remains highly informative regarding the risk of death over 10 years,” write the authors.

The aim of ART is rapid and sustained suppression of viral load to below the limit of detection (between 50 to 20 copies/ml depending on testing assay). Treatment guidelines suggest that viral load should be undetectable six months after the initiation of treatment. Newer antiretroviral drug combinations, especially those containing an integrase inhibitor, suppress viral load more rapidly.

Ongoing low-level viral replication despite therapy is associated with the emergence of drug-resistant virus, causing treatment failure and an increase in the risk of HIV- and non-HIV-related illnesses. Small increases in viral load once complete suppression has been achieved, above the limit of detection on occasional tests, so-called viral load `blips`, do not predict treatment failure and are not problematic. This study looked at the failure of treatment to achieve viral suppression after six months.

Analysing viral load measurements taken six months after ART initiation, a team of US investigators sought to determine the level of low-level viraemia (up to 1000 copies/ml) which was associated with an increased risk of all-cause mortality over ten years.

Their study population consisted of approximately 8000 adults who initiated ART between 1998 and 2014. Study participants were followed until death or for up to ten years.

Median age at baseline was 40 years; 83% of participants were male; 62% were in the men who have sex with men risk group; 45% were white and 12% reported ever injecting drugs. The median pre-ART viral load was 75,000 copies/ml and the median year of ART initiation was 2007. Approximately a third of people had been diagnosed with AIDS before starting treatment.

The median period of follow-up was 6.2 years, during which time there were 863 deaths.

Over half (57%) of viral load measurements six months after starting therapy were below 20 copies/ml, with 15% measured at 1000 copies/ml or higher.

As expected, compared to a viral load below 20 copies/ml, a viral load above 999 copies/ml was strongly associated with an increased risk of all-cause mortality over ten years (HR = 1.96; 95% CI, 1.56-2.46). A slightly increased risk of mortality was discernible at a viral load as low as 130 copies/ml (HR = 1.39; 95% CI, 1.02-1.88).

“While we observed an increased hazard of death with low-level viral loads, discernible at 130 copies/ml,” write the authors, “this association was largely driven by the elevated mortality risk experienced by patients with viral load between 400 and 999 copies/ml.”

The average ten-year mortality risk for people with a viral load below 20 copies/ml was 13%, similar to the 14% risk observed in individuals with a viral load between 20 and 400 copies/ml. The ten-year mortality risk was 20% for people with a viral load between 400 and 999 copies/ml, comparable to the 23% risk for people with a viral load of 1000 copies/ml or higher.

“Low-level viral loads between 400 and 999 copies/ml shortly after starting ART appear to place patients at a significantly higher 10-year risk of death than patients with viral loads under 20 copies/ml, and occurrences of viral loads in this range may need to be treated similarly as viral load that exceed 1000 copies/ml,” conclude the authors. “Given the importance of rapidly achieving virologic suppression after initiating treatment, further investigation of the causes of unsuppressed viral loads between 400 and 999 copies/ml is warranted.”

The authors suggest that incomplete viral suppression six months after starting treatment may be a marker for several problems. Apart from lack of adherence to treatment or poor retention in care, incomplete viral suppression might be a consequence of undetected drug resistance, or of drug-drug interactions that lead to low levels of antiretroviral drugs. Planning in advance to prevent these problems from undermining treatment, and prompt investigation of any problems, are likely to improve the chances of viral suppression

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