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Too much online support can be harmful for HIV patients

 For individuals living with HIV, online communities provide the support system they need to engage in positive self-care, which is critical in managing the virus and its ill effects.

However, as new University at Buffalo School of Management research finds, beyond a certain threshold, online support can become overwhelming for HIV patients, leading to negative health behaviors.

“Despite advancements in research and treatment, HIV is still a devastating diagnosis and a highly stigmatized disease,” says senior author Rajiv Kishore, PhD, associate professor of management science and systems in the UB School of Management. “Many patients feel isolated and uncomfortable revealing their diagnosis, even to close friends and family. Without that support system, many HIV patients turn to social media and online forms for emotional reassurance and health-related information.”

Forthcoming in the Journal of the American Medical Informatics Association, the study analyzed more than 30,000 discussion threads from an online community for people living with or affected by HIV/AIDS from May 2006 to March 2017, representing about 15,500 users and 330,000 individual posts.

Using text mining and linguistic analysis methods, the researchers measured the emotional support or information the posts provided, from both objective sources and personal experience, as well as the level of self-care patients expressed in response. The researchers collaborated with three HIV health specialists to ensure their methods were valid.

“Initially, we found that as an individual receives more words of encouragement and health information, their self-care improves,” Kishore says. “They develop comforting relationships and better understand the virus and how to manage it, which encourages them to engage in positive self-care behaviors.”

Above a certain level, however, too much social support negatively affects HIV patients’ self-care behaviors, the study found.

“Self-care is about having control, feeling like you can make a difference in your own health,” Kishore says. “Many people perceive excessive emotional support as forced optimism and may become stressed and lose hope as a result. Similarly, patients who receive too much information may become overwhelmed and give up on reading material that’s necessary for understanding and implementing appropriate health behaviors.

“In both cases, we find patients cope by disengaging from productive self-care,” Kishore says.

Next, the researchers plan to replicate their study with other stigmatized and nonstigmatized chronic diseases.

Kishore’s co-authors on the study were UB School of Management doctoral students Xunyi Wang and Srikanth Parameswaran, along with Darshan Mahendra Bagul, a master’s student in the UB Computer Science and Engineering Department.


Author: Matthew Biddle

HIV-Positive Patients Six Times More Likely to Have Schizophrenia

A recent study has found that patients with HIV are six times more likely to have schizophrenia compared with those who do not have the virus.

The study, led by research coordinator Kalysha Closson, MSc, was presented at the 25th Conference on Retroviruses and Opportunistic Infections (CROI) found a distinct association between the mental disorder and HIV — a relationship sparsely analyzed before.

Researchers from the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, conducted a population-based retrospective cohort study that estimated schizophrenia prevalence and mortality outcomes in individuals living with HIV, as well as a 10% random sample of individuals in British Columbia, from 1998 to 2013.

For the study, the research team assessed schizophrenia prevalence using physician and hospital-based administrative data, as well as International Classification of Disease 9/10 codes.

The survival time by HIV-status was accessed by a Kaplan-Meier plot, and age and sex-adjusted mortality rates were calculated with the 2016 Canada population used as reference. Researchers examined the association between HIV and all-cause mortality among patients with schizophrenia using logistic regression.

The researchers found that of the 515,913 British Columbia residents from 1998 to 2013 observed in the study, 13,412 (2.6%) were individuals living with HIV. Furthermore, schizophrenia was diagnosed in 6.3% of that population — significantly higher than the diagnosis rate in the non-HIV population (1.1%; < 0.001).

Among those who had both HIV and schizophrenia, the population was mostly male (75%), residing within an urban setting (91%), with a history of injection drug use (75%), and was at least once on anti-psychotic medication (49%; <0.001). The population of patients with schizophrenia, who were not HIV-positive, reported lesser rates of injection drug use (20%) and use of antipsychotic medication (39%).

Through the Kaplan-Meier plot, researchers indicated that time from schizophrenia diagnoses to death was significantly short for those with HIV compared to those without the virus (< 0.001). Controlling for sex, baseline age, and injection drug age, HIV status was significantly associated with mortality in patients with schizophrenia (aOR= 2.31; 95% CI; 1.84-2.89).

The results indicate 2 reactions, according to Closson: that patients with schizophrenia who do not have HIV need to be better monitored for the virus, and that patients with both conditions need better care and psychiatric access.

“We found that with this group — because they had the highest mortality — having access to psychiatric care or psychiatric meds, as well as accessing a psychiatrist, was associated with reduced odds of mortality,” Closson said.

Patients are usually treated for conditions in regard to the condition’s specialty, according to Closson. Very few “one-stop shops” exist for patients who are suffering from both virus and mental condition.

More holistic services need to be put in place, Closson said, to ensure these patients have continued care and lessened mortality risk.




High-Risk HIV, Sexual Behavior Among Youth in Criminal Justice System Reduced by PHAT Life Intervention

A proactive interventional approach titled PHAT (Preventing HIV/AIDS Among Teens) Life, comprised of videos, games, role-playing and skill-building educational exercises, is effective for teaching high-risk teens in the juvenile justice system about HIV/AIDS and for reducing the risk for high-risk sexual behavior, according to study findings from the School of Public Health at the University of Illinois at Chicago.1

PHAT Life is one of the first interventions to successfully reduce sexual risk among juvenile offenders on probation, a population at exceptionally high risk for poor health outcomes,” Geri R. Donenberg, PhD, lead study author and Professor in the Departments of Medicine and Psychology at the University of Illinois at Chicago, told MD Magazine. 

According to Donenberg, findings from this study indicate that the importance of PHAT Life, in addition to other evidence-based interventions, should be “delivered and sustained in juvenile justice settings to alter these teens’ negative trajectories.”

In this study, researchers enrolled a total of 163 male and female adolescents (aged 13–17 years) who were recently arrested and placed on probation. The majority of participants were African American (90%), and over half were male (66%). Investigators compared participants’ sexual behavior at baseline with behavior reported at 6-month follow-up.

Participants were randomized to PHAT Life (n= 163) or a similar health promotion program (n= 147). At 6 months, participants randomized to PHAT Life who engaged in highest baseline sexual behavior risk (composite or multiple partners and irregular condom use) reported a significantly lower risk level (no sex or 1 partner plus regular condom use) compared with high-risk participants in the control group (odds ratio [OR] = 4.28, 95% CI [1.37, 13.38], SE = 0.58, P =.01).

Additionally, sexually active participants assigned to PHAT Life and engaged in sexual activity prior to the age of 12 years reported significantly fewer sexual partners than controls at 6-month follow-up (partial eta squared= .32, P= .002).

The short follow-up period of 6 months was a likely limitation of this study, and the self-reported nature of the results may have led to social desirability bias. Despite these limitations, the researchers demonstrated that an educational program may be feasible and effective in at-risk teens for reducing high-risk sexual behavior, ultimately decreasing the chances of HIV/AIDS.

“The 17-year research-to-practice gap is unacceptable, and future study is needed to determine how best to disseminate programs like PHAT Life to ensure that they are self-sustaining,” according to Donenberg.

Although the current findings are promising, implementation of this program in the juvenile criminal justice system is needed to see real-world results.

“Several of the strategies used in PHAT Life could be adapted for the clinical setting and doctor’s office visit. Clinicians have the added advantage of the doctor-patient relationship to address some of the key predictors of risk behavior and help teenagers plan for prevention,” explained Donenberg. “As an example, PHAT Life helps youth identify their unique risk-related triggers, namely people, places, moods and situations that promote unhealthy behavior, and then develop personalized plans to manage these triggers. This approach could be adopted and implemented during the medical visit.”



Author: Brandon May

3 things to know about sex, HIV and gay health

Preventing and treating HIV has developed fast in the last few years – and we’re now a long way from the times when being ‘safe’ only referred to ‘wrapping it up’. There are now lots more options for having great, carefree sex while still having control over your sexual health.

So in this new world of HIV prevention, has what it means to be ‘positive’, ‘negative’ or ‘practicing safer sex’ got lost in translation?

We’re here to break down the jargon with this quick and easy, no-nonsense guide to gay health, sex and HIV. Let’s get started:


The word ‘undetectable’ describes people who are living with HIV, but whose treatment is so effective that HIV doesn’t affect their health and can’t be passed on. The level of virus has been reduced so much that it can’t even be detected in HIV tests!

To know that you are undetectable you need to have your viral load tested regularly. But so long as you get the ‘A-OK’ from your doctor there’s no way to pass on HIV through sex, even if you don’t use a condom. You don’t necessarily stay undetectable indefinitely though, so getting checked regularly is a must.

“On PrEP” 

PrEP (or pre-exposure prophylaxis, if you want to be fancy) is a pill that if taken as prescribed can eliminate the risk of getting HIV! So if you’re negative but on PrEP, you’ve got HIV covered!

Just remember though that it doesn’t protect you from other STIs, so it’s important to go for regular check-ups if you’re not using condoms.

Sadly, PrEP isn’t available everywhere, so talk to your healthcare provider to see if it is an option for you, or go online to sites such as if you want to look into buying the drug yourself. But if you do buy it on your own, make sure you can still get support and monitoring from health professionals.

 “HIV negative”

Being HIV-negative means that someone doesn’t have the virus, but importantly you can only be sure that you are HIV-negative if you have tested since your last risky sex.

Nowadays, there are even new ways to self-test for HIV, so that you don’t even have to leave the house.

In short, what all this means is that, whether you are HIV-positive or HIV-negative, there are now more ways than ever to have fun, carefree sex with whoever you want, without worrying about HIV.


Use of HIV Prevention Drug Grows, but Lags Among Minorities


The pill, known as PrEP, can reduce the risk of contracting the virus that causes AIDS by 90 percent. Its use has expanded sharply, but more among whites than minority groups.


Eric Russell, 24, recently joined a health support group for young Latino and black gay men, where he learned about the HIV-prevention pill known as PrEP. He resisted the medication at first, convinced he didn’t need it and fearful that taking it would stigmatize him.

But after Russell learned more about PrEP, short for pre-exposure prophylaxis, he decided it would be a good investment in his health. The Los Angeles man started taking the drug this year and now encourages other young minority men to do the same.

“A lot of people won’t necessarily tell you their [HIV] status,” said Russell, who is on Medicaid, the public health insurance program for low-income people. “You have to look out for yourself.”

Medicaid beneficiaries in California are taking the HIV-prevention pill in greater numbers than ever before. Across the United States, PrEP use is also rising significantly, according to data released this week.

In California’s Medicaid program, known as Medi-Cal, the number of PrEP users rose from 79 in the first half of 2012—the year the drug was first approved for preventive purposes—to 3,295 by the end of 2016, according to a report released last month by the California HIV/AIDS Policy Research Centers.

Nationally, the total number of PrEP users rose from 8,768 in 2012 to 77,120 in 2016—an average annual increase of 73 percent in each of those four years, according to new data released by, an HIV website run jointly by Emory University’s Rollins School of Public Health and Gilead Sciences Inc., which manufactures the pill. Gilead told financial analysts in July 2017 that 136,000 people in the U.S. were taking PrEP, also known by its brand name, Truvada.

Truvada was first approved by the Food and Drug Administration in 2004 to treat HIV, then eight years later to help prevent it. It can reduce the risk of contracting HIV by more than 90 percent, according to the federal Centers for Disease Control and Prevention. If taken daily, the medicine’s presence in the bloodstream can prevent the HIV virus from taking hold and spreading in the body. It costs about $1,500 a month but is covered by Medicaid and many private insurers.

Wide ethnic and racial disparities persist in its use, however, with far less uptake among non-white Medicaid enrollees than among their white counterparts.

The authors of the California study found the rate of PrEP use among black Medi-Cal enrollees in 2016 was 37 percent lower than the white rate, even though new diagnoses among blacks are four times that of whites. Latinos had the lowest rate of PrEP usage among Medi-Cal recipients—about one-quarter that of whites—while their rate of new infection was 1.5 times higher.

That disparity exists nationwide as well, with disproportionately low use of the HIV-prevention pill among blacks and Latinos.

About 44 percent of people who could potentially have benefited from PrEP in 2015 were African-Americans, but only 1.4 percent of those—7,000 out of about half a million—had prescriptions for PrEP, according to a new studyreleased Tuesday by the CDC. And in a similar time period, a quarter of people who could have benefited from PrEP—nearly 300,000—were Latino, but only about 3 percent of them had PrEP prescriptions, according to the study. Among whites who were candidates for the drug, 14 percent had prescriptions.

Disparities in use of the HIV-prevention pill are also geographic. Nearly half of all PrEP users reside in five states that account for 37 percent of the U.S. population—California, Florida, New York, Illinois and Texas—according to AIDSVu. The majority of new HIV diagnoses—52 percent—are in the South.

The California researchers cited several possible reasons for the racial and ethnic disparities, including a lack of knowledge about PrEP, the perceived stigma of taking it, mistrust of doctors and an inadequate understanding—or denial—of the HIV risk. They also found disparities by age, with greater use among people 25 and older.

The report was based on 2012-16 data from the California Department of Health Care Services, which runs Medi-Cal. The report’s authors said studying PrEP use among Medicaid patients is important because they are particularly vulnerable to HIV infection and “might most benefit from public health policy interventions to support uptake” of the prevention drug.

The ethnic and racial disparities shown in the data are an important finding because of the role the pill can play in helping reduce new infections, said Nina Harawa, an associate professor at the David Geffen School of Medicine at UCLA, and the lead author of the California study.

“We are at this point where it’s really possible to turn the tide on new infections,” Harawa said. “PrEP is a huge part of the strategy to eventually get to zero cases of new HIV. We need to make sure resources around PrEP are being used wisely and getting to the right people.”

Hoping to encourage wider use of the drug, California eliminated a rule in 2014 that had required doctors to seek pre-authorization to prescribe it. State health officials say they believe that decision helped increase the number of prescriptions. Two years later, another law required that information about the HIV-prevention pill be provided to people who test negative for HIV.

Tony Cava, spokesman for the Department of Health Care Services, said the rise in PrEP prescriptions can also be attributed to outreach by advocacy groups and dissemination of educational materials in areas with residents at high risk of HIV.

More resources are needed to “redouble efforts to reach the communities that are impacted,” said Craig Pulsipher, another author of the study and a state affairs specialist at AIDS Project Los Angeles, which sponsored the group that Eric Russell attended.

Such efforts paid dividends in New York, where the number of Medicaid enrollees using the HIV-prevention drug rose more than 300 percent in the two years from July 2013 to June 2015, following a statewide initiative to educate doctors and patients about it, according to a study published by the CDC in 2015.

Doctors play an important role in the uptake of PrEP, Pulsipher said.

“We hear very frequently about providers who are still unfamiliar with PrEP or unwilling to prescribe it,” he said. “If you live in West Hollywood, you can just walk down the street” to find a doctor willing to prescribe Truvada. “If you live in South L.A., access looks very different.”

Last year, the Los Angeles LGBT Center launched a campaign to educate black and Latino gay and bisexual men, as well as transgender women, about the HIV-prevention medication. The campaign began with volunteers distributing information about PrEP in West Hollywood bars, and has continued with art installations and conversations with people at gay pride and other events, said Paul Chavez, the campaign’s manager.

“What we found in our outreach was that a lot of people are not aware that Truvada actually exists,” Chavez said.

He said outreach workers must gain the trust of people who haven’t always felt comfortable seeking medical care, much less cared to prevent HIV. “Accessing health care can be overwhelming, period,” Chavez said. “You add these layers on top of this, and the barriers start piling up.”

Author: Anna Gorman


Alzheimer’s disease will become manageable like HIV, say award-winning scientists 

People will be able to take drugs to prevent Alzhiemer's, scientists believe 
People will be able to take drugs to prevent Alzhiemer’s, scientists believe 

Alzheimer’s sufferers may be able to live with the disease without the devastating symptoms within the next few decades, scientists said as they were awarded the Brain Prize for their work fighting the illness.

Professor Michel Goedert, of Cambridge University, who discovered the importance of tau protein in Alzheimer’s said he could see a time when dementia became a chronic illness like HIV.

Prof Goedert who shares the one million euro Brain Prize with four colleagues, said: “Alzheimer’s will become something like HIV. It’s still there but it has been contained, or whittled down by drug treatments.

“It will disappear as a major problem from society.”

Prof Goedert was awarded the prize alongside Professors John Hardy and Bart De Strooper of University College London who developed the hypothesis that Alzheimer’s is caused by a build-up of amyloid protein in the brain, and Professor Christian Haass of Ludwig-Maximilians-University of Munich.

Prof Hardy said in the future, treatments for Alzheimer’s would be taken before the disease developed to prevent symptoms rather than trying to reverse them. He said may drug trials had failed because they had started when the disease was too well established.

Prof John Hardy celebrating with colleagues in London
Prof John Hardy celebrating with colleagues in London

“The mistakes we have made is the trials is that treatment has been given too late,” he said.

“It’s like popping a statin to stop a heart attack.

“But when we first started we knew almost nothing about Alzhiemer’s and now we understand a huge amount.”

Prof De Strooper added: “In 10 years we will have a completely different picture.”

The Brain Prize organisers said the winners had made essential contributions to the genetic and molecular knowledge of Alzheimer’s disease ‘which are the foundations for finding new ways to diagnose, treat and possibly even prevent it and other devastating diseases of the ageing brain’

Professor Anders Bjorklund, chairman of the Lundbeck Foundation Brain Prize selection committee, said: “Alzheimer´s disease is one of the most devastating diseases of our time and the remarkable progress that has been made during the last decades.

“These four outstanding European scientists have been rewarded for their fundamental discoveries unravelling molecular and genetic causes of the disease that have provided a basis for the current attempts to diagnose, treat and possibly even prevent neurodegenerative brain diseases.

“The award recognises that there is more to Alzheimer´s disease than amyloid, and that the field of dementia research is more than Alzheimer´s disease alone.”


High uptake and use of vaginal ring for HIV prevention observed in open-label study

Nearly 90 percent of participants in an open-label study of a vaginal ring infused with a drug to prevent HIV are using the monthly ring at least some of the time, according to an interim analysis of study data. In addition, the rate of HIV infection among participants in the open-label study, which has no placebo arm for comparison, is half of what might be expected in the absence of the ring, according to mathematical modeling that has significant limitations.

These preliminary findings from the HIV Open Label Extension (HOPE) study were presented today during a press conference at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston and will be reported tomorrow in an oral presentation at the meeting.

“It would be ideal for women to have discreet HIV prevention tools that they want to use and can control by themselves,” said Carl W. Dieffenbach, Ph.D., director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH and the primary funder of the study. “Interim data from the HOPE open-label extension study appear to be sending a positive signal about the desirability of the anti-HIV vaginal ring in a setting more like the real world than previous trials. We look forward to the final results from this study, which should provide more definitive information.”

The HOPE study launched in 2016 as a follow-on to the NIH-funded ASPIRE clinical trial. ASPIRE demonstrated that a silicone ring that continuously releases the anti-HIV drug dapivirine in the vagina safely reduced the risk of HIV infection by 27 percent. An exploratory analysis of the Phase 3 ASPIRE study data subsequently found that the monthly ring reduced the risk of HIV infection by at least 56 percent in women who used it most or all of the time. The goals of the current HOPE study are to gather data on whether and how women use the dapivirine ring knowing it is safe and moderately effective, and to further examine the relationship between adherence to the ring and protection from HIV infection. Final results are expected in 2019.

Since all HOPE study participants previously completed the ASPIRE trial without becoming HIV-infected, an aspect of their behavior other than the use of the vaginal ring may be contributing to protection from the virus, according to the study investigators. HOPE study participants received HIV prevention counseling and services during their participation in ASPIRE, which lasted for a median of one year and seven months. The women continue receiving HIV prevention counseling and services in the current study.

The Phase 3b HOPE study, also known as MTN-025, is being implemented by the NIH-funded Microbicide Trials Network (MTN) at 14 former ASPIRE study sites in Malawi, South Africa, Uganda and Zimbabwe. Because women accounted for 58 percent of new HIV infections among adults in southern and eastern Africa in 2016, protecting them from acquiring the virus is essential to controlling the HIV epidemic.

The Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, both part of NIH, co-fund the MTN with NIAID.

While ASPIRE study participants did not know until the end of the trial whether they had received the dapivirine ring or a placebo ring, the HOPE study team is offering the dapivirine ring to all who enroll. HOPE study participants are sexually active, HIV-negative women ages 20 to 49 years who participated in ASPIRE and are not pregnant. More than 1,400 women had enrolled in the HOPE study as of October 2017, the data cutoff for the interim analysis.

The HOPE study is being led by Jared Baeten, M.D., Ph.D., a professor of global health, medicine and epidemiology at the University of Washington in Seattle; Thesla Palanee-Phillips, Ph.D., M.Sc., director of network trials and research center programs at the Wits Reproductive Health and HIV Institute in Johannesburg, South Africa; and Nyaradzo M. Mgodi, M.B.Ch.B., M.Med., a clinical pathologist and clinical research site leader at the University of Zimbabwe-University of California San Francisco Collaborative Research Program in Harare, Zimbabwe.

“Our interim analysis suggests that women in the HOPE study are choosing to use the dapivirine ring at least some of the time now that they know it can safely reduce their risk of HIV infection, and this is helping them achieve a level of protection,” said Dr. Baeten.

Participants in the HOPE study are being offered the dapivirine ring to insert into their vagina for a month at a time for up to 12 consecutive months. During the first three months, the women attend monthly study visits where they may obtain a new ring. Thereafter, they attend quarterly visits where they may obtain three rings at a time, a schedule that more closely resembles how the ring might be distributed in a real-world setting.

Participants may remain in the HOPE study regardless of whether they accept or use new rings. By allowing women to opt out of ring use but remain in the study, researchers are gaining insight into whether participants like using the ring and why, as well as what factors influence use and non-use. More than 90 percent of participants accepted the ring when they entered the study.

Adherence to the ring is being assessed by measuring residual levels of dapivirine in returned rings and blood levels of dapivirine. Some 89 percent of the rings returned as of October 2017 have residual dapivirine levels consistent with some use during the prior month. In contrast, 77 percent of returned rings in the ASPIRE study had residual dapivirine levels consistent with some use during the prior month, suggesting that adherence in the HOPE study is roughly 16 percent higher than it was in ASPIRE. Investigators lacked data to precisely quantify the duration of ring use in either study. The ring is designed to be worn continuously throughout the month to provide effective protection. Measurements of blood levels of dapivirine were not included in the interim analysis.

As of October 2017, HOPE study participants have become infected with HIV at a rate of 1.9 new infections per 100 person-years of follow-up. Person-years are the sum of the number of years that each participant has been in the study.

Other forms of HIV prevention have proven to provide high levels of protection from the virus. For instance, oral tablets of the medication Truvada for HIV pre-exposure prophylaxis (PrEP) reduce the risk of HIV infection by up to 92 percent in people at high risk when taken daily as prescribed, although taking a daily pill can be challenging for some people.

Because the HOPE study lacks a concurrent control group receiving a placebo ring, investigators used a mathematical approach to estimate what the HIV incidence would be if the women in the study had lacked access to the dapivirine ring.

First, the researchers determined the characteristics of the HOPE study population based on age, location and presence of a curable sexually transmitted infection when joining the study. Next, they identified an equal number of women from the placebo group in the ASPIRE trial who had similar characteristics and calculated the HIV incidence in that set. Then the investigators repeated this mathematical sampling of the ASPIRE placebo group 10,000 times. In this modeling exercise, the average HIV incidence was 4.1 new infections per 100 person-years for the ASPIRE participants receiving the placebo–twice the rate found in the new interim analysis of the HOPE study population. The investigators never calculated an HIV incidence as low as 1.9 per 100 person-years in their mathematical sampling of the ASPIRE placebo group. Comparing the HOPE study population to the ASPIRE placebo group is significantly limited by the differences between the two groups, however. In addition, the HOPE study is not powered to determine the effectiveness of the ring.


AIDS Saskatoon closing La Ronge support operation

Changes to federal funding are going to take a toll on the fight against HIV in northern Saskatchewan. These changes are forcing Jason Mercredi to make a difficult decision, cutting AIDS Saskatoon‘s only support worker in the La Ronge region.

“This is a major setback, especially for northern Saskatchewan,” Jason Mercredi, executive director of AIDS Saskatoon, said.


AIDS Saskatoon’s last funding agreement with the federal government was for $293,532 per year over a three-year period. But following a request to renew funding for operations through 2020, they were turned down.

The organization is one of 40 HIV-AIDS service organizations across the country being denied funding as the Public Health Agency of Canada (PHAC) shifts its focus to prevention from care and peer support.

“Peer support has been consistently identified as best practice for getting the hardest to engage people engaged in services,” Mercredi said. “And when we engage people in services, we save lives.”

After initial confusion, PHAC provided AIDS Saskatoon transitional funding until March 31.

“Transitional funding was provided to help organizations establish new partnerships, seek other sources of funding, transfer their services to other local providers, or close out their currently funded projects,” PHAC said in a press release.

The current support worker being lost in La Ronge is an Indigenous woman living with HIV, an invaluable support for the region. It’s a position she’s held for five years and her employment will come to an end on March 31.

“She’s devastated,” Mercredi said. “She’s a solid employee, she’s on our management team; we’re one of the few AIDS service organizations across Canada that actually have HIV-positive Indigenous women on the management team.”


Adele Cook works out of the Scattered Sites Outreach Building in La Ronge, educating the public on the virus, operating the needle exchange and serving as an outreach person for HIV-positive people in the area.

According to Mercredi, having that support worker on the ground in La Ronge has helped significantly with resource development. This fiscal year, they’ve been able to visit 19 northern communities; they also held a body mapping art retreat to support HIV-positive women in the north. In 2017, over 100,000 condoms were sent to northern Saskatchewan to help with prevention.

“We want local people on the ground,” Mercredi said. “Northern Saskatchewan is one of the hardest hit areas for new infections for HIV rates and so it’s going to be tough.”

HIV rates are on the rise across Saskatchewan, with 170 new cases in 2016 – 10 of those in the La Ronge region.

But the PHAC said the changes to the funding requirements doesn’t mean cuts to funding.

“Four previously funded organizations in Saskatchewan will receive the same or more funding from PHAC, and three new organizations, not previously funded, are now being funded to implement activities to address HIV and other sexually transmitted infections in Saskatchewan through the Community Action Fund,” PHAC said in a statement.

Battlefords Family Health Centre and All Nations Hope Inc. were also denied funding.

The good news is, talks to get AIDS Saskatoon’s funding reinstated are ongoing after the Canadian AIDS Society called for an external investigation into the funding decisions by PHAC.

“The answers being given for refusal of their projects were not in line with the project requests, so that was a big indicator at the time,” Gary Lacasse, executive director of the Canadian AIDS Society, said.

“There is some openness from the Public Health Agency and the Minister’s office to address these gaps.”

Despite that, the goal remains the same for Mercredi.

“We just want to keep maintaining and supporting those communities as best we can,” he said.


Lessons Learned from the Early Days of HIV/AIDS

Harold W. Jaffe, MD

By looking back on the early days of the HIV/AIDS epidemic, the medical community can learn many lessons, including the value of multidisciplinary teams, the vital role of acute care clinicians, the insight that can be gained from simple studies, how to properly engage infected communities, and how to address the fears of the public.

“Given that emerging infections continue to surprise, are we now more prepared than we were in the early days of AIDS?” Harold W. Jaffe, MD, said in a presentation at the 25th Conference on Retroviruses and Opportunistic Infections (CROI), in Boston, Massachusetts. “In some ways, I think the answer is yes.”

When the Centers for Disease Control and Prevention (CDC) published its weekly morbidity and mortality report on June 5, 1981, Jaffe said, “Neither I nor my CDC colleagues were prepared for what crashed down on our heads.”

That year, Jaffe, an infectious disease specialist with the CDC, was working with colleagues on suppressing a reemergence of syphilis in the United States. At the time, physicians in the US believed the end of infectious disease was in sight. Just 3 years prior, Robert G. Petersdorf, MD, had written that “even with my great personal loyalties to infectious disease,” he could not fathom the need for more of these specialists.

Yet, as Jaffe would point out, they were faced with a new pestilence, one they could not have prepared for: human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).

Originally believed to be complex cases of Pneumocystis pneumonia (PCP) and Kaposi sarcoma (KS), within a month, more reports of patients with the condition were coming from Los Angeles, New York City, and San Francisco. Some of these patients were dying, most were of the men who have sex with men (MSM) population, and all were found to be immunodeficient, which confused physicians at the time, Jaffe said.

In order to determine what was occurring, the CDC began collecting systematic reports, developing a case definition of KS/OI (Kaposi sarcoma/opportunistic infections). “Soon we began receiving reports of KS/OI in gay men from additional American cities,” Jaffe said. “We also noticed that a small number of cases had been diagnosed in 1979 and 1980 but had not been reported.”

Born forth of this puzzling and alarming scenario were 3 major theories, Jaffe said. They were the sexually transmitted infections (STI) theory, the environmental theory, and the immune overload theory.

“Given the high rates of sexually transmitted infections seen in MSM at the time, a [sexually transmitted disease] was a prime suspect,” Jaffe said. “The environmental theory postulated that an immunosuppressive drug or chemical was the cause, and here, the leading suspects were nitrite inhalants, known as ‘poppers,’ used to enhance sex with men. Finally, there was the immune overload theory, that suggested there was no single ideology—rather, immunodeficiency resulted from the cumulative effects of multiple infectious agents, environmental toxins, and perhaps other factors, such as exposure to semen.”

After a CDC-run trial revealed that this patient population was more likely to have more sexual partners and that ‘poppers’ were not immunotoxins, as believed, the STI theory gained traction, and the condition became known as AIDS.

The public reception of the condition that seemingly only impacted MSM was mostly flippant, Jaffe said, until January 1983, when the CDC revealed a wider population of at-risk patients, which included those who were transfusion recipients, patients with hemophilia, injection drug users, female sex partners of men with AIDS, and those born to mothers with AIDS.

Then, on March 4, 1983, the CDC published its first guidelines for prevention of AIDS, which recommended that sexual content avoided with those with AIDS, that high-risk group members should be aware that increased sexual partners raised their risk, and that those at-risk should refrain from blood and plasma donations.

“In retrospect, these key recommendations related to sexual activity and blood donation were essentially correct, and were based entirely on epidemiologic studies,” Jaffe said.

Just 2 months later, François Barré-Sinoussi, Luke Montagnier, and colleagues in Paris, reported isolating a novel retrovirus that they called LAV (lymphadenopathy-associated virus), from the lymph node of a homosexual man, Jaffe said. A year after that, Robert C. Gallo and colleagues demonstrated the virus that they called HTLV-III (human t-lymphotropic retrovirus type III), which they claimed was the cause, and subsequently helped to develop the first diagnostic test to screen antibodies of the virus in the blood.

Meanwhile, Jaffe noted, African patients with AIDS began to appear in European clinics, bringing the infectious disease community’s attention to central Africa, where yet another epidemic was underway. These patients were remarkably heterogeneous compared to previously noted populations—the male to female ratio was approximately 1 to 1. Additionally, homosexuality, intravenous drug use, and blood transfusions were not found to be risk factors among this population.

By 1985, the concern about the virus in the United States quickly became fear. People began to believe casual contact could transmit the disease.

“This fear resulted in unwarranted discrimination against infected persons,” Jaffe said. “A leading symbol of this discrimination was Ryan White, an HIV-infected teenager with hemophilia who was not allowed to attend school for fear of contagion. As his school attendance was being debated, someone fired a bullet through the window of his home.”

Fortunately, a Montefiore Medical Center and CDC study soon brought forth the guidelines for the education and foster care of HIV-infected children. Coupled with studies dispelling the believed occupational risks of acquiring HIV, they soon became the basis for public health education to destigmatize the disease.

As time passed, more federal programs and funding would lead to antiretroviral therapies and advancements in the treatment of the condition. As important, however, are the lessons to learn from the early days, which “have been and will be tested by new health threats,” Jaffe said.

While it tested the medical community, the epidemic taught lessons to physicians that have advanced the way infectious disease is approached. Jaffe noted that there are now international health regulations which aide in countries’ abilities to respond to and assess health threats.

With the absence of a vaccine or curative therapy, Jaffe said, conventional wisdom says that it is too hard to end the epidemic as a public health threat.

“But looking back on the early days of AIDS, we see the conventional wisdom may be wrong,” Jaffe said. “In speaking about the goals of the US Space program more than 50 years ago, President John F. Kennedy said, ‘We choose to go to the moon not because it is easy, but because it is hard.’ I’d like to think that if he were speaking about AIDS, President Kennedy would say we choose to end the epidemic not only because it is hard, but also because it is right.”

Author: Matt Hoffman

LGBT Resource Center will offer free HIV testing for students, faculty 

LGBT Resource Center
(Photo by David A. Barnes)

On Thursday, March 8 between 12-5 p.m., the University of Georgia LGBT Resource Center will be hosting quick and free HIV testing.

This event will be open to all UGA students and faculty on a first come, first serve basis and will occur in room 221 of Memorial Hall.

The resource center is promoting National Women and Girls HIV/AIDS Awareness Day, coming up on March 10, but all genders and gender identities are welcome to get tested.

According to senior coordinator Rashad Small, the center has been providing free HIV tests for about two years.

This event is made possible with help from the Specialty Care Clinic of the Northeast Health District of Georgia, who will be providing licensed professionals to give the HIV tests. The clinic, located in the Clarke County Health Department, typically offers free HIV testing on weekdays.

Live Forward, previously known as AIDS Athens, is another organization that will be providing volunteers. The goal of their organization is to provide stable housing to individuals living with or affected by HIV/AIDS and they also provide free HIV testing with quick results.

To participate in the event, there is no need to sign up — testing will be done on a first come, first serve basis.

Author: Sofi Gratas