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HIV Analysis Reveals Some ‘Exclusively Heterosexual’ Men Probably Aren’t

 

LGBT rights have a come a long way in the past fifty years, but there’s no denying that gay, lesbian and bisexual men and women around the world still face daily discrimination. As a result of this, a stigma still surrounds diseases such as HIV – which remains a particular risk for men who have sex with men. Many may find it unsurprising, then, to discover that a significant proportion of British men who describe themselves as exclusively heterosexual have contracted HIV by having sex with another man.

This discovery was made during a large study of HIV in the UK. Researchers carried out genetic analysis on a database of HIV-positive people, seeking out ‘clusters’ whose HIV shared a common ancestor. The clusters that were all male indicated that the people contained within that cluster had contracted HIV from sex with other men. Looking closer, the researchers found that 249 of the men in the all-male clusters had described themselves as heterosexual.

In the study, which is described in detail here, these men are labelled ‘non-disclosed men who have sex with men’ (ndMSM). It was found that ndMSM in the database were more likely to be of black African descent, and were typically on the edges of a cluster – meaning that they were usually linked to that specific HIV group by just one sexual partner.

The study, which was presented at the 2017 Conference on Retroviruses and Opportunistic Infections, is interesting to HIV/AIDS researchers, campaigners and doctors because, while the ndMSM were found on the edges of all-male clusters – meaning they had typically had one male partner and weren’t a high risk for spreading the virus to other men – they were often found to be the ‘viral link’ between heterosexual women and gay or bisexual men.

These kinds of findings point to a greater need for HIV and sex education, and – perhaps more importantly – a stronger push for the acceptance of homosexuality and bisexuality. Men who label themselves heterosexual, but privately engage in sex with other men, could be putting their sexual partners at risk of infection. And unfortunately, it is MSM who need to be particularly aware of the risk of HIV – MSM only make up 2-3% of the male population and yet in 2015, more than half of the people newly diagnosed with HIV in the UK were MSM.

To find out more about HIV and how you can stay safe, read on.

What is HIV?

The human immunodeficiency virus is an infection that attacks your immune system, breaking down your body’s ability to fight off diseases. It is carried in bodily fluids and is most commonly transmitted through unprotected sex.

When left untreated, HIV can progress into AIDS, the final stage of infection. However, with the right treatment, this is now uncommon – in 2015, over 100,000 people were recorded as living with HIV, but only 305 were diagnosed with an AIDS-defining illness.

How is HIV spread?

HIV is carried in the bodily fluids of an infected person (blood, semen, vaginal and anal fluid, breast milk). It is not carried in sweat or urine.

The vast majority of people who contract HIV have had unprotected anal or vaginal sex with an infected person. Other activities which can lead to transmission include oral sex, sharing needles, sharing sex toys and receiving medical or dental care in a developing country.

How can I stay safe?

The best way to protect yourself against HIV is always to use condoms during sex when you aren’t sure your sexual partner is free from infection. You should also get tested for HIV if you are at risk of exposure – Public Health England recommends that MSM get tested every three months, if they are having sex without a condom with new or casual partners.

You can get tested at NHS centres for free, or you can send off for a home test kit from a service such as www.TheGUMClinic.com. Click here to find out more about their test.

Lastly, remember that communication is important: try to always be open and honest with your sexual partners, and encourage them to do the same. Concealing sexual behaviour, as we have seen with this study, can be a real risk.

 

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What is PrEP and Does it Work?

If there’s one thing the medical community is known for, it’s acronyms – and the latest to have got people talking is PrEP, which stands for pre-exposure prophylaxis. This is a type of medicine taken to prevent the transmission of HIV.

In the past two years, the discussion around PrEP has widened as more and more health institutions have come out in favour of the treatment. Earlier this month, the Kenyan government announced that they would be rolling out PrEP for HIV-negative people who are most at risk of infection. This is significant, as Kenya – along with many other sub-Saharan African countries – is still widely affected by HIV; in 2015, there were an estimated 1.5 million people living with HIV in Kenya alone.

Currently, PrEP is not available on the NHS, but it can be obtained privately from certain sexual health clinics. The good news is that the NHS will be carrying out a PrEP trial over the next three years – and if this is successful, we could see the treatment become available soon afterwards.

The question many people will be asking is: does PrEP really work? We put together a guide to answer that question.

An Introduction to PrEP

Pre-exposure prophylaxis works by interfering with the human immunodeficiency virus’s ability to multiply in the body. Taking PrEP every day should provide protection against HIV, even if you have been exposed to the virus. It must be taken for at least seven days (but in many cases, for three weeks) before it becomes effective.

Currently, one type of PrEP medicine is recommended by health bodies across the globe: Truvada. Truvada is a tablet which contains tenofovir and emtricitabine, antiretrovirals which are used to treat HIV as well as to prevent it.

According to the Centers for Disease Prevention and Control, PrEP (in the form of Truvada) can reduce the risk of HIV in high-risk HIV-negative people by up to 92%. However, this number is dependent upon consistent (i.e. daily) use. Inconsistent use of PrEP will not offer the same levels of protection.

In other words, PrEP can be extremely effective – provided it is taken as directed.

Reasons to Consider PrEP 

PrEP is only suited to people who are particularly high-risk for HIV infection. Typically, people taking PrEP will be in an ongoing sexual relationship with an HIV-positive person. It’s also recommended for people who inject drugs, as HIV can be transmitted through shared needles.

It’s important to bear in mind that taking PrEP does not mean it is safe to stop using condoms during sex. PrEP only offers protection against HIV, and not other STIs.

Interestingly, recent research has indicated that the administration of the antibiotic doxycycline after potential STI-exposure proves effective in men using PrEP. This research found that such use of doxycycline could help significantly lower the risk of chlamydia and syphilis, but not gonorrhoea. Condom use, in other words, remains vital.

HIV Prevention

Because PrEP is not available on the NHS, it’s important to be aware of other HIV prevention methods. The main way to stay safe is to always practise safe sex if you aren’t sure your sexual partner is STI-free. During sex you should always:

  • Use condoms
  • Avoid sharing sex toys
  • Be cautious about oral sex, following this guidance and using dental dams on the vagina or anus where necessary

Using water-based lubricants during sex can also help prevent transmission; this is because too much friction during sex can break the condom, or lead to vaginal or anal tears.

Good HIV prevention is also about getting regularly tested for HIV if you are at risk of exposure. It is recommended that men who have sex with men – a particularly high-risk group for HIV – get tested every three months if they are having unprotected sex with new or casual partners.

Lastly, be aware that other STIs such as chlamydia and gonorrhoea can actually increase your risk of contracting HIV. For this reason, it’s a good idea to get tested for these kinds of infections whenever you get screened for HIV.

You can get tested for chlamydia and gonorrhoea at NHS centres. Alternatively you can take an easy home test; visit The STI Clinic.

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HIV and the ‘Patient Zero’ Who Wasn’t

The man blamed for the HIV pandemic in the West has finally been exonerated by scientists, who have been able to reconstruct the actual route taken by HIV and AIDS when it arrived in the United States.

 An international research team used sophisticated genetic techniques to reveal that the virus actually came from the Caribbean, where a pre-existing pandemic was already underway, arriving in New York during the early 1970s and spreading west across the rest of the country.

 The research offers final confirmation that French-Canadian flight attendant Gaetan Dugas, who was dubbed “Patient Zero” in a 1984 study of gay men diagnosed with AIDS, was not in fact the first person to be infected in the United States. Dugas was subsequently characterised as irresponsible and promiscuous by author Randy Shilts, who named him in 1987 and claimed he played an important role in the spread of the virus throughout the United States.

 However, the new analysis of the HIV genome in Dugas, who died in 1984 after helping with studies into whether the virus was transmitted sexually, has shown it not to be the root of the virus’s diversification in North America, but simply a typical strain of the HIV virus that was already present in the United States. The authors of the study say that the findings tally with a large body of already existing evidence, which exonerates Dugas from culpability in the history of HIV’s spread in the US.

 The importance of AIDS testing

 HIV testing is a matter of great importance, as not only is it a vital issue in terms of personal health, but also in preventing the spread of the infection to others. In addition to this, although there is no cure for HIV at present, there are many treatments available today that can serve to lessen the severity of its effects, making it all the more important to positively identify HIV if you believe you may be at risk.

 HIV testing for older people

 Older people may wonder if there is any need for them to undergo testing, but the answer is a definite yes. Research has demonstrated that in more than 15% of positive HIV cases, those infected were older people who believed that they had nothing to worry about with regard to their sexual activity. This erroneous belief has resulted in a number of otherwise preventable cases, so older people do need to consider getting tested.

 Adolescent HIV testing

 Adolescents seem to be engaging in sexual activity much earlier in life, with the average age being thirteen, although there are even cases of children aged ten or under being involved in sexual activity, making them another factor in the importance of HIV testing. Many adolescents are also engaging in sexual acts with more than one partner, further increasing the danger of exposure to sexually transmitted infections such as HIV. It is important that sexual education teach youngsters not only how to make use of protection, but also the importance of undergoing regular tests, for the sake of their own health as well as the health of others.

 Prevention

 Having a sexual relationship with one partner, ending the relationship, and then immediately launching into a sexual relationship with a new partner is one of the biggest yet most commonplace mistakes that many people make regarding their sexual health. The failure to undergo a test for sexually transmitted infections between sexual relationships with different partners has caused a chain reaction, resulting in many people being unnecessarily infected with HIV.

 People may also believe that they cannot be infected with HIV and other sexually transmitted infections because they always use a condom during sexual intercourse. The bad news, however, is that while condoms can be very helpful in preventing unwanted pregnancies, if not used correctly they may not always stop such infections from being transmitted. Condoms are the most reliable method of preventing STIs, but using them does not mean people never need to be tested.

 HIV testing is of vital importance, not only to the lives of those being tested but to the lives of their sexual partners and those that they care about.