#PrEP HIV infection

[reasonsforhope]

"A large clinical trial in South Africa and Uganda has shown that a twice-yearly injection of a new pre-exposure prophylaxis drug gives young women total protection from HIV infection.

The trial tested whether the six-month injection of lenacapavir would provide better protection against HIV infection than two other drugs, both daily pills. All three medications are pre-exposure prophylaxis (or PrEP) drugs.

Physician-scientist Linda-Gail Bekker, principal investigator for the South African part of the study, tells Nadine Dreyer what makes this breakthough so significant and what to expect next.

Tell us about the trial and what it set out to achieve

The Purpose 1 trial with 5,000 participants took place at three sites in Uganda and 25 sites in South Africa to test the efficacy of lenacapavir and two other drugs.

Lenacapavir (Len LA) is a fusion capside inhibitor. It interferes with the HIV capsid, a protein shell that protects HIV’s genetic material and enzymes needed for replication. It is administered just under the skin, once every six months.

The randomised controlled trial, sponsored by the drug developers Gilead Sciences, tested several things.

The first was whether a six-monthly injection of lenacapavir was safe and would provide better protection against HIV infection as PrEP for women between the ages of 16 and 25 years than Truvada F/TDF, a daily PrEP pill in wide use that has been available for more than a decade.

Secondly, the trial also tested whether Descovy F/TAF, a newer daily pill, was as effective as F/TDF...

The trial had three arms. Young women were randomly assigned to one of the arms in a 2:2:1 ratio (Len LA: F/TAF oral: F/TDF oral) in a double blinded fashion. This means neither the participants nor the researchers knew which treatment participants were receiving until the clinical trial was over.

In eastern and southern Africa, young women are the population who bear the brunt of new HIV infections. They also find a daily PrEP regimen challenging to maintain, for a number of social and structural reasons.

During the randomised phase of the trial none of the 2,134 women who received lenacapavir contracted HIV. There was 100 percent efficiency.

By comparison, 16 of the 1,068 women (or 1.5%) who took Truvada (F/TDF) and 39 of 2,136 (1.8%) who received Descovy (F/TAF) contracted the HIV virus...

What is the significance of these trials?

This breakthrough gives great hope that we have a proven, highly effective prevention tool to protect people from HIV.

There were 1.3 million new HIV infections globally in the past year. Although that’s fewer than the 2 million infections seen in 2010, it is clear that at this rate we are not going to meet the HIV new infection target that UNAIDS set for 2025 (fewer than 500,000 globally) or potentially even the goal to end Aids by 2030...

For young people, the daily decision to take a pill or use a condom or take a pill at the time of sexual intercourse can be very challenging.

HIV scientists and activists hope that young people may find that having to make this “prevention decision” only twice a year may reduce unpredictability and barriers.

For a young woman who struggles to get to an appointment at a clinic in a town or who can’t keep pills without facing stigma or violence, an injection just twice a year is the option that could keep her free of HIV.

What happens now?

The plan is that the Purpose 1 trial will go on but now in an “open label” phase. This means that study participants will be “unblinded”: they will be told whether they have been in the “injectable” or oral TDF or oral TAF groups.

They will be offered the choice of PrEP they would prefer as the trial continues.

A sister trial is also under way: Purpose 2 is being conducted in a number of regions including some sites in Africa among cisgender men, and transgender and nonbinary people who have sex with men.

It’s important to conduct trials among different groups because we have seen differences in effectiveness. Whether the sex is anal or vaginal is important and may have an impact on effectiveness.

How long until the drug is rolled out?

We have read in a Gilead Sciences press statement that within the next couple of months [from July 2024] the company will submit the dossier with all the results to a number of country regulators, particularly the Ugandan and South African regulators.

The World Health Organization will also review the data and may issue recommendations.

We hope then that this new drug will be adopted into WHO and country guidelines.

We also hope we may begin to see the drug being tested in more studies to understand better how to incorporate it into real world settings.

Price is a critical factor to ensure access and distribution in the public sector where it is badly needed.

Gilead Sciences has said it will offer licences to companies that make generic drugs, which is another critical way to get prices down.

In an ideal world, governments will be able to purchase this affordably and it will be offered to all who want it and need protection against HIV."

-via The Conversation, July 3, 2024

[frameacloud]

Brittney McNamara (December 5, 2016). "What to Do If You've Been Exposed to HIV." Teen Vogue.

The more people who know about what to do in that situation, the better.

[fidicushiv]

Call : +917997101303 | Whatsapp : https://wa.me/917997101505 | Website : https://fidicus.com

ఎక్కువ మందితో ప్రొటెక్షన్ లేకుండా కలుస్తున్నారా? Unprotected Sex | HIV AIDS PrEp Treatment Cure

Stay protected from HIV infection even when engaging in sex with multiple unknown partners by using PrEP (Pre-Exposure Prophylaxis) treatment. This YouTube video explains how PrEP effectively reduces the risk of HIV transmission when taken consistently. Learn about the importance of regular medical consultations, proper condom use, and adherence to the medication. Stay informed and safeguard your health with these essential prevention strategies.

Dr. Bharadwaz | HIV AIDS | Health & Fitness | Homeopathy, Medicine & Surgery | Clinical Research

#PrEP #HIVPrevention #SafeSex #SexualHealth #hivawareness

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#ClingeniousHealth #HelseformFitness #FidicusHomeopathy #ClingeniousResearch

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#Treatment #Cure #Prevent #Relieve #Medicine #Vaccine

#AlternativeTherapy #AdjuvantTherapy #AlternativeMedicine #AlternativeSystem

Specialty Clinic Fidicus HIV highest success with homeopathy Improve Wellness | Increase Longevity | Addresses Questions

[afeelgoodblog]

The Best News of Last Week

1. ‘We are just getting started’: the plastic-eating bacteria that could change the world

In 2016, Japanese scientists Oda and Hiraga published their discovery of Ideonella sakaiensis, a bacterium capable of breaking down PET plastic into basic nutrients. This finding marked a shift in microbiology's perception, recognizing the potential of microbes to solve pressing environmental issues.

France's Carbios has successfully applied bacterial enzyme technology to recycle PET plastic waste into new plastic products, aligning with the French government's goal of fully recycling plastic packaging by 2025.

2. HIV cases in Amsterdam drop to almost zero after PrEP scheme

According to Dutch AIDS Fund, there were only nine new cases of the virus in Amsterdam in 2022, down from 66 people diagnosed in 2021. The organisation claimed that 128 people were diagnosed with HIV in Amsterdam in 2019, and since 2010, the number of new infections in the Dutch capital has fallen by 95 per cent.

3. Cheap and drinkable water from desalination is finally a reality

In a groundbreaking endeavor, engineers from MIT and China have designed a passive solar desalination system aimed at converting seawater into drinkable water.

The concept, articulated in a study published in the journal Joule, harnesses the dual powers of the sun and the inherent properties of seawater, emulating the ocean’s “thermohaline” circulation on a smaller scale, to evaporate water and leave salt behind.

4. World’s 1st drug to regrow teeth enters clinical trials

The ability to regrow your own teeth could be just around the corner. A team of scientists, led by a Japanese pharmaceutical startup, are getting set to start human trials on a new drug that has successfully grown new teeth in animal test subjects.

Toregem Biopharma is slated to begin clinical trials in July of next year after it succeeded growing new teeth in mice five years ago, the Japan Times reports.

5. After Decades of Pressure, US Drugmaker J&J Gives Up Patent on Life-Saving TB Drug

In what can be termed a huge development for drug-resistant TB (DR-TB) patients across large parts of the world, bedaquiline maker Johnson and Johnson said on September 30 (Saturday) that it would drop its patent over the drug in 134 low- and middle-income countries (LMICs).

6. Stranded dolphins rescued from shallow river in Massachusetts

7. ‘Staggering’ green growth gives hope for 1.5C, says global energy chief

The prospects of the world staying within the 1.5C limit on global heating have brightened owing to the “staggering” growth of renewable energy and green investment in the past two years, the chief of the world’s energy watchdog has said.

Fatih Birol, the executive director of the International Energy Agency, and the world’s foremost energy economist, said much more needed to be done but that the rapid uptake of solar power and electric vehicles were encouraging.

---

That's it for this week :)

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[hellyeahscarleteen]

How is HIV spread?

"HIV is spread through 6 body fluids: blood, vaginal fluids, semen, pre-cum, rectal fluids, and breastmilk. To get HIV from one of these fluids, there are 4 things that need to happen.

HIV has to be present in the fluid. You can only get HIV from someone who is infected with HIV.

HIV needs to be present in a large enough quantity to cause an infection. HIV dies outside of the human body, so things like old, dried blood don’t spread HIV. Likewise, if someone is on treatment for their HIV and the amount of virus in their body is very low, they are unlikely to give you HIV.

HIV needs to get into your body. This can happen if fluids from someone with HIV get into your blood – like through a needlestick, cut, or open sore – or if fluids come into contact with the inside of your rectum, urethra, or vagina. You cannot get HIV from touching things like blood or semen with unbroken skin.

You need to be susceptible to HIV infection. Some things, like taking PrEP to prevent HIV infection, make you less susceptible. Other things, like having an untreated STI, make you more susceptible."

(From Positively Informed: An HIV/AIDS Roundup)

[macgyvermedical]

Harm Reduction Ideas for Substance Use Disorder

Recently I have been listening to a podcast called The Curbsiders Addiction Medicine. If you are a clinician that works even sometimes with people who use substances (every clinician ever), it is a fantastic look at all the harm reduction practices you can use to make these individuals safer. Plus, you get free CME.

I’m hardly going to do the podcast itself justice with this post, but I wanted to share some things I learned from it:

If the dangers of using substances (social and legal consequences, time commitment, health problems, money problems, etc…) was a deterrent, people wouldn’t be doing it. But it’s not. Because uncontrolled substance use is a chronic disease that generally does not get better without treatment. When people are treated, not only do they generally use less, but they have a much lower chance of death and a much higher chance of a happy, productive life- whatever that means for the patient.

Previously (even a few years ago) we hung such treatment on the requirement that people be abstinent from substances in order to receive help. This works for some people, but far from everyone.

The evidence shows that best thing we can do for many individuals is to make their use safer and less of a burden on their life and health. This is called harm reduction, and it WORKS.

Here are some evidence-based ideas for how to help your patients:

Create a space where you are working together with your patient and following your patient’s lead. Do they want to become abstinent? Great! Do they want to use less or use in a more controlled way? Also great! Do they want to continue use in a safer way? You guessed it, also great! Support them in whatever their goal is

Provide or prescribe safe, clean tools of use. Things like clean needles, Pyrex pipes, and straws. This decreases rates of infection and abscesses

Prescribe medications that reduce cravings or reduce/eliminate withdrawal (methadone, buprenorphine, topiramate, bupropion, naltrexone) without requiring abstinence

Teach people safer use practices and safer routes, such as rectal (booty bumping) or oral (parachuting) instead of injection drug use

Prescribe PrEP if people are at risk of HIV without requiring abstinence

Test for and treat the consequences of substance use (such as HIV and Hep C) without requiring abstinence

Provide fentanyl and xylazine test strips so people know what is in the substances they are using and can adjust doses/use pattern accordingly

Recommend Never Use Alone hotlines to prevent overdose death or better yet, take turns using with a buddy

Prescribe naloxone to anyone who uses any substance- nearly all street drugs are contaminated with synthetic opioids and naloxone is an effective way to prevent deaths

People use substances for a reason, especially early in their journey- pain, coping with depression/other mental illness, ADHD, and social issues like being unhoused. Treat the problem if you can find it, and you can help people significantly decrease use or use in a more controlled way

Be aware that return to use (or return to uncontrolled use) is a thing you can plan for with the patient and manage before it even happens

It’s hard sometimes to change the idea of addiction/substance use disorder as something that can only be treated as a reward for staying sober. But thats why so few people seek treatment for it. The evidence does not equivocate. Harm reduction WORKS.

[drdemonprince]

Is "safe sex" even real? Never done it so idk but you mentioned risk profiles once. I feel like demographically I've got a higher risk profile and the anxiety about that really prevents me from going and trying anything. Do you think that's overly anxious in a negative way?

"safe sex" is a really misleading and binary term. There is never any guarantee of safety in anything we do. Every choice we make comes with risks. Hell, choosing not to connect with other people sexually (if you have any desire to) does ITSELF come with its own risks and costs over time.

The chase after perfect, guranteed safety will only lead to us feeling powerless and afraid, because it is an impossibility. All that we can do is inform ourselves of the risks, mitigate the risks we are the most concerned about and that affect others, and then knowingly accept what risks we still face as the cost of leading a full, enjoyable life.

When we inform ourselves about risk mitigation, we learn there are certain steps that we should probably take to protect ourselves and others if we are engaging in behavior that carries risk. If you're having sex with a complete stranger, it's probably smart to use a condom. If you have sex regularly you might want an HPV vaccine or to be on PreP to prevent HIV transmission. When you meet up with people you should get tested for COVID. You should get vaccinated against COVID. If you want to get suspended in rope from the ceiling don't use a hardware store $3 carabeener, get the good shit from the rock-climbing supply store. Things like that.

But even if you use a condom, you might get herpes or HPV or crabs or a yeast infection. Even if you never have sex, you might already have herpes or HPV or crabs or a yeast infection. I've had several of those things, including some of the "scarier" sounding ones, and they're really not that big a deal. They're just a thing that happens in life. Most people have them. You pop a Valtrex when you have symptoms, you shove a suppostiory up your vulva when it itches, you sleep without underwear on, you communicate with partners, you move on with your life.

Sure, I do what I can to avoid the risks I am most concerned about. I take PreP right now because not getting HIV would be preferable to me. But I could still live if I got it. I am informed about the realities of living with HIV today, which makes that fear more manageable. It is easier for me to make carefully considered and yet realistic decisions surrounding my risk profile because I can confront the realities that scare me and learn more about them.

The body is not separable form its environment. We are connected to our surroundings and the people around us, and our bodies get sick, catch viruses, grow old, get messy, and die inevitably and return to the earth. With our one life, we each have to choose what is most important to us and what potential costs we can stand. But with each year that passes, a cost to our bodies is already incurred, and there's nothing we can do to prevent aging and death from coming our way.

So what would you like to do while you are around? Would you like to have sex with condoms? Go on PreP? Get the HPV vaccine? Take random loads in a glory hole? Make out and dry hump with a cutie at a party and catch her cold sore? Cross the street in the dark after looking both ways? Go out dancing so late that your sleep is disrupted for the whole week? Get your heart broken? Have a great all-consuming love? Have children? Endure a torn labia while giving birth? Try psychedelics? Go on a swinger's cruise? Get a UTI from spermicide? Roleplay online instead of meeting in person? Fuck people with a strap-on?

The choice is yours. And no choice you make will be perfect or come without risk. No life is safe. Accepting loss is one of the necessary tasks of leading a life. But you can educate yourself, reflect on what you most want out of life and what you fear, and then take steps to demystefy your worst fears and mitigate the risks that loom largest to you and the people you care about.

Whatever you decide, I hope you have some fun.

[rwrbmovie]

#RWRBMovie: Designing the sex scenes

“We need to make sure that it is unambiguous to anyone watching this scene what precisely is happening,” he says. “We’re going to be accurate to the body positioning, to the breath, to the moment of insertion.” Working with intimacy coordinator Robbie Taylor Hunt, López thought through every possible detail about how two men have sex — and what about that process needed to make it into the scene: “We talked about, ‘Does the prince douche before they go in? Do we need to tell the audience that? Does the audience just assume that that’s going on?’” A great deal of time was spent on whether Prince Henry would be on PrEP, a medication taken to prevent HIV infection during sex. “Robbie and I decided together that the prince is probably not on PrEP, because it would be too dangerous for him to ask for prescription,” López says. “So the prince absolutely uses condoms. And because we couldn’t really effectively answer the PrEP question narratively, we wanted to also just tell the story that the prince engages in safe sex practices and takes his sexual health seriously.” Eagle-eyed viewers have indeed caught sight of condom wrappers near Henry and Alex’s bed during a couple of points in the film — alongside a bottle of lube.  “Once we had passed a certain part in the story, I was like, OK, let’s empty out some of the lube,’” López says. “Robbie and I were looking at it, like, ‘How much would they use? Like, well, let’s take it down about this much. OK, that makes sense to me.’” It was also vitally important to López to block out every beat of the sex scene in Paris. “Days before we shot that scene, Robbie and I actually got into the bed together,” the director says through laughter. “There are videos that could, like, ruin both our careers. Because we were like, ‘Alright, we’re having sex. What are we going to do? Okay, this pillow goes here. The condom’s going to land here. I’m going to do this.’ We probably overdid it in terms of the preparation for the scene. But we also wanted to make sure that we got on to set and we had an answer for every conceivable question.” The opportunity to show two men having sex in what amounts to a major studio romantic comedy was not lost on López. “I’d be a liar if I told you there wasn’t strategy to the scene, that I didn’t want to cause a conversation about why they’ve never seen this scene in a studio film,” he says. But he was also keenly aware of what he was asking of his actors. “Look, I don’t know if I could do it,” he says. “I’m fully aware that I’m asking two actors to do something that I’m probably not willing to do. I better make sure that I’m not wasting their time, that I’m not making them feel exploited, and that they are included in every single decision, every step of the way. It’s the only responsible way to do it. We knew that if Taylor and Nick didn’t feel safe, we would never have gotten that scene out of them.”

[lastoneout]

Things that can go in/pass through the vagina just fine:

penis (and/or semen)

sex toys made of body-safe materials

condoms (male and female)

lube

infants you are actively giving birth to

all that other shit that comes outta there during childbirth

period blood

mucus your body naturally produces so long as it doesn't smell or look weird

tongue

fingers

tampons and menstrual cups

IUD or other insertable birth control methods

ovulation tests

medical devices used during pap smears and pelvic exams or IVF treatments

dilators for those who've had bottom surgery

medications as directed by your doctor(like estrogen cream to prevent vaginal atrophy when on testosterone)

Things that should not go in there!!!

soap, oh my god do not put soap in there holy shit

food

flavored condoms/lube

douching fluids

crystals/special rocks

blood that isn't yours

pregnancy tests(you're supposed to pee on them)

sex toys made out of non-body safe materials unless you put a condom on them

stuff that isn't sterile or hasn't been cleaned properly

no fr like if you are doing anal you NEED to clean your penis/sex toy or at least swap to a new condom before putting it in the vagina holy fucking infections batman

anything you're allergic to(this includes everything on the safe list, if you're allergic to it it's not safe)

the body parts/bodily fluids of someone who has an STI unless you guys have protection(condoms, dental dams, latex gloves, you're taking PrEP/medications to keep your HIV viral load low enough that you can't pass it on, ect.)

Not a comprehensive list ofc but like since it does seem we occasionally need the reminder here ya go. If you're unsure about anything planned parenthood has a lot of sex education material up on their website, def check it out!!

[reasonsforhope]

"Since it was first identified in 1983, HIV has infected more than 85 million people and caused some 40 million deaths worldwide.

While medication known as pre-exposure prophylaxis, or PrEP, can significantly reduce the risk of getting HIV, it has to be taken every day to be effective. A vaccine to provide lasting protection has eluded researchers for decades. Now, there may finally be a viable strategy for making one.

An experimental vaccine developed at Duke University triggered an elusive type of broadly neutralizing antibody in a small group of people enrolled in a 2019 clinical trial. The findings were published today [May 17, 2024] in the scientific journal Cell.

“This is one of the most pivotal studies in the HIV vaccine field to date,” says Glenda Gray, an HIV expert and the president and CEO of the South African Medical Research Council, who was not involved in the study.

A few years ago, a team from Scripps Research and the International AIDS Vaccine Initiative (IAVI) showed that it was possible to stimulate the precursor cells needed to make these rare antibodies in people. The Duke study goes a step further to generate these antibodies, albeit at low levels.

“This is a scientific feat and gives the field great hope that one can construct an HIV vaccine regimen that directs the immune response along a path that is required for protection,” Gray says.

-via WIRED, May 17, 2024. Article continues below.

Vaccines work by training the immune system to recognize a virus or other pathogen. They introduce something that looks like the virus—a piece of it, for example, or a weakened version of it—and by doing so, spur the body’s B cells into producing protective antibodies against it. Those antibodies stick around so that when a person later encounters the real virus, the immune system remembers and is poised to attack.

While researchers were able to produce Covid-19 vaccines in a matter of months, creating a vaccine against HIV has proven much more challenging. The problem is the unique nature of the virus. HIV mutates rapidly, meaning it can quickly outmaneuver immune defenses. It also integrates into the human genome within a few days of exposure, hiding out from the immune system.

“Parts of the virus look like our own cells, and we don’t like to make antibodies against our own selves,” says Barton Haynes, director of the Duke Human Vaccine Institute and one of the authors on the paper.

The particular antibodies that researchers are interested in are known as broadly neutralizing antibodies, which can recognize and block different versions of the virus. Because of HIV’s shape-shifting nature, there are two main types of HIV and each has several strains. An effective vaccine will need to target many of them.

Some HIV-infected individuals generate broadly neutralizing antibodies, although it often takes years of living with HIV to do so, Haynes says. Even then, people don’t make enough of them to fight off the virus. These special antibodies are made by unusual B cells that are loaded with mutations they’ve acquired over time in reaction to the virus changing inside the body. “These are weird antibodies,” Haynes says. “The body doesn’t make them easily.”

Haynes and his colleagues aimed to speed up that process in healthy, HIV-negative people. Their vaccine uses synthetic molecules that mimic a part of HIV’s outer coat, or envelope, called the membrane proximal external region. This area remains stable even as the virus mutates. Antibodies against this region can block many circulating strains of HIV.

The trial enrolled 20 healthy participants who were HIV-negative. Of those, 15 people received two of four planned doses of the investigational vaccine, and five received three doses. The trial was halted when one participant experienced an allergic reaction that was not life-threatening. The team found that the reaction was likely due to an additive in the vaccine, which they plan to remove in future testing.

Still, they found that two doses of the vaccine were enough to induce low levels of broadly neutralizing antibodies within a few weeks. Notably, B cells seemed to remain in a state of development to allow them to continue acquiring mutations, so they could evolve along with the virus. Researchers tested the antibodies on HIV samples in the lab and found that they were able to neutralize between 15 and 35 percent of them.

Jeffrey Laurence, a scientific consultant at the Foundation for AIDS Research (amfAR) and a professor of medicine at Weill Cornell Medical College, says the findings represent a step forward, but that challenges remain. “It outlines a path for vaccine development, but there’s a lot of work that needs to be done,” he says.

For one, he says, a vaccine would need to generate antibody levels that are significantly higher and able to neutralize with greater efficacy. He also says a one-dose vaccine would be ideal. “If you’re ever going to have a vaccine that’s helpful to the world, you’re going to need one dose,” he says.

Targeting more regions of the virus envelope could produce a more robust response. Haynes says the next step is designing a vaccine with at least three components, all aimed at distinct regions of the virus. The goal is to guide the B cells to become much stronger neutralizers, Haynes says. “We’re going to move forward and build on what we have learned.”

-via WIRED, May 17, 2024

[autistichalsin]

Slut-shaming and stigmatizing PrEP, condoms, and safe-sex measures as exclusively for "degenerates" who want to "avoid the consequences of their actions" (ironically, the same line that gets used on people with uteruses who want birth control and abortion access) doesn't lower the rates of HIV and other STIs. It just leads to higher rates of infection, as well as people who refuse medical care out of fear they'll be shamed for having an STI.

Granted, the cruelty is the point to most sex-negative people; most enjoy the idea of 'sinners' and 'degenerates' being 'punished' for their promiscuity. But if there's any of you who actually DO think this will reduce rates of infection, if there are any of you who are just misguided: Please know that you are wrong.

[liberaljane]

Today marks #WorldAIDSDay, a time to show support for people living with #HIV and those who lost their lives to AIDS.

First commemorated in 1988, World AIDS Day raises awareness to end the spread of HIV and the stigma and discrimination that surrounds it.

Despite the progress made, HIV is still a major public health threat globally. In 2021, there were 1.5 million new HIV infections. In particular, girls in sub-Saharan Africa continue to be disproportionately affected by HIV, accounting for 63% of the region's new HIV infections in 2021.

However, it's important to know that in our modern era, people with HIV live long and happy lives thanks to access to antiretroviral therapy (ART). People living with HIV deserve care, not punishment.

To end AIDS, we must look and address underlying inequalities. Solutions include:

Increase availability of HIV testing, treatment and prevention (such as PrEP).

Reform laws and policies that perpetuate the stigma and exclusion of people living with HIV.

Ensure equal access to the best HIV science, between the Global South and North.

Collaboration with UNFPA

[Digital illustration of a Black fem with long curly hair. She’s wearing a white shirt that reads, “Living with HIV doesn't define me.” She’s also wearing gray jeans, a red ribbon and a black choker necklace. Behind her is a sky of gray clouds and a moon.]

[covid-safer-hotties]

Also preserved on our archive

By Robert Pearl, M.D.

In the late 1970s and early ‘80s, a mysterious illness spread through America’s overlooked communities, mainly affecting intravenous drug users and homosexual men.

The disease, which caused a sudden and devastating collapse of the immune system, was unlike anything doctors had seen before. Patients arrived at hospitals with rare infections like Kaposi’s sarcoma and fungal pneumonia.

But despite the rising number of cases, public health officials remained silent for years. Few Americans saw it as a national emergency, especially since the disease seemed confined to society’s fringes, at least initially.

By the time the government and public fully grasped the threat in 1986—following Dr. C. Everett Koop’s “Surgeon General’s Report on AIDS”—tens of thousands of Americans had already died.

Looking back on this and other public health crises, it’s clear that medical science alone isn’t enough to save lives. To prevent similar tragedies, public health leaders and elected officials must first understand the role denial plays in people’s perception of medical threats. They must then develop effective strategies to overcome it.

The Psychological Basis For Denial Denial is a powerful, usually unconscious defense mechanism that shields individuals from uncomfortable or distressing realities. By repressing objective facts or experiences—especially those that provoke fear or anxiety—people can maintain a sense of stability in the face of overwhelming threats.

Historically, denial was vital to daily life. With little protection against illnesses like smallpox, tuberculosis or plague, people would have been immobilized by fear if not for the ability to repress reality. Denial, mixed with superstition, took the place of facts, allowing society to function despite the ever-present risks of death and disability.

Today, even with tremendous advances in medical knowledge and technology, denial continues to influence individual behavior with detrimental consequences.

For example, more than 46 million Americans use tobacco products, despite their links to cancer, heart disease and respiratory illness. Similarly, tens of millions of people refuse vaccinations, disregarding scientific consensus and exposing themselves—and their communities—to preventable diseases. Denial extends to cancer screenings, as well. Surveys show that 50% of women over 40 skip their annual mammograms, and 23% have never had one. Meanwhile, about 30% of adults between 50 and 75 are not up to date on colorectal cancer screenings, and 20% have never been screened.

These examples demonstrate how denial leads individuals to make choices that jeopardize their health, even when life-saving interventions are readily available.

A Pattern of Denial: How Inaction Fuels Public Health Crises When individual denial scales up to the collective level, it fuels widespread inaction and worsens public health crises. Throughout modern medical history, Americans have repeatedly underestimated or dismissed emerging health threats until the consequences became impossible to ignore.

Early warnings of the HIV/AIDS epidemic were largely ignored, as the stigma surrounding affected populations made it easier for the broader public to deny the severity of the crisis. Even within at-risk populations, the lengthy delay between infection and symptoms created a false sense of security, leading to risky behaviors. This collective denial allowed the virus to spread unchecked, resulting in millions of deaths worldwide and a public health challenge that persists in the United States today.

Even now, four decades after the virus was identified, only 36% of the 1.2 million Americans at high risk for HIV take PrEP (Pre-Exposure Prophylaxis), a medication that is 99% effective in preventing the disease.

Chronic diseases like hypertension and diabetes mirror this pattern of denial. The long gap between early signs and life-threatening complications—such as heart attack, stroke and kidney failure—leads people to underestimate the risks and neglect preventive care. This inaction increases morbidity, mortality and healthcare costs.

Whether the issue is an infectious disease or a chronic illness, denial causes harm. It allows medical problems to take root, it delays care and it leads to tens of thousands preventable deaths each year.

The Unseen Parallels: COVID-19 And Mpox Our nation’s responses to COVID-19 and mpox (formerly known as monkeypox) similarly illustrate how denial hampers effective management of public health emergencies.

By March 2020, as COVID-19 began to spread, millions of Americans dismissed it as just another winter virus, no worse than the flu. Even as deaths rose exponentially, elected officials and much of the public failed to recognize the growing threat. Critical containment measures—such as travel restrictions, widespread testing and social distancing—were delayed. This collective denial, fueled by misinformation and political ideology, allowed the virus to take root across the country.

By the time the severity of the pandemic was undeniable, hospitals and health systems were overwhelmed. The opportunity to prevent widespread devastation had passed. More than 1 million American lives were lost, and the economic and social consequences continue today.

Mpox presents the most recent example of this troubling pattern. On August 14, the World Health Organization declared mpox a global health emergency after identifying rapid spread of the Clade 1b variant across several African nations. This strain is significantly more lethal than previous variants, having already caused over 500 deaths in the Democratic Republic of Congo, primarily among women and children under 15. Unlike earlier outbreaks associated mainly with same-sex transmission, Clade 1b spreads through both heterosexual contact and close family interactions, increasing its reach and putting everyone at risk.

Despite these alarming developments, awareness and concern about mpox remains low in the United States. International aid has been limited, and vaccination efforts have fallen far behind the growing threat. As a result, by the time the WHO issued its emergency declaration, only 65,000 vaccine doses had been distributed across Africa, where more than 10 million people are at risk. Already, cases have appeared in Sweden and Thailand, and the U.S. may soon follow.

Even with the added danger of the new variant and the proven efficacy of the JYNNEOS vaccine, only one in four high-risk individuals in the United States has been vaccinated against mpox. Our slow and delayed response to Covid-19, mpox, HIV/AIDS and nearly-all chronic diseases demonstrate how widespread denial is, the lives it continues to claim and the urgent need to address this hidden defense mechanism. The best way to overcome denial—both individually and collectively—is to bring the risks into clear focus. Simply warning people about the dangers isn’t enough. Strong leadership is crucial in breaking through this subconscious barrier.

Lessons To Learn, Actions To Take Dr. C. Everett Koop’s public health campaign on AIDS in the 1980s demonstrated how clear, consistent messaging can shift public perception and drive action. Similarly, former Surgeon General Luther L. Terry’s landmark 1964 report on smoking educated the public about the dangers of tobacco. His report spurred subsequent efforts, including higher taxes on tobacco products, restrictions on smoking in public places and health campaigns using vivid imagery of blackened lungs—leading to a significant decline in smoking rates.

Unfortunately, government agencies often fall short, hampered by bureaucratic delays and overly cautious communications.

Officials tend to wait until all details are certain, avoid acknowledging uncertainties, and seek consensus among committee members before recommending actions. Instead of being transparent, they focus on delivering the least risky advice for their agencies. People, in turn, distrust and fail to heed the recommendations.

Early in the COVID-19 pandemic, and more recently with mpox, officials hesitated to admit how little they knew about the emerging crises. Their reluctance further eroded public trust in government agencies. In reality, people are more capable of handling the truth than they’re often given credit for. When they have access to all the facts, they usually make the right decisions for themselves and their families. Ironically, if public health officials focused on educating people about the risks and benefits of different options—rather than issuing directives—more people would listen and more lives would be saved.

With viral threats increasing and chronic diseases on the rise, now is the time for public health leaders and elected officials to change tactics. Americans want and deserve the facts: what scientists know, what remains unclear and the best estimates of actual risk.

[mariacallous]

Since it was first identified in 1983, HIV has infected more than 85 million people and caused some 40 million deaths worldwide.

While medication known as pre-exposure prophylaxis, or PrEP, can significantly reduce the risk of getting HIV, it has to be taken every day to be effective. A vaccine to provide lasting protection has eluded researchers for decades. Now, there may finally be a viable strategy for making one.

An experimental vaccine developed at Duke University triggered an elusive type of broadly neutralizing antibody in a small group of people enrolled in a 2019 clinical trial. The findings were published today in the scientific journal Cell.

“This is one of the most pivotal studies in the HIV vaccine field to date,” says Glenda Gray, an HIV expert and the president and CEO of the South African Medical Research Council, who was not involved in the study.

A few years ago, a team from Scripps Research and the International AIDS Vaccine Initiative (IAVI) showed that it was possible to stimulate the precursor cells needed to make these rare antibodies in people. The Duke study goes a step further to generate these antibodies, albeit at low levels.

“This is a scientific feat and gives the field great hope that one can construct an HIV vaccine regimen that directs the immune response along a path that is required for protection,” Gray says.

Vaccines work by training the immune system to recognize a virus or other pathogen. They introduce something that looks like the virus—a piece of it, for example, or a weakened version of it—and by doing so, spur the body’s B cells into producing protective antibodies against it. Those antibodies stick around so that when a person later encounters the real virus, the immune system remembers and is poised to attack.

While researchers were able to produce Covid-19 vaccines in a matter of months, creating a vaccine against HIV has proven much more challenging. The problem is the unique nature of the virus. HIV mutates rapidly, meaning it can quickly outmaneuver immune defenses. It also integrates into the human genome within a few days of exposure, hiding out from the immune system.

“Parts of the virus look like our own cells, and we don’t like to make antibodies against our own selves,” says Barton Haynes, director of the Duke Human Vaccine Institute and one of the authors on the paper.

The particular antibodies that researchers are interested in are known as broadly neutralizing antibodies, which can recognize and block different versions of the virus. Because of HIV’s shape-shifting nature, there are two main types of HIV and each has several strains. An effective vaccine will need to target many of them.

Some HIV-infected individuals generate broadly neutralizing antibodies, although it often takes years of living with HIV to do so, Haynes says. Even then, people don’t make enough of them to fight off the virus. These special antibodies are made by unusual B cells that are loaded with mutations they’ve acquired over time in reaction to the virus changing inside the body. “These are weird antibodies,” Haynes says. “The body doesn’t make them easily.”

Haynes and his colleagues aimed to speed up that process in healthy, HIV-negative people. Their vaccine uses synthetic molecules that mimic a part of HIV’s outer coat, or envelope, called the membrane proximal external region. This area remains stable even as the virus mutates. Antibodies against this region can block many circulating strains of HIV.

The trial enrolled 20 healthy participants who were HIV-negative. Of those, 15 people received two of four planned doses of the investigational vaccine, and five received three doses. The trial was halted when one participant experienced an allergic reaction that was not life-threatening. The team found that the reaction was likely due to an additive in the vaccine, which they plan to remove in future testing.

Still, they found that two doses of the vaccine were enough to induce low levels of broadly neutralizing antibodies within a few weeks. Notably, B cells seemed to remain in a state of development to allow them to continue acquiring mutations, so they could evolve along with the virus. Researchers tested the antibodies on HIV samples in the lab and found that they were able to neutralize between 15 and 35 percent of them.

Jeffrey Laurence, a scientific consultant at the Foundation for AIDS Research (amfAR) and a professor of medicine at Weill Cornell Medical College, says the findings represent a step forward, but that challenges remain. “It outlines a path for vaccine development, but there’s a lot of work that needs to be done,” he says.

For one, he says, a vaccine would need to generate antibody levels that are significantly higher and able to neutralize with greater efficacy. He also says a one-dose vaccine would be ideal. “If you’re ever going to have a vaccine that’s helpful to the world, you’re going to need one dose,” he says.

Targeting more regions of the virus envelope could produce a more robust response. Haynes says the next step is designing a vaccine with at least three components, all aimed at distinct regions of the virus. The goal is to guide the B cells to become much stronger neutralizers, Haynes says. “We’re going to move forward and build on what we have learned.”

[lookingforcactus]

"The Food and Drug Administration announced Thursday it would end its ban on allowing blood donations from men who have recently had sex with men. New guidelines instead advise asking all potential donors the same questions about their recent sexual history, regardless of their sexual orientation, sex or gender.

At the same time, the agency said they would not allow donations from people taking PrEP to prevent HIV, because the medication can cause a false negative test for HIV/AIDS.

The new policy is based on multiple scientific studies and follows the lead of Canada and the United Kingdom, which have adopted similar approaches. The update has the potential to “expand the number of people eligible to donate blood, while also maintaining the appropriate safeguards to protect the safety of the blood supply,” the FDA said in a press release.

LGBTQ advocacy groups have long criticized the ban on blood donations from gay men — ostensibly a way to prevent the spread of HIV — as discriminatory. In 2015, the FDA ended its lifetime ban on donations from gay men, replacing it with a requirement for one year of abstinence before a donation would be accepted.

The latest policy eliminates screening questions specific to men who have sex with men and their partners. Instead, anyone who reports having anal sex, or sex with new or multiple partners, in the past three months could have their blood donation delayed to reduce the risk of taking donations from people who have recently been infected with HIV, the agency’s press release said.

GLAAD’s president and CEO Sarah Kate Ellis posted a statement on Twitter lauding “the FDA’s decision to follow science,” calling the updated guidelines “the beginning of the end of a dark and discriminatory past rooted in fear and homophobia.”"

-via Rolling Stone, 5/11/23

[stellanix]

learning about PrEP and PEP and progress in developing vaccines and other ways of preventing and treating HIV and being amazed at how far medical science has come in the past few decades. i have hope that i will live to see a day when this horrible disease that's taken so many lives is a thing of the past

and i am also infuriated at people who think that getting HIV and other STIs is a moral failing and that these medical advances are unnecessary because "people should just stop being sluts"

y'know what? i think pleasure is inherently good. if medical science can make it possible to fuck nasty with lots of complete strangers without risking infection, then hell yeah let's do that! sluttiness and promiscuity and casual sex are fun and cool and good and beautiful and it would be good if people had more freedom to do that