World AIDS Day: Moving Toward an HIV-Free Generation

Rear Admiral Susan Blumenthal, MD, Senior Policy and Medical Advisor at amfAR, The Foundation for AIDS Research coauthored an article with Kate Goertzen and Yuri Hanada on "World AIDS Day: Moving Towards an HIV Free Generation" published on today's Huffington Post. Full text below:


World AIDS Day: Moving Toward an HIV-Free Generation

Susan Blumenthal, M.D.
Public Health Editor at HuffPost and Former U.S. Assistant Surgeon General
Co-authored by Kate Goertzen and Yuri Hanada


On this World AIDS Day, achieving an HIV-free generation must be a top priority. In many areas of the world, including the United States, youth bear the brunt of the HIV/AIDS epidemic.

In 2009, 370,000 children who became HIV-positive globally were infected by mother to child transmission (MTCT). That's 1,000 children every day. Provision of anti-retroviral medications (ARVs) to pregnant women living with HIV could prevent most of these infections, but only 53 percent of pregnant women who are HIV positive receive these drugs in low and middle income countries. In contrast, thanks to public health education and access to lifesaving ARV medications, MTCT has been virtually eliminated in the United States, and most babies are now born HIV-free. This makes the current HIV infection rate for this generation of young people in America all the more alarming: As many as 250,000 youth are living with HIV in America today. Furthermore, in 2006, more HIV infections occurred among people ages 13-29 in the United States than any other age group, according to the Centers for Disease Control and Prevention (CDC). Despite considerable progress in the scientific understanding of HIV as well as the eradication of MTCT in America, the incidence and prevalence of, and misconceptions about, HIV among our youngest generation suggest that we have much work to do to effectively alter the course of the epidemic among youth.

America's youth are coming of age at a time when AIDS is considered to be a treatable disease. Unlike young people in the early days of the epidemic in the U.S., most young people today have not witnessed the deaths of peers from this illness. Complacency surrounding HIV/AIDS in America has led to a kind of AIDS amnesia, particularly among youth. The results: large numbers of young people who are unaware of their risk for infection, who have never been tested, and who take unnecessary risks with their health.

In the U.S., statistics concerning HIV/AIDS among young people are particularly startling for the most vulnerable groups. Young men who have sex with men (MSM), ages 13-24, accounted for 84 percent of HIV/AIDS cases from 2004-2007. Yet, a 2005 survey of young MSM in seven major cities revealed that only 23 percent of those who had tested positive were already aware they were infected. In 2007, African Americans, another vulnerable group, represented 17 percent of adolescents ages 13-19 in the U.S., but accounted for 72 percent of HIV/AIDS cases in this age group. Young women, intravenous drug users, and youth whose parents are living with HIV/AIDS are also at increased risk.

Scientists have found that the dynamic developmental phase of adolescence itself contributes to vulnerability as a result of significant physiological changes, including those of the reproductive anatomy, which increase susceptibility to HIV infection. Additionally, youth mount robust immunological responses that may surpass those of adults, and it is unclear exactly when the switch from the biological mechanisms of child to adult drug metabolism occurs. These factors can potentially affect the safety and dosing requirements in vaccine and other biomedical prevention technology trials and yet prevention and treatment recommendations for young people are often extrapolated from the results of adult-only studies. For example, the recent finding that anti-retroviral (ARV) medication taken as a prophylactic "prevention pill" (PrEP) can reduce transmission by 43.8 percent and when taken as prescribed by as much as 90 percent is game changing; the median age in this study of MSM was 25, underscoring why youth must be included in future clinical trials.

There are additional considerations that place young people at high risk. While adolescence marks a period of exploration that may translate to episodic and risky sex, young people may not have the interpersonal skills necessary to negotiate safe behaviors that can protect them from HIV, other sexually transmitted infections (STIs), and unintended pregnancies. Lesbian, gay, bisexual and transgender youth may face stigmatizing and isolating environments that affect their psychological and sexual health, as those who are unable or unwilling to disclose their sexual orientation may withdraw from critical sources of social support and prevention services.

Furthermore, structural factors such as homelessness, transportation, and state laws regarding the confidentiality of minors' health information impede young people's access to youth-friendly services and health information. Approximately one-third of all junior and senior high schools have no on-site health services. Meanwhile, half of sexually active youth will have contracted an STI by age 25, increasing their risk for HIV, but approximately two-thirds of 15-17-year-olds and half of 18-24-year-olds have never been tested for an STI. This is why comprehensive, evidence-based, and age-appropriate sex education is needed in schools today.

The HIV/AIDS burden on youth underscores the urgent call for an enhanced focus on their unique needs. The Obama Administration's first-ever National HIV/AIDS Strategy (NHAS), announced in July, identifies the importance of addressing the growing HIV epidemic among young people. NHAS presents a prime opportunity to prioritize and target vulnerable youth with appropriate prevention and service-delivery programs while expanding efforts to reach all young people with vital HIV/AIDS information.

Every hour, two young people in the U.S. become infected with HIV; of those who do become infected, approximately 80 percent do not know that they are HIV-positive. Altering this trajectory will require a comprehensive, multifaceted approach -- one that invests in research and mobilizes all sectors of society to design and implement prevention and treatment programs that specifically address youth issues. This is the roadmap to attain an HIV-free generation in the United States. For our nation's future, we must act now.



Rear Admiral Susan Blumenthal, M.D., M.P.A. (ret.) is the Senior Policy and Medical Advisor at amfAR, The Foundation for AIDS Research. She is also a Clinical Professor at Georgetown and Tufts University Schools of Medicine and Chair of the Global Health Program at the Meridian International Center. Dr. Blumenthal served for more than 20 years in senior health leadership positions in the Federal government in the Administrations of four U.S. Presidents, including as Assistant Surgeon General of the United States, the first Deputy Assistant Secretary of Women's Health, as a White House Advisor on Health, and as Chief of the Behavioral Medicine and Basic Prevention Research Branch at the National Institutes of Health. She is the Public Health Editor of the Huffington Post. Admiral Blumenthal has received numerous awards including honorary doctorates and has been decorated with the highest medals of the US Public Health Service for her pioneering leadership and significant contributions to advancing health in the United States and worldwide. She is the recipient of the 2009 Health Leader of the Year Award from the Commissioned Officers Association and was recently named a 2010 Rock Star of Science.

Kate Goertzen serves as a Research and Policy Assistant at amfAR, The Foundation for AIDS Research.
Yuri Hanada is an Alan Rosenfield Health Policy Fellow at amfAR, The Foundation for AIDS Research.

Today is World AIDS Day

World AIDS Day, observed December 1 each year, is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection.

AIDS has killed more than 25 million people between 1981 and 2007, and an estimated 33.2 million people worldwide live with HIV as of 2007, making it one of the most destructive epidemics in recorded history. Despite recent, improved access to antiretroviral treatment and care in many regions of the world, the AIDS epidemic claimed an estimated 2 million lives in 2007, of which about 270,000 were children.

Take this quiz to find out if you've been at risk for HIV and to read a great resource from a UK-based HIV prevention website:

http://www.worldaidsday.org/Facts-and-Stats/Have-you-put-yourself-at-risk.aspx

Infographic I saw on Reddit - click image to see full size

Halloween Message

Did you share the October Halloween message with your friends? If so, answer a few quick questions and you could win $20 to Tisane!

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It's easy and it'll help us figure out how many people we are reaching with the Safety Net project.

Thanks!
--jamie

Happy Halloween! October's Safety Net Message

BOO! Don't be scared to talk about safer sex before you hook up at those Halloween parties. Whatever costume you wear, always accessorize it with a condom! -- From your friends on the Safety Net Team

and hey, you can be the coolest one at the party & send the right message with the condom costume! (Dang, I wish I thought of this first, but I decided to go with a nurse. I work at the Health Collective, I thought it was fitting!)

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are YOU missing out on a $25 gift card to VIP [Very Intimate Pleasures] ? If you shared the September Safety Net message ("stay safe, play safe") on Facebook/Twitter or by email/text message, answer a few quick questions here and you will be entered to win this month's drawing for the Safety Net project!


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44 pct of gay, bisexual men with HIV don't know it

ATLANTA – One in five sexually active gay and bisexual men has the AIDS virus, and nearly half of those don't know they are infected, a federal study of 21 U.S. cities shows.

Experts said the findings are similar to earlier research, but the study released Thursday is the largest to look at gay and bisexual U.S. men at high risk for HIV. More than 8,000 men were tested and interviewed, and 44 percent of those who had the virus didn't know they had it.

Overall, less than half of 1 percent of Americans have the AIDS virus, according to a calculation by the Kaiser Family Foundation, a research and policy organization in Washington, D.C.

But gay and bisexual men continue to be infected at much higher rates, said Jennifer Kates, Kaiser's director of global health and HIV policy.

"We don't have a generalized epidemic in the United States. We have a concentrated epidemic among certain populations," she said.
That's why a new national AIDS strategy, unveiled by the White House in July, is emphasizing more of a government focus on men who have sex with men and others at the highest risk of getting infected, Kates said.

The Centers for Disease Control and Prevention recommends HIV testing at least once a year for all men who have sex with men and are sexually active, but research indicates more than half don't get tested.

An earlier study in just five cities in 2004-05 found similar results.

The new study, conducted in 2008, included 16 additional cities. Researchers offered free testing to the men, interviewed them and paid around $25 for their participation.

Black men were more likely to have HIV, with 28 percent reportedly infected, compared to 18 percent of Hispanic men and 16 percent of white men.

Black men were also least likely to know they were infected — about 60 percent didn't know they had HIV — compared 46 percent of Hispanic men and 26 percent of whites.

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Online:
CDC report: http://www.cdc.gov/mmwr

September's Safety Net Message

Stay safe, play safe! Condoms can prevent HIV if used correctly, every time. Get a sampler pack with many varieties at HGLHC!

"Stay safe, play safe! Condoms can prevent HIV if used correctly, every time. Get a sampler pack with many varieties at HGLHC! -- from your friends @ Safety Net"

Once you've sent it out, don't forget to answer 5 questions here:

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You could win $25 to VIP!

Thank you for all that you do for the community.
-Jamie

Respect Yourself-- Protect Yourself!

http://www.youtube.com/italkbecause



http://www.youtube.com/italkbecause



Just for Fun!

My mom bought this for me. I guess she understands my sense of humor!

It's CLOBBERIN' HIV TIME!