Researchers Report that PrEP May Be Accepted as HIV Prevention in UK's Gay Men

via AIDSmap.com, by Roger Pebody

Pre-exposure prophylaxis (PrEP) would be an acceptable HIV prevention strategy for large numbers of gay, bisexual and other men who have sex with men in major UK cities, according to two studies presented to the British HIV Association (BHIVA) conference in Birmingham this week.

The conference also heard details of a small pilot PrEP study, likely to start recruiting later this year.

A cross-sectional survey of 842 HIV-negative gay and bisexual men, recruited at bars, clubs and saunas in London, suggested that half the respondents would be interested in taking PrEP.

Respondents were given information about pre-exposure prophylaxis and asked: “If PrEP were available, how likely is it that you would take a pill (oral dose) on a daily basis to prevent HIV infection?”.

Half said yes, with 16% saying they were likely to take PrEP and 34% saying they were very likely to. Men interested in PrEP were slightly more likely to be under the age of 35 (AOR adjusted odds ratio 1.58), have attended a sexual health clinic in the past year (AOR 1.59) and to have previously taken post-exposure prophylaxis (PEP) (AOR 1.96). After statistical adjustment, various measures of risky sex were no longer associated with interest in PrEP.

In this survey, 17 men (2.1% of those answering the question) said that they had previously taken antiretroviral drugs to reduce their risk of HIV infection.

Secondly, clinicians at the Manchester Centre for Sexual Health surveyed HIV-negative men attending their service who reported unprotected receptive anal intercourse. Of the 121 men who responded, 36% said they would be “very willing” to take PrEP while only 14% said they would not take the treatment. Daily dosing was perceived as a better option by four fifths of respondents – just one fifth would prefer taking a dose before sexual activity.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Treatment outcomes among different ethnic groups similar for UK gay men

via Aidsmap, by Michael Carter

HIV treatment outcomes among gay men in the UK are similar across ethnic groups, investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

The study showed that gay men from black and minority ethnic (BME) populations were approximately 17% less likely to initiate antiretroviral therapy than white gay men. However, after starting treatment there were no differences by ethnicity in treatment outcomes.

“The provision through the NHS [National Health Service] of publicly funded HIV care with universal access has resulted in equitable utilisation and outcomes of HIV care across different ethnic MSM [men who have sex with men] groups,” comment the investigators. “Nevertheless we have shown that there are disparities in the uptake of cART [combination antiretroviral therapy] and the reasons for this warrant further study.”

Gay men remain one of the groups most affected by HIV in the UK. Prevalence of the infection differs significantly according to ethnicity and is higher among BME gay men compared to white gay men.

US research showed that differences in health insurance status meant that MSM from minority racial populations were less likely to access healthcare compared to white MSM.

In the UK, however, the NHS provides universal and equitable access to healthcare. Despite this, there is some evidence suggesting that BME patients are more likely to report dissatisfaction with their care and longer waiting times for appointments.

Investigators from the UK Collaborative HIV Cohort (UK CHIC) therefore analysed differences in retention in HIV care, uptake of antiretroviral therapy and HIV treatment outcomes between MSM according to ethnicity.

The study involved 16406 gay male patients who received care between 1996 and 2008. The analysis of HIV treatment utilisation was restricted to individuals who were seen after 2000. Examination of treatment outcomes was restricted to the subgroups of individuals who received care after 2007.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

PrEP Preferences of Gay Men in the UK

via aidsmap, by Roger Pebody

"Prior awareness of PrEP was low. Only 17% of respondents said that they had already heard of the idea of taking a pill before sex in order to prevent HIV infection."

"Fifty five per cent would prefer a daily pill, 28% before and after sex, and 18% were not sure."

While few gay men in England are currently aware of pre-exposure prophylaxis (PrEP), most men who are introduced to the idea support PrEP being made available. Half would consider taking it themselves, but most would prefer to take it on a daily basis, rather than before and after each time they have sex. These findings come from a snapshot survey of gay men in England, published by Sigma Research this week.

Pre-exposure prophylaxis (PrEP) involves HIV-negative people taking anti-HIV drugs in order to reduce their risk of infection. Results of the iPrEX study into the safety and effectiveness of PrEP in gay and other men who have sex with men showed that, overall, it reduced infections by 43%. Much higher levels of efficacy were seen in men with good adherence to PrEP.

Recent studies with American gay men have shown that while only a minority of men is aware of PrEP, a majority would consider using it. Most men say PrEP would not affect their own use of condoms, particularly if it is only partially effective.

To investigate the views of gay men in England, researchers put a series of questions to members of the Sigma Panel in June 2011. The panel is made up of approximately 1500 gay men, bisexual men and other men that have sex with men (MSM) who respond to monthly cross-sectional online surveys about HIV and sexual health. The surveys have a short turnaround for analysis and reporting to health workers.

Only men who do not have diagnosed HIV were asked about PrEP; 1259 responded.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

The British legacy of homophobia

via New Statesman, by Philip Dayle

Excerpt:

Eric Heinze, professor of law at Queen Mary, University of London, believes that there is a "manufactured sensitivity" in pressing human rights relating to sexual orientation. Why shouldn't gay rights attract the same moral revulsion as the fight against racism or violence against women? Can the UK call out its former colonies on this issue? What kind of deference is shown to culture or religion in this type of human rights activism?

Not surprisingly, the colonial history of many developing countries makes them resistant to calls for reform from metropolitan centres in Europe. Activism that is viewed as patronising harks back to the days of empire, when important decisions were made in London and force-fed back to the colonies. These seemingly symbolic considerations are as important as substantive arguments in advocacy for change in this regard.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Could Your Mobile Phone Diagnose an STI?

From The Guardian, by Denis Campbell

Mobile phones and computers will soon be able to diagnose sexually transmitted diseases under innovative plans to cut the UK's rising rate of herpes, chlamydia and gonorrhoea among young people.

Doctors and technology experts are developing small devices, similar to pregnancy testing kits, that will tell someone quickly and privately if they have caught an infection through sexual contact.

People who suspect they have been infected will be able to put urine or saliva on to a computer chip about the size of a USB chip, plug it into their phone or computer and receive a diagnosis within minutes, telling them which, if any, sexually transmitted infection (STI) they have. Seven funders, including the Medical Research Council, have put £4m into developing the technology via a forum called the UK Clinical Research Collaboration.

Sexual health experts hope it will help reduce the growing number of STIs, which have increased for the last decade and reached a record 482,696 last year. Two-thirds of women reporting a new STI were under 25, as were more than half of men.

The self-testing devices are aimed at technology-savvy young people. Public health experts are concerned that, although most STIs occur among that age group, many are too embarrassed to visit a GP or a genito-urinary medicine clinic to get tested and therefore continue to suffer and potentially pass the disease on. Doctors hope that the ability to obtain a private, confidential diagnosis will overcome their widespread reluctance to take a test.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Gay Asylum Seekers from Iran and Cameroon Win Appeal

Via BBC

Two gay men who said they faced persecution in their home countries have the right to asylum in the UK, the Supreme Court has ruled. The panel of judges said it had agreed "unanimously" to allow the appeals from the men, from Cameroon and Iran. They had earlier been refused asylum on the grounds they could hide their sexuality by behaving discreetly.

For the full story click here.

HIV is not a gay disease

via guardian.co.uk, by Chris Ward

The gay community is very aware of HIV. Indeed, the infection used to go by the name of gay-related immune deficiency (Grid) before it was discovered to have been transmitted through other non-sexual means such as intravenous drug use. It seems that history can leave quite a mark, not just in the perceptions of individual members of society, but within the guidelines of public organisations too. It is still the case, although hopefully not for much longer, that once a man has had sex with another man, even with a condom, they are banned from giving blood for life.

In every year since 1999, most new diagnoses of HIV have been through heterosexual contact. Although many point out that a good chunk of these infections are believed to have been contracted abroad, statistically meaning that in the UK you are still less likely to be infected if you engage in heterosexual activities, the numbers are still very chilling. It proves convincingly that many heterosexuals do not consider HIV to be an infection likely to affect them. The myth of the gay disease may have heightened awareness of HIV among gays, but it has also sent a wave of complacency across the heterosexual community.

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Buzzzzzz --- Rectal Microbicides!

by Mariama Kamara (African HIV Policy Network, UK)

and Dr. Carolina Herrera (St. George’s University, London, UK)

Our third Buzz Café ( hosted by the UK African Microbicides Working Group on December 4) focused on rectal microbicides and the possibilities of having a rectal Microbicides before a vaginal one. The topic in itself is quite controversial but it was a space for advocates to discuss and enhance their knowledge of rectal microbicide research and development. Anal intercourse is increasingly understood as a more common practice amongst heterosexuals. Dr Carolina Herrera from St George’s University shared information about their recent research findings on rectal microbicides and what they have accomplished over the past four years.

To date the National Institutes of Health (NIH) and amfAR have funded for the first time, projects aiming to develop rectal microbicides and efforts to understand colorectal transmission of HIV. The laboratories of Professor Robin Shattock and Martin Cranage at St. George’s, University of London have been involved in both projects.

A laboratory model of the colorectal tract based on little pieces of tissue, known as explants, and obtained from surgery has been developed. This model allows screening of compounds, to test possible combinations of compounds and to determine possible inflammatory responses of the tissue after exposure to compounds and their possible formulations. Furthermore, it gives the possibility to assess the replication capacity of resistant isolates against different compounds and to measure the early responses of the tissue to viral exposure. Understanding the mechanism of HIV-1 transmission in the colorectal tract and determining the best combinations of compounds to inhibit resistant isolates will be key to the design of successful prevention strategies. This funding has allowed the first Phase 1 trial of a reverse transcriptase inhibitor, UC781, in vaginal formulation applied rectally; and next year, another Phase 1 trial will be conducted with PMPA/Tenofovir, again in the vaginal formulation and applied rectally.

The Buzz Café brought together ideas from scientists and advocates about working more closely together and sharing new research ideas to further understanding amongst both groups and contribute to informed advocacy for microbicides research.

The UK is all a-BUZZ about rectal microbicides!

click image to enlarge

As part of its ongoing series of highly successful Buzz Cafés, the UK African Microbicides Working Group is hosting its next event on December 4th. Guest speaker Dr. Carolina Herrera from St. George's University, discussions about participants' role in rectal microbicide advocacy, general camaraderie and (non)caffeinated beverage of your choice are all on the menu!

RSVP your attendance to mariama.kamara@ahpn.org today!

UK Campaign for Microbicides Springs into Action!

The UK Campaign for Microbicides has recently sent a letter to the UK Department for International Development (DfID).

The letter does an excellent job at balancing praise for the government’s recent announcement, expressing concern on certain aspects of this announcement, and offering to become involved in the process.

Namely, the UK Campaign has expressed:

* Support for the commitment to increase by 50 per cent funding available for the research and development of vaccines and microbicides from 2008 to 2015

* Interest in working with partners to take forward this commitment

* Concern on two fronts:

- The restrictive definition of microbicides used by DfID, which fails to recognize that both vaginal and rectal microbicides development require support, and that microbicides are needed for women and men

- The need for social and behavioural research

Congratulations to UK advocates for your work over the years, which undoubtedly led to the commitment to increased funding, as well as for your well-crafted letter. We await DfID’s response with great anticipation!

Revealed: the truth about brothels

A survey into London's off-street sex industry has exposed just how widespread it is - and documents in disturbing detail the plight of the women trapped in it.

Via The Guardian

The men were undertaking research for Big Brothel: a Survey of the Off-Street Sex Industry in London, the most comprehensive study ever conducted into brothels in the UK. The project, which gathered information from 921 brothels in the capital, was commissioned by the Poppy Project, the only British organisation that offers support for women trafficked into prostitution.

My co-author Helen Atkins and I recruited male friends and colleagues to help with the research, and warned them that the work might be upsetting. They were to telephone brothels, posing as potential punters, with a list of questions including "What nationalities are on offer tonight?", "Do the girls do anal?", "How about oral without a condom?", and "What age are they?" We wanted to look at what really goes on in brothels - how much control the women really have; whether there is evidence of trafficking; if local councils are giving licences for saunas and massage parlours when it is clear that they are brothels; and how the sex industry is growing and evolving.

During 120 hours of telephone calls, we established the following: at least 1,933 women are currently at work in London's brothels; ages range from 18 to 55 (with a number of premises offering "very, very young girls"); prices for full sex start at £15, and go up to £250; and more than a third of the brothels offer unprotected sex - including, in some cases, anal penetration. The lowest price quoted for anal sex was £15. "Come along and bring your mates," said one brothel owner. "We have a Greek girl who is very, very young." While kissing used to be off-limits for women selling sex, it can now be bought for an extra tenner.

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