What’s new in HIV testing and prevention?

by Lisa Oldson, MD, Medical Director

There’s always something new in the world of HIV research…and in recognition of National HIV Testing Day on June 27, I’d like to tell you about a fascinating new study that was recently published about HIV screening for MSM (men who have sex with men).

The research project began three years ago when the National HIV Behavioral Surveillance System interviewed and tested more than 7,000 men for HIV…in the year prior to the study, 61% of those men had tested negative for HIV, and the remaining participants had not been tested at all. Based on their interview responses, participants were divided into groups depending on whether or not they participated in high-risk sexual behaviors (e.g., MSM who have multiple or anonymous sex partners, sexual activity in conjunction with illicit drug use, etc.).

It was found that 7% of those who reported high-risk sexual behaviors were HIV positive, while 8% of those who practiced safer sex were also HIV positive. What does that tell us?

Well, until now, we thought that high-risk sexual behaviors correlate to a higher risk of becoming HIV positive…which is why the Centers for Disease Control and Prevention (CDC) recommend that people who participate in risky behaviors get screened for HIV and other sexually transmitted infections more frequently (every 3 to 6 months) than those who don’t.

But the current research shows us that MSM who engage in risky sexual behaviors are at the same risk of contracting HIV as those who play it safe…and that more frequent testing may be a good idea for all sexually active MSM, regardless of the sexual behaviors.

A significant number of participants in the study were found to be HIV positive…even those who had tested negative within the past 12 months. So it follows that, by being tested more often, MSM can reduce the time from HIV infection to diagnosis, which helps reduce overall transmission of the virus.

What’s the bottom line? Although this study hasn’t led to a change in the CDC’s current guidelines just yet, it conveys a very important message: all MSM can benefit from being tested for HIV more frequently, even those who do not engage in risky sexual behaviors.

What’s new in HIV prevention?
It turns out that Truvada, a drug approved in 2004 as part of a multidrug regimen to treat HIV, may also be effective in preventing HIV infection in high-risk populations. A recent study by Dr. Robert Grant of the Gladstone Institutes of Virology and Immunology showed that – when taken as instructed – daily use of Truvada alone stopped HIV in over 70% of cases.

Asa  a result, the CDC issued new guidelines stating that Truvada should be prescribed to men who are at a high risk of contracting HIV. While this is exciting news, Truvada costs about $13,000 a year…which leaves condoms as the #1 way to help prevent HIV.

HIV remains a serious public health challenge. The CDC reports that there are 1.1 million Americans living with HIV and as many as 21% don’t know they’re are infected. Let’s work together to improve those statistics…use condoms and, if you think you might have been exposed to HIV, don’t delay testing. Because the earlier HIV is diagnosed, the better it can be treated and managed.

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