Hepatitis C Twice for HIV+ Gay Men

posted: 16/03/2011

Just over one-quarter of gay men with HIV cured of early stage hepatitis C in Amsterdam got it again within two years. The men got hepatitis C from different people the second time.
 

10 times more reinfection – better prevention needed
The hepatitis C reinfection rate among these Amsterdam HIV positive men is ten times higher than the rate they of first hepatitis C infection among men with HIV.
 

It is clear that much better health promotion work is needed if men are to avoid reinfection with hepatitis C.
 

Sexually transmission of hepatitis C among gay and bisexual men happens widely especially in cities like Manchester, Brighton, London, Amsterdam, Berlin, as well as in North America and Australia.
 

Sex risks and networks
Various explanations have been offered for the greater vulnerability of men with HIV infection, including chosing sexual partners who also have HIV (called sero-sorting), and networks of sexual partners where many of the men have HIV. However it is the sexual and drug-using practices which affects who gets hepatitis C.
 

Heptatitis C reinfection
Researchers from Amsterdam Academic Medical Centre and the Amsterdam Public Health Service reported HIV+ men reinfected after being successfully treated for hepatitis C.
Twenty-eight men were successfully treated. Two men relapsed and hepatitis C reappeared within two months of the end of their hepatitis C treatment. Of the remaining 26 men, 7 were reinfected within two years, an incidence of 19.6 per 100 person years of follow-up. The time to reinfection was typically one year but could be much sooner.
 

Different type of hepatitis C
In every man reinfected they had a different genetic version of hepatitis C - three who first had genotype 4 then got genotype 1, while two men who started with genotype 1 get genotype 4 the second time. One man got genotype 1 again but even this was from a different clade, a different subtype.
 

Better prevention
The researchers say that discussion about prevention measures needs to take place not only at the time of diagnosis, but during and after treatment.
In particular men need to understand all the possible sexual and drug sharing transmission routes, and must to feel free to have frank discussions with doctors about sexual practices, drug-using behaviour and other risk factors. Too many HIV positive men with hepatitis C feel unable to talk freely because they feel judged, shamed and blamed by their HIV clinic.
 

Keep testing
Regular HCV testing in previously-treated individuals is also essential. We reported recently that while around 8% of gay and bi men with HIV in the UK have hepatitis C, one quarter of positive gay men were not checked for this in 2008, when every person with HIV should be checked at least once a year.

A German study showed similar reinfection among HIV-positive men. 22% became reinfected within six years, despite the number of first hepatitis C infections in Germany falling. 

Treatment of acute hepatitis C infection with pegylated interferon and ribavirin prevents early HIV infection progressing to chronic infection, which is harder to treat in HIV-positive people.
European guidelines on treatment of acute hepatitis C infection note that HIV-positive patients have a good response rate to treatment begun within a year of infection.

Source  with reference

Fresh Gay Men’s HIV Prevention

posted: 16/03/2011

HIV prevention work for gay and bi men in England has been freshened up in the latest edition of Making it Count. Making it Count is the HIV prevention framework used in England by gay men’s and other HIV prevention organisations.
 

Making it Count first appeared in 1998 and the new edition describes how to do HIV prevention and education with gay and bisexual men. It’s been totally rewritten and is available here. It's produced by the CHAPS gay men's HIV prevention and sexual health partnership.

George House Trust is not part of CHAPS but we play a lively and active role. At the CHAPS conference last week we made two conference presentations based on our experience of the sexual health and HIV support needs of HIV+ gay and bi men.

George House Trust also made detailed comments and suggestions for improving the latest Making It Count.

Risky Choices

The new edition of Making It Count considers the various choices facing men who have sex with men that make a difference to HIV transmission, and puts more emphasis on what motivates and drives men in making these critical decisions on sexual risks.

Making It Count brings education and empowerment together in HIV prevention, in a way that values and respects gay and bi men, including men with HIV. It includes using social norms to influence men’s sexual behaviour.

Best Sex with Least Harm
Making It Count aims to promote the best sex with the least harm among gay men and bisexual men.

Making It Count Briefing Sheets

Making It Count Briefing Sheets are also available. These are handy summaries of the evidence on important HIV prevention and sexual health issues.

Making It Count Briefing Sheets already available are 

• Using fear in HIV prevention
• Herpes
• LGV
• Gonorrhoea, chlamydia and non-gonococcal urethritis (NGU)
• Hepatitis C
• Social marketing.

Future Briefings will soon be added for

• Poppers
• Microbicides
• PEP
• Undiagnosed HIV infection.

Making It Count Briefing Sheets

Making It Count from Sigma Research

Football, HIV and Saving Lives

posted: 16/03/2011

When Birmingham City play Arsenal in the Carling Cup Final this weekend, they are launching a HIV awareness campaign for soccer fans.
 

Birmingham City and England goalie Ben Foster with midfielders Alexander Hleb and Craig Gardner are supporting Football Saving Lives, a national health promotion project.
 

Get Tested, then Stay Negative or Get Treated
“Saving lives is, of course, a lot harder than saving goals,” says Ben Foster, “but I’m a proud to be an ambassador for this campaign, precisely because it makes things so simple: get tested, get treated.

It’s as easy as that. It is definitely in your best interest to get HIV tested if you get the opportunity: if you’re negative, then you can stay that way, and if you turn out positive there are now life saving treatments available ”.
 

22,000 people do not know they have HIV
Football Saving Lives is part of a Birmingham NHS HIV campaign. Dr Steve Taylor says “One in four of those who have HIV are unaware they’re infected. That means that they cannot access the life-saving treatment we can now offer, and in addition they may well be unknowingly infecting others. We need to tackle this problem and diagnose the 22,000 people in the UK who have HIV but are totally unaware.”
 

Football Saving Lives raises public HIV awareness and corrects the wrong ideas people may have about HIV and HIV testing. Being rhis reluctance to take HIV tests, or thinking you are not at risk, remain key reasons why so many are untested and often end up in hospital because of the damage HIV infection causes over time.
 

People still die of HIV even though excellent treatment gives people reasonable health and life propects as long as people are tested and diagnosed early.
Soccer fans may not give much thought to HIV so the players and campaigns hopes to make fans think and act.
 

HIV hasn’t gone away
“I grew up in Birmingham,” says Blues midfielder Gardner, “and I remember the HIV prevention campaigns at school. But I haven’t heard anybody talk about HIV for years – I thought it had just gone away. But to think that there are some 22,000 people out there who have no idea they are infected is a really scary statistic. I’m supporting this campaign because I believe that education and raising awareness are the best ways of helping young people look after their sexual health and start to reduce the spread of HIV.”
 

Testing and timely HIV treatment allows people to live a near normal life. Treatment also helps cut the spread of HIV because people on successful HIV treatment with undetectable viral loads are far less likely to pass on HIV.
 

Almost all pregant women get tested - why not soccer fans?

Ninety-five per cent of pregnant women already receive an HIV test as standard, and if the mother has HIV treatment of the mother and baby means babies now rarely get HIV.
 

“Football Saving Lives is about getting these really important public health messages regarding sexual health and HIV testing out to the public,” summarises Alexander Hleb, on loan to Birmingham City from Barcelona.
 

Football Saving Lives, includes player profiles

Source

U-Sex Survey for Gay Men

posted: 14/03/2011

The u-sex study is trying to find out more about why some gay and bi men have anal sex without using condoms. There’s an online survey to take part in for all gay and bi men (with or without HIV).

Later parts of the study will look at negative and untested men, living in London, who have had condom-less anal sex recently.
 

The survey, which takes about 20 minutes, asks you your background, sexual behaviour, and experiences and views about anal sex without condoms. Whatever you say in the online survey is all confidential - and it's on a secure website.
 

Join the U-Sex survey

The online survey is on the secure site (https) surveymonkey and you start here – please tick the box at the bottom left to agree to take part in the survey.

The survey is being done at City University, London by researcher Matthew - more information about it here.

Mambo, Health and Africans

posted: 07/03/2011

Mambo 6 is the latest issue of the healthier lifestyle magazine for Africans who are living in the UK. Features in this issue include African and gay  and homophobia in Uganda . There is a look at issues facing HIV positive children  and a new London testing initiative.

Positive Pastor tells Congregation

Pastor Gideon Byamugisha is one of the first African religious leaders talking openly about their HIV positive status, and David Olapoju talks about overcoming tuberculosis.

There is also the latest round up of news from Africa  and you can win a Nokia smartphone  by entering their survey.

Mambo 6 download pdf