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In-Brief: March 9th, 2018

In Brief is NEAETC's news service covering the latest developments and educational resources about HIV, hepatitis, health disparities, and related topics. To subscribe, please click HERE.

Conference News

2018 Conference on Retroviruses and Opportunistic Infections 

As this issue of In Brief went to press, the 2018 Conference on Retroviruses and Opportunistic Infections (CROI) was under way in Boston, Massachusetts.  For persons interested in following news from CROI, we recommend the following websites:

We plan to summarize selected highlights from 2018 CROI in the next issue of In Brief.

HIV Among Youth 

CDC Study Finds Large Differences in HIV Diagnosis Rates by Age Among Young Persons

Although young persons between the ages of 13 and 29 represented 23% of the U.S. population during 2014, they accounted for 40% of new diagnoses during that year, according a recent report from the U.S. Centers for Disease Control and Prevention (CDC).  However, the diagnosis rates were not uniformly high among young persons, but instead varied substantially by age. During the period from 2010 through 2014, HIV diagnosis rates per 100,000 population rose rapidly with increasing age from 0.7 among persons aged 13 to 15 years, 4.5 among those 16 to 17 years, 16.5 among those 18 to 19 years, and 28.6 among those 20 to 21 years. The HIV diagnosis rates per 100,000 population were higher, but less variable, among persons aged 22 to 23 years (34.0), 24 to 25 years (33.8), 26 to 27 years (31.3), and 28 to 29 years (28.7).

"These findings underscore the importance of targeting primary prevention efforts to persons aged under 18 years, specifically those aged 16 to 17 years, and continuing through the period of elevated risk in the mid-twenties," according to CDC study researchers. "Much remains to be understood about the factors that affect adolescents and young adults at high risk for acquiring or transmitting HIV infection . . . When implementing effective HIV prevention strategies, a multifaceted approach that incorporates the educational, social, policy, and health care systems can help support youths as they transition from adolescence into young adulthood."

Cancer and HIV

NCCN Issues New Guidelines for Managing Cancer in People Living with HIV

Compared to the general population, people living with HIV (PLWH) have higher rates of many types of cancers - both AIDS-defining malignancies and non-AIDS-defining cancers.  In addition, PLWH and cancer have higher mortality rates than uninfected persons with cancer.  "Reasons for this increased mortality include delayed diagnoses, advanced cancer stage, other comorbidities, and immunosuppression," according to the National Comprehensive Cancer Network (NCCN).  "However, there is also significant disparity in cancer treatment between PLWH and the general cancer population, with many PLWH not receiving any cancer treatment at all." NCCN notes that a recent survey of U.S. oncologists suggests that a lack of consensus guidelines and provider education has contributed to the substandard cancer care often offered to PLWH. "...To help fill that gap in education and enable health care providers to provide optimal cancer to PLWH, NCCN recently issued detailed cancer guidelines specifically for this population.

The new guidelines include specific recommendations for managing cervical cancer, anal carcinoma, non-small cell lung cancer, and Hodgkin lymphoma in PLWH.  They also provide guidance on: HIV management for persons undergoing cancer therapy, systemic therapy and drug-drug interactions, radiation therapy, surgery, supportive care, and the use of medical imaging in PLWH. The cancer and HIV guidelines can be viewed and downloaded for free from the NCCN website.  However, persons who wish to access the guidelines must first register with NCCN.

HIV Prevention 

PHAT Life Intervention Reduces HIV Risk Among Youth in the Criminal Justice System

An HIV risk-reduction intervention called PHAT Life - Preventing HIV/AIDS Among Teens - significantly reduced sexual risk-taking among a group of juvenile offenders in Chicago's Cook County, according to a recent study published in the journal Health Psychology. PHAT Life is a group intervention that uses a combination of role-playing, videos, games, and skill-building exercises to promote knowledge about HIV/AIDS, positive coping, and problem-solving skills among high-risk youth on probation.   PHAT Life consists of eight sessions, each lasting 90 to 120 minutes, delivered over the course of a two-week period. For the study, 310 urban youth between the ages of 13 to 17 who were on probation were randomized into either PHAT Life or a health information program of equal intensity.

The study researchers found that PHAT Life participants were more than four times as likely to report a reduction in the number of sexual partners and an increase in consistent condom use, compared to participants in the health information program. "Uniquely tailored interventions like PHAT Life that reduce adolescent risk behavior are essential to mitigate young offenders' poor long-term trajectories," noted Geri Donenberg, the lead researcher for the study from the University of Illinois-Chicago. "Limited resources require evidence-informed decisions about who can benefit the most from HIV-prevention efforts. Our findings suggest that PHAT Life can reduce sexual risk among the highest-risk teens."

Funding Opportunities 

Two HIV/AIDS Funding Opportunities from the Ryan White Program 

The Health Resources and Services Administration's HIV/AIDS Bureau (HRSA/HAB) currently has two open funding opportunities under the Ryan White HIV/AIDS Program.  One of these opportunities, with a deadline of March 26, is for a new three-year initiative called Evidence-Informed Approaches to Improving Health Outcomes for People Living with HIV (PLWH). According to HRSA, this program will "support a single organization that will systematically identify, catalog, disseminate, and support the replication of evidence-informed approaches and interventions to engage PLWH who are not receiving HIV health care (i.e., individuals who are not currently in care or have never been in care) or are at risk of not continuing to receive HIV health care."

The second HRSA/HAB open funding opportunity, with a deadline of April 2, is for a new three-year demonstration project called Improving Sexually Transmitted Infection Screening and Treatment for People Living with or at Risk for HIV.  The organization selected for this project will work with HRSA staff "to promote clinical service and system-level interventions leading to an increase and/or improvements in the screening and treatment of STIs [sexually transmitted infections] among low-income people living with HIV or at risk for HIV who are served by HRSA's Ryan White HIV/AIDS Program and/or Health Center Program."

Health Communication and Social Media

More Tips on Digital Marketing from HIV.gov

During the past month, the HIV.gov blog has published several new posts focusing on digital marketing as part of its ongoing series to help agencies and organizations make better use of digital tools for HIV communication.  These include:

How to Know if Your Social Media Strategy is Successful - This post describes approaches for gauging the engagement and reach of your media strategy with your target audience(s).

Is Your Content Ready for Mobile Users? Tips for Making the Most of the Small Screen - This post provides tips for making information attractive to smartphone users, including: incorporating engaging visuals; shortening headlines, paragraphs, and overall content; using bullet points; and linking to more in-depth content.

Awareness Day Promotion: Should You Be Using Videos? - This post describes the great popularity of video content, outlines why videos are an effective way to engage target audiences, and provides nine ideas for creating promotional videos for raising awareness, encouraging action (such as HIV testing), or promoting events associated with HIV/AIDS awareness days.  

Other Resources

Biktarvy Fact Sheet from AIDSinfo

The U.S. Department of Health and Human Services (HHS) AIDSinfo site recently published a fact sheet on Biktarvy - a new one-pill-per-day HIV regimen that was approved by the U.S. Food and Drug Administration on February 7.  The document provides extensive information about Biktarvy, including the drugs it contains, who it is approved for, drug dosing and what to do if someone misses a dose, and side effects, including the potential for serious adverse reactions.  A Spanish version of the fact sheet is also available on HHS's infoSIDA site. 

HHS Updates Opportunistic Infections Guidelines with New Information for Human Herpesvirus-8

The latest revision to HHS's Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents provides updated information about Human Herpesvirus-8 (HHV-8) - also known as Kaposi sarcoma-associated herpesvirus (KSHV).   As its alternative name indicates, HHV-8 is the virus responsible for the AIDS-defining illness Kaposi's sarcoma, and it is also associated with a condition called multicentric Castleman's disease.  The revised HHV-8 section includes the most recent data on the epidemiology of HHV-8 infection and HHV-8-related malignancies, new treatment recommendations for multicentric Castleman's disease, as well as information about a newly described clinical syndrome called the KSHV inflammatory cytokine syndrome (KICS).

CDC Fact Sheet and Web Pages

CDC recently published several new and updated HIV resources:

Internalized HIV-Related Stigma: This 2-page fact sheet describes internalized HIV-related stigma, its manifestations, and its prevalence by race/ethnicity, age, and gender. It also summarizes ways people living with HIV can reduce internalized HIV-related stigma.

HIV Among People Who Inject Drugs (PWID): This web page provides updated statistical data about HIV among PWID, including new HIV diagnoses and HIV prevalence.  The page also describes challenges in preventing HIV infection among PWID and highlights CDC programs that support HIV surveillance, prevention, outbreak response, and treatment in this high-risk group.

Injection Drug Use and HIV Risk: This web page discusses the risk of HIV, other infections, and overdose among PWID. It also describes steps PWID can take to reduce the risks associated with injection drug use, and includes links to related resources on injection drug use, HIV, hepatitis C, and overdose prevention.