In Brief: HIV and Hepatitis News
 
A Message from NEAETC
 
Since 2011, NEAETC and the AIDS Action Committee have published the online HIV and Health Disparities Update, focusing on news and developments in HIV and viral hepatitis, with particular emphasis on health disparities by race/ethnicity, sexual orientation and identity, gender, income, and risk group.
 
NEAETC is now launching a new information resource – In Brief: HIV and Hepatitis News – that will replace the newsletter. As you'll see below, In Brief consists of concise summaries of the latest information about HIV, hepatitis, and health disparities organized by topic for easy review. Each item includes links to source materials and resources in case you want to explore particular news and developments in greater depth.
 
We'll also provide links to related information about NEAETC events and online resources to help build and maintain your expertise on all matters related to HIV, viral hepatitis, and related issues.
Continuum of Care
 
Low Retention in Care and Viral Suppression Rates in U.S. Gay and Bisexual Men
Despite recent overall improvements in the U.S. national continuum of HIV care, some groups, including gay, bisexual, and other men who have sex with men (MSM) have lagged behind. Among MSM living with diagnosed HIV infection at the end of 2014, 74% received any care, 58% were retained in care, and 61% had achieved viral suppression, according to a new CDC report published in Morbidity and Mortality Weekly Report. Black MSM had the lowest rates of retention in care and viral suppression – 54% and 52%, respectively. The report authors concluded that, “Tailored strategies for MSM that increase care and achieve viral suppression, particularly among young MSM and Black or African American MSM, are needed to reduce HIV infections, improve health outcomes for persons living with HIV infection, and reduce HIV-related health disparities.”
 
New HIV Diagnoses in San Francisco Have Fallen Nearly 50% in Four Years
In its latest HIV surveillance report, the San Francisco Department of Public Health documented continued progress toward ending the city’s HIV epidemic. New HIV infections declined 16% in 2016 alone, and have fallen 49% over a four-year period. The latest data indicate that an estimated 93% of people living with HIV in San Francisco have been diagnosed – a rate well above the national average. Among persons newly diagnosed, 78% were linked to care within one month after diagnosis, 64% remained in care, and 77% achieved viral suppression within a year after diagnosis. Despite the overall gains achieved in San Francisco, new HIV diagnoses remained comparatively high and treatment outcomes were poorer among the city’s homeless population. In 2016, 13% of all new HIV diagnoses were among homeless persons, and viral suppression rates in this group were very low – just 31% within a year after diagnosis.
Cancer and HIV
 
MGH Study Projects Very High Lung Cancer Death Rates Among HIV+ Smokers
HIV+ smokers who are successfully treated for HIV but continue smoking are much more likely to die from lung cancer than from HIV itself, according to a recent study led by researchers from the Massachusetts General Hospital (MGH). The researchers used a simulation model to estimate lung cancer death rates for HIV+ smokers who enter HIV care at age 40 and continue smoking. The model indicated that, by age 80, the cumulative lung cancer mortality among these HIV+ smokers would be about 23% for men and 21% for women. This means that they would be approximately 6 to 13 times more likely to die from lung cancer than from traditional AIDS-related causes. Fortunately, stopping smoking can dramatically reduce lung cancer mortality. The model projects that HIV+ smokers who quit would reduce their cumulative lung cancer death mortality to just 6% for men and 5% for women.
 
Sexually Transmitted Diseases
 
U.S. STD Levels Reach Record Highs in 2016
New cases of sexually transmitted diseases (STDs) increased to record levels in 2016, according to CDC’s 2016 Sexually Transmitted Diseases Surveillance report published in late September. Some key statistics for 2016 are summarized below:
·        Chlamydia: 1.59 million cases, up 4.7% from 2015
·        Gonorrhea: 468,514 cases, up 18.5% from 2015
·        Syphilis: 27,814 cases, up 17.6% from 2015
Responding to the report, the National Coalition of STD Directors called on the Trump Administration and the U.S. Congress “to support a $40 million increase to STD funding to provide a much-needed jump-start for state and local health departments and clinics to fight the rise in STDs.” To help increase awareness of STDs both nationally and in individual states, CDC has produced new STD infographics: one ready-to-use graphic focusing on STDs nationally, and another editable graphic that users can customize with statistics for their particular state.
Care Guidelines
 
HIV Medicine Association Issues First Guideline for Treating Chronic Pain in People with HIV
Noting that “Pain has always been an important part of HIV disease and its experience for patients,” an expert medical panel has developed the first clinical practice guideline for the treatment of chronic pain in persons living with HIV. The expert panel reviews the types of chronic pain commonly seen with HIV infection, the available treatments, and the management of chronic pain in special populations, including persons with substance use and mental health disorders. To help clinicians treat chronic pain most effectively, the guideline also includes information on possible drug interactions between analgesics and antiretroviral medications. The guideline was published in Clinical Infectious Diseases, under the auspices of the HIV Medicine Association of the Infectious Diseases Society of America (IDSA), which has produced a news release summarizing important features of the guideline.
 
Conference News
 
Blog.HIV.gov Posts Highlights from 2017 U.S. Conference on AIDS
On September 7 through 10, policy-makers, researchers, and community activists gathered at the 21st U.S. Conference on AIDS (USCA) in Washington, D.C.  Participants discussed a wide range of topics from HIV research, policy, the continuum of care, hepatitis C coinfection, and stigma, to using social media to extend the reach of HIV services. The federal HIV.gov website has provided extensive coverage of the USCA, including several online blog posts and a series of livestream videos covering selected conference highlights. For links to these USCA resources, see HIV.gov’s September 21 blog post.
New Resources from AETC
 
Now Available: Curricula on HIV and HIV/Hep C Coinfection
The AIDS Education and Training Center (AETC) network and its partners have developed two new national curricula that are now available online.  The National HIV Curriculum is a free educational web site from the AIDs Education & Training Center’s National Coordinating Resource Center and the University of Washington. According to AETC, the HIV curriculum “is designed to inform and update healthcare professionals about national guideline recommendations for quality HIV infection prevention, diagnosis, and treatment.” The HIV Curriculum currently includes four modules: screening and diagnosis, basic HIV primary care, antiretroviral therapy, and prevention of HIV. Two other modules – co-occurring conditions and special populations – are expected to be released soon. Each module includes:
·        an overview/quick reference section;
·        an interactive question bank with board-review style questions (with CE credit);
·        a self-study section, which allows users to track their progress and receive CE credit; and
·        a clinical challenges section, which includes expert opinions for challenging and controversial cases.
 
The goal of the AETC HIV/HCV Co-infection Curriculum is to provide free, evidence-based training for healthcare providers and trainers of healthcare providers to increase their knowledge on HIV/HCV co-infection among people of color in the U.S. and its territories. Topics covered include: epidemiology; prevention; screening, testing, and diagnosis; HCV treatment; recommendations for subpopulations of HIV/HCV co-infected persons; and addressing barriers and other co-factors that may adversely affect treatment outcomes among co-infected persons of color. 
 
Recent Papers on HIV Prevention from NEAETC Rhode Island Regional Partners
Nunn AS, Brinkley-Rubinstein L, Oldenburg CE, Mayer KH, Mimiaga M, Patel R, Chan PA: Defining the HIV Pre-Exposure Prophylaxis Care ContinuumAIDS. 2017 Mar;31(5):731-734.
Chan PA, Flanigan TP: Effective HIV Prevention Interventions and the Need for Rapid Mobilization to Address HIV Outbreaks Among At-Risk PopulationsJournal of Infectious Diseases. 2017 May;2015(10):1491-1492.
Other Services and Resources
 
Free, Confidential Hep C Consultation Service from UCSF
The University of California-San Francisco’s Clinician Consultation Center (CCC) recently expanded its free clinician-to-clinician consultative services to include the management of hepatitis C virus (HCV) infection. Consultations may include the following HCV management issues:
·        HCV staging and monitoring
·        regimen selection and dosing
·        drug interactions
·        HIV/HCV management strategies
·        prior HCV treatment failure, including management of complex clinical problems such as cirrhosis and renal disease
·        HCV transmission and prevention
·        HCV screening and diagnostic testing
·        HCV in special populations (pregnancy, co-occurring substance use and/or alcohol use disorders, psychiatric disorders, post-transplant, ESRD/dialysis, pediatrics)
For a consultation, clinicians may call the following phone number – (844) HEP‐INFO or (844) 437-4636 – on Mondays through Fridays from 9 a.m. through 8 p.m. EST. Alternatively, clinicians may submit case consultation information online by visiting CCC’s hepatitis C management page.
 
Updated AIDSinfo Consumer Fact Sheets
The AIDSinfo site has recently updated its consumer fact sheets that provide an overview to HIV, including the basics of HIV transmission, testing, and treatment, as well as clinical trials and vaccines. The updated fact sheets are listed below:
·        HIV/AIDS: The Basics
·        The HIV Life Cycle
·        The Stages of HIV Infection
·        HIV Testing
·        FDA-Approved HIV Medicines
·        HIV/AIDS Clinical Trials
Spanish-language versions of the HIV fact sheets are available from the infoSIDA site.
Multiple-Language HIV Materials Available Through AIDSource
If you’re looking for educational materials in multiple languages on a range of HIV-related topics, check out the Multiple Languages Search on the National Library of Medicine’s AIDSource site. You can use the search box to find resources on specific topics – such as treatment, transmission, prevention, or substance use – or leave the box blank and click on “search” to see a listing of the more than 100 resources available in multiple languages. Materials available through the site include brochures, audio recordings, and videos.

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