The latest annual report on HIV diagnosis, treatment and testing in the UK should have come out, as they normally do, in advance of World AIDS Day, 1 December last year. It did not, due to the embargo on government publications during the general election campaign. Out on 16 January, the largely positive findings from Public Health England (PHE) provide evidence, via several different indicators, that new HIV infections within the UK are continuing to fall at such a rate that new diagnoses are outstripping them.
“That's it, I'm never having sex with anybody ever again”: what helps people with HIV get over these feelings
For people living with HIV, sexual adjustment after diagnosis is affected by fears of transmitting the virus and of possible rejection by sexual partners, new qualitative research shows. Healthy sexual adjustment over time is facilitated by partner acceptance; peer, community and professional support; and up-to-date knowledge of HIV transmission, including U=U.
Services in the UK’s National Health Service (NHS) are legally obliged to enforce rules on charging migrants and refugees, but clinicians working in HIV, sexual and reproductive health have significant gaps in their knowledge, according to a survey published last month in the Journal of Public Health. Seventy-one per cent said they would like more training on the topic.
A PrEP programme targeting 5% of gay and bisexual men in the Netherlands would not only cause big reductions in HIV incidence, but would lead to even greater reductions in gonorrhoea. In the 'base case' of the model, gonorrhoea would almost be eliminated, with 2027 only having 3% of the infections seen in 2018, the year the model assumes the PrEP programme was started.
Testing proviral DNA for drug resistance can help to select new drug regimens that are better tolerated and easier to take in treatment-experienced people, while preventing a treatment switch leading to viral rebound, University of Arizona researchers report in the journal Open Forum Infectious Diseases.
People with HIV more willing to consider a medication offering a 'cure' for HIV than one providing 'clinical remission'
People with HIV are more likely to consider hypothetical medications that offer a “cure” for the virus than those offering “clinical remission,” according to US research published in AIDS and Behavior. These findings could have implications for recruitment to future HIV 'cure' studies, with potential participants more likely to join medication trials if a potential outcome is eradication of the virus rather than medicine-free remission.
Approximately 30% of new sexually transmitted HIV infections can be attributed to herpes simplex virus-2 (HSV-2), according to research published in The Lancet Infectious Diseases. Africa was the world region with the highest proportion of incident HIV attributable to HSV-2, followed by the Americas. The investigators, led by Dr Katherine Looker of Bristol University Medical School, suggest that interventions to treat and prevent HSV-2 would not only improve the quality of millions of people's lives, but also have a tangible impact on the spread of HIV.
Gonorrhoea testing and treatment in Europe: survey reveals better testing for gay men, but gaps in resistance testing
Aside from HIV, gonorrhoea is the sexually transmitted infection that attracts the keenest attention, with 87 million infections occurring worldwide every year. In Europe cases have more than tripled since 2008, with gay and bisexual men accounting for 25 to 30% of cases, about ten times the rate in heterosexuals.
Although there are now two drug combinations which can be used for HIV prevention as PrEP, there is stronger and broader evidence for the older combination (Truvada), which should remain the first-line choice, four leading US doctors argue in the Annals of Internal Medicine. The authors emphasise the excellent safety profile of both drugs.
Less than half of individuals diagnosed with STIs or other markers of HIV risk accepted an active offer of PrEP, according to Canadian research published in AIDS and Behavior. Offers of a PrEP referral were made by nurses to people diagnosed with rectal STIs, syphilis, sexual contact with an HIV-positive individual and also those who had used a course of HIV post-exposure prophylaxis (PEP). However, only 48% accepted the offer of PrEP. Commonly cited reasons for refusal included lack of perceived HIV risk, lack of interest in PrEP, an inability to manage the treatment and negative perceptions of the safety and tolerability of the medication.