No More Silos – PrEP is One Component of Gay Men’s Sexual Health: A Health Department Approach to PrEP

By Barry Callis, Director of Behavioral Health and Infectious Disease Prevention, Office of HIV/AIDS, Bureau of Infectious Disease and Dawn Fukuda, Director, Office of HIV/AIDS, Bureau of Infectious Disease, Massachusetts Department of Public Health

Barry Callis and Dawn Fukuda

Barry Callis and Dawn Fukuda

Many of us in the Office of HIV/AIDS at the Massachusetts Department of Public Health (MDPH) were huddled excitedly around our computer screens when the first reports of success from the iPrEx clinical trial were released. It was December of 2010, and at long last, we had confirmed proof that an antiviral medicine (Truvada) could protect against HIV infection before exposure, and that it worked for gay and bisexual men and transgender women. It was a possibility we had only dreamed of in the early 1990’s, when effective antiretrovirals were first widely available as treatment. Continue reading

“All the Threads of the Tapestry are Equal in Value,” Dr. Maya Angelou

By Dr. Shanell L. McGoy, Director of HIV/STD, Tennessee Department of Health

Shanell McGoy

Dr. Shanell L. McGoy

Dr. Maya Angelou’s pen was silenced earlier this year; yet her bold, brilliant, and beautifully crafted words will live forever.  Her words speak of love – self-love and love for others, resilience, and the richness of diversity.  Dr. Maya Angelou wrote, “We all should know that diversity makes for a rich tapestry, and we must understand that all the threads of the tapestry are equal in value.”  The 1.1 million people living with HIV in the United States are as richly diverse as the tapestry Dr. Angelou describes in her poignant quote.  HIV/AIDS knows no boundaries, no specific race or ethnicity, age, gender, sexual preference, education level, profession, income, or religion.  Though we know that there are well documented HIV-related disparities that exist across a variety of demographics, we can be proud of our collective progress to reduce these disparities. Continue reading

How the National HIV/AIDS Strategy is Influencing Health Department Funding and Programs for Gay Men

By Erin McElderry, Associate, Prevention, NASTAD

NHPI ImageThe National HIV/AIDS Strategy (NHAS), released in 2010, is the nation’s guide towards taking measureable steps to end the HIV epidemic. It proposes a bold vision: “The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.” Within that overarching vision is a call to action to target resources towards communities disproportionately impacted by HIV—in particular gay men and other men who have sex with men (MSM). The NHAS stressed, “the United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men.” Continue reading

How New York is Using Pre-Exposure Prophylaxis (PrEP) to End HIV

By Dan O’Connell, Director, AIDS Institute, New York State Department of Health

The AIDS Institute, New York State Department of Health

The AIDS Institute, New York State Department of Health

In June of this year, New York’s Governor, Andrew M. Cuomo, announced a plan to bring HIV below epidemic levels in New York State by 2020. In this plan, pre-exposure prophylaxis (PrEP) is identified as one of three key strategies for reducing new HIV infections to sub-epidemic levels, and is a great example of how health departments can bring the domestic HIV epidemic to its end within a rapidly changing system of HIV prevention and care services and raising the bars of the HIV care continuum. Continue reading

How Health Departments Are Modernizing HIV Prevention with Pre-Exposure Prophylaxis (PrEP)

By Christopher Cannon, Manager, Health Care Access, NASTAD

PrEPPrior to the approval of Truvada as PrEP, health departments feared there would be a rush of affluent gay men demanding access to Pre-Exposure Prophylaxis (PrEP)-the use of antiretroviral medication to prevent the infection of HIV-to abandon condom use altogether. In so doing, they would create greater health disparities among vulnerable populations like young gay and bisexual men, Black and Latino gay and bisexual men, and transgender women who are often disenfranchised. However interest in PrEP outside of clinical trials across the country has been very limited. Gilead, manufacturer of Truvada, reports only 2,319 prescriptions filled for Truvada as PrEP from January 1, 2012 (prior to FDA approval in July 2012) to September 30, 2013 in the United States, which currently has an estimated 50,000 HIV infections each year. Continue reading