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

NASTAD Partners With National Organizations to Encourage Gay Youth to “Speak Out” About HIV

By Carlos De Leon, Senior Associate, Health Equity and Prevention, NASTAD

Speak Out LogoEvery person carries with them a unique story that, in some manner, affects the person that they are and they embody. It is uncommon to be given a platform and adequate time to openly and honestly talk about these experiences in depth while feeling safe and comfortable in exposing our raw selves. This is especially true for sexual minorities, same gender loving men and other men who have sex with men (MSM), especially men of color within this group. Gay men/MSM continue to be the most severely affected community by HIV and Black and Latino gay men/MSM are disproportionately affected. Young gay men/MSM, aged 13 – 24, from 2008 – 2011 accounted for the greatest percentage increase (26%) in diagnosed HIV infections. In the aforementioned youth group, Blacks and Hispanic/Latinos constituted 58% and 20%, respectively, of all young gay men/MSM in 2011 infected with HIV. Black young gay men/MSM aged 13 – 24 experienced the largest increase in diagnosed HIV infections among all racial/ethnic groups. The over representation of Black and Latino gay men/MSM newly infected or living with HIV is due to numerous issues including access to health care and institutionalized stigma. Moreover, many gay men/MSM encounter unique challenges in expressing their sexuality openly and comfortably. 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

Improving Health Equity for Gay Men through the Affordable Care Act

By Amy Killelea, Senior Manager, Health Care Access, NASTAD

Health Equity for Gay Men/MSM

HIV/AIDS disproportionately impacts gay men and other men who have sex with men (MSM), particularly gay men/MSM of color, in the form of higher infection rates, less likelihood of timely linkage to care, and less likelihood of viral suppression. To make headway against the epidemic and to meet the goals of the National HIV/AIDS Strategy (NHAS), we need tools and strategies that are aimed at improving prevention, access to care, and retention in care for gay men/MSM.

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