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Study: Chronic diarrhea among top HIV/AIDS symptoms

Pharmaceutical company developed a drug to treat issue



Josh Robbins is an HIV/AIDS advocate from Nashville, Tenn., who is using Mytesi, a medication that prevents chronic diarrhea in people with the virus. He spoke with the Washington Blade on Sept. 7, 2017, at the U.S. Conference on AIDS in D.C. (Washington Blade photo by Michael K. Lavers)

A study that a pharmaceutical company released earlier this month indicates chronic diarrhea is among the top symptoms from which people with HIV/AIDS suffer.

Napo Pharmaceuticals, which is a subsidiary of Jaguar Health, on Sept. 12 released the results of a survey of 271 board certified gastroenterologists in the U.S.

Ninety-three percent of the gastroenterologists who responded to the survey said they have people with HIV in their practice. The survey also found 84 percent of their patients said diarrhea ranks among their “top three complaints,” while 53 percent described diarrhea “is the number one complaint in HIV/AIDS patients.”

The survey found 65 percent of the respondents’ patients with diarrhea said the condition is “chronic.”

“While it’s typically not the main reason patients come to see me, frequently my patients with HIV inform me that they suffer from chronic diarrhea,” said Dr. Maurizio Bonacini, associate professor of clinical medicine at the University of California, San Francisco, in a press release that Napo Pharmaceuticals released.

Bonacini noted diarrhea “appears to be more common in patients who have been HIV-positive for several years” and is “most likely due to” the virus’ impact on the lining of the intestine.

“Diarrhea is a significant problem in many HIV patients, and unfortunately, they think there is nothing they can do and that they just have to live with it,” he said.

HIV/AIDS advocate: Anti-diarrhea medication ‘made me feel normal’

Diarrhea is among the serious side effects that antiretroviral drugs cause in people with HIV who are on them.

Napo last October launched Mytesi, a drug that seeks to provide long-term diarrhea relief in people with the virus. It is the only antidiarrheal drug for people with HIV in the U.S. and has been approved by the Food and Drug Administration.

Jaguar Health President Lisa Conte in a press release notes the Centers for Disease Control and Prevention estimates more than 70 percent of Americans with HIV will be at least 50 by 2020. She also said chronic diarrhea “remains a significant, under-reported complaint of HIV/AIDS patients, and it is a problem that will increase significantly as the HIV+ population gets older.”

Josh Robbins — an HIV/AIDS advocate and educator from Nashville, Tenn. — is taking Mytesi to prevent chronic diarrhea. He told the Washington Blade on Sept. 7 during an interview at the U.S. Conference on AIDS at the Marriot Marquis Hotel in downtown Washington that he “didn’t know it was an issue” when he received his HIV diagnosis in 2012.

“I knew that it was an issue for me, but I didn’t know it was an issue (for people with HIV),” said Robbins. “I just thought this is something that I have to live with.”

Robbins told the Blade that one of his doctors told him the same thing. He said another doctor told him “diarrhea’s not an issue” when he told him that he had begun working with Napo Pharmaceuticals to promote Mytesi.

“I’m like ok . . . you’re not in the bathroom with me,” said Robbins. “I said ok, well I really want to try this drug so I’m either going to get it from you or order it from India or something.”

Robbins told the Blade that he once had to reschedule a doctor’s appointment because diarrhea forced him to use the bathroom.

“They made me reschedule my appointment because I wasn’t there,” he said. “I was literally in the bathroom shitting.”

His doctor prescribed him Mytesi after a test determined he did not have infectious diarrhea. Robbins told the Blade he “really didn’t see a difference” in the first couple of weeks.

“Then it was just like a light switch,” he said. “It started going away. It wasn’t this remarkable moment. It just made me feel normal.”



Gilead awards $5 million grant to HRC’s HIV and health equity programs

Money to support efforts to end the epidemic and combat stigma



Human Rights Campaign headquarters in D.C.(Washington Blade photo by Michael Key)

The Human Rights Campaign was awarded a $5 million grant from drugmaker Gilead Sciences to expand the organization’s HIV and health equity programs, supporting efforts to end the HIV epidemic by 2030 while combatting stigma in Black and Latino communities.

Funds will be used over the next three years for the HRC Foundation’s HIV and Health Equity Program, its Historically Black Colleges and Universities Program, and its Transgender Justice Initiative, HRC said in a statement Wednesday announcing receipt of the award, which extends Gilead’s $3.2 million grant to the HRC Foundation in 2021.

The organization said its HIV and Health Equity Program plans to develop a “benchmarking tool for institutions that provide HIV services, helping better evaluate the quality of care and measure racially and socially inclusive approaches” while defining “best practices, policies and procedures to optimize HIV service provision for BIPOC LGBTQ+ communities.”

HRC President Kelley Robinson said, “Since the beginning of the HIV epidemic, racism and anti-LGBTQ+ discrimination have created dangerous hurdles for those seeking prevention or treatment.”

“With the generous support of Gilead Sciences, we’ll be able to continue providing critical
resources to help overcome these hurdles, especially focusing on Black and Latine communities in the U.S. South,” Robinson added. “We’ll also be able to expand our efforts, as we seek to remove institutional barriers often unknowingly created by HIV service providers. We must decrease the disparities that place an unnecessary burden on Black and Latine LGBTQ+ people and people living with HIV.”

Gilead Executive Vice President of Corporate Affairs and General Counsel Deborah Telman said the company “is committed to advancing health equity, particularly in Black communities and other communities of color that are disproportionately affected by HIV.”

“This grant will build on the impactful work HRC has done with community partners and HBCUs to increase awareness of HIV treatment and prevention options and reduce health disparities, combat discrimination and fight stigma,” Telman said.

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New CDC data shows HIV infections dropped, but mostly among whites

Socioeconomic factor into disproportionate rates



Data published Tuesday by the Centers for Disease Control and Prevention shows a significant decline in new HIV infections, but suggests the impact of prevention efforts was far less substantial for Black and Latino populations.

From 2017-2021, as rates of HIV testing, treatment and the use of pre-exposure prophylaxis (PrEP) medication rose, new cases dropped by 12 percent overall and by as much as 34 percent among gay and bisexual males aged 13-24.

The numbers show a “move in the right direction,” CDC Director Rochelle Walensky said in a press release.

However, when broken down by race, the CDC found new infections were down by 27 percent and 36 percent, respectively, among Black and Latino populations, compared with 45 percent of whites.

Similarly, by 2021 about one third of those who are considered eligible were taking PrEP for HIV prevention, but the CDC noted this number includes “relatively few Black people or Hispanic/Latino people” despite the significant increase in prescriptions up from just 13 percent in 2017.

“Longstanding factors, such as systemic inequities, social and economic marginalization and residential segregation,” Walensky noted, continue to act as barriers “between highly effective HIV treatment and prevention and people who could benefit from them.”

She added, “Efforts must be accelerated and strengthened for progress to reach all groups faster and equitably.”

Robyn Neblett Fanfair, acting director of the CDC’s Division of HIV Prevention, said that “At least three people in the U.S. get HIV every hour — at a time when we have more effective prevention and treatment options than ever before.”

“These tools must reach deep into communities and be delivered faster to expand progress from some groups to all groups,” she said.

The HIV+Hepatitis Policy Institute issued a press release following the CDC’s announcement of the new data, noting both the encouraging progress and need for improvement.

“It appears that our investments in HIV prevention are providing some positive results, but the persistent high number of new diagnoses and the low usage of PrEP among the communities most impacted by HIV point to the need for increased resources, particularly for a national PrEP program,” said the group’s executive director, Carl Schmid.

President Joe Biden’s FY24 budget requested $237 million for a national PrEP program along with $850 million to support the U.S. Department of Health and Human Services’ “Ending the HIV Epidemic in the U.S.” initiative.

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Officials eye mpox prevention, vaccination initiatives for this summer’s LGBTQ events

New cluster of cases reported in Chicago



Drs. Robert Fenton and Demetre Daskalakis, coordinator and deputy coordinator for the White House national mpox response, during a briefing in August 2022 (Official White House Photo by Cameron Smith)

Federal health agencies, in coordination with their state and local counterparts and community partners, are exploring opportunities to offer mpox prevention initiatives and vaccinations at LGBTQ events this summer, Dr. Demetre Daskalakis said on Thursday.

Daskalakis, the deputy coordinator for the White House’s national mpox response, described these deliberations in response to a question from the Washington Blade during a media telebriefing on mpox that was hosted by the Centers for Disease Control and Prevention.

The CDC on Monday issued a Health Alert Network Health Update on the potential risk for new mpox cases.

Since the peak of about 460 cases per day in August 2022, new cases have steadily declined, but following the cluster recently reported in the Chicago area, the update warns, “spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events.”

“We have the vaccine, and we have organizations that are willing to do it,” Daskalakis said during Thursday’s call, adding that resources are available and can be deployed flexibly because they are built into existing “HIV and STI funding to allow for this work.”

And the Mpox Crisis Response Cooperative Agreement, Daskalakis said, “provides even more resources locally for such efforts.”

Daskalakis and CDC Mpox Response Incident Manager Dr. Christopher R. Braden also briefed reporters on findings from new studies on the efficacy of the JYNNEOS vaccine for the prevention of mpox.

That data, per the CDC’s Morbidity and Mortality Weekly Report, reveals that “Among gay, bisexual, and other MSM and transgender adults aged 18-49 years, two doses of the JYNNEOS vaccine were 86 percent effective against mpox, indicating substantial protection against mpox.”

Additionally, “All routes of vaccine administration provided similar protection.”

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