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Study: Chronic diarrhea among top HIV/AIDS symptoms

Pharmaceutical company developed a drug to treat issue

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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 ā€œtop three complaints,ā€ while 53 percent described diarrhea ā€œis the number one complaint in HIV/AIDS patients.ā€

The survey found 65 percent of the respondentsā€™ patients with diarrhea said the condition is ā€œchronic.ā€

ā€œWhile itā€™s typically not the main reason patients come to see me, frequently my patients with HIV inform me that they suffer from chronic diarrhea,ā€ 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 ā€œappears to be more common in patients who have been HIV-positive for several yearsā€ and is ā€œmost likely due toā€ the virusā€™ impact on the lining of the intestine.

ā€œDiarrhea 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,ā€ he said.

HIV/AIDS advocate: Anti-diarrhea medication ā€˜made me feel normalā€™

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 ā€œremains a significant, under-reported complaint of HIV/AIDS patients, and it is a problem that will increase significantly as the HIV+ population gets older.ā€

Josh Robbins ā€” an HIV/AIDS advocate and educator from Nashville, Tenn. ā€” 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 ā€œdidnā€™t know it was an issueā€ when he received his HIV diagnosis in 2012.

ā€œI knew that it was an issue for me, but I didnā€™t know it was an issue (for people with HIV),ā€ said Robbins. ā€œI just thought this is something that I have to live with.ā€

Robbins told the Blade that one of his doctors told him the same thing. He said another doctor told him ā€œdiarrheaā€™s not an issueā€ when he told him that he had begun working with Napo Pharmaceuticals to promote Mytesi.

ā€œIā€™m like ok . . . youā€™re not in the bathroom with me,ā€ said Robbins. ā€œI said ok, well I really want to try this drug so Iā€™m either going to get it from you or order it from India or something.ā€

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

ā€œThey made me reschedule my appointment because I wasnā€™t there,ā€ he said. ā€œI was literally in the bathroom shitting.ā€

His doctor prescribed him Mytesi after a test determined he did not have infectious diarrhea. Robbins told the Blade he ā€œreally didnā€™t see a differenceā€ in the first couple of weeks.

ā€œThen it was just like a light switch,ā€ he said. ā€œIt started going away. It wasnā€™t this remarkable moment. It just made me feel normal.ā€

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MISTR announces itā€™s now prescribing DoxyPE

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MISTR, the telemedicine provider that offers free online PrEP and long-term HIV care in all 50 states, D.C., and Puerto Rico, announced it is now prescribing Doxycycline Post-Exposure Prophylaxis (DoxyPEP), an antibiotic that reduces bacterial STIs, including gonorrhea, chlamydia, and syphilis. Patients can now use MISTRā€™s telehealth platform to receive DoxyPEP online for free, according to a release from the company.

With this launch, MISTR plans to offer patients access to post-exposure care, in addition to its existing preventive and long-term HIV treatment options, which include PrEP and antiretroviral therapy (ART). This comes at a time when the rate of STIs continue to rise. In 2022, more than 2.5 million cases of syphilis, gonorrhea, and chlamydia were reported in the U.S; of that population, gay and bisexual men are disproportionately affected, the company reported.

ā€œDespite an ongoing STI epidemic affecting the LGBTQ+ community, there are few resources available for this underserved, vulnerable community to get the preventative medication they need,ā€ said Tristan Schukraft, CEO and founder of MISTR. ā€œIā€™m proud that MISTR is democratizing access to PrEP, HIV care, and now DoxyPEP.ā€

An NIH-funded study published by the New England Journal of Medicine in April 2023 found that doxycycline as post-exposure prophylaxis, now known as DoxyPEP, reduced syphilis by 87%, chlamydia by 88%, and gonorrhea by 55% in individuals taking HIV PrEP, and reduced syphilis by 77%, chlamydia by 74% and gonorrhea by 57% in people living with HIV. 

MISTR is a telemedicine platform offering free online access to pre-exposure prophylaxis (PrEP) and long-term HIV care Visit mistr.com for more information.

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UNAIDS to commemorate Zero Discrimination Dayā€™s 10th anniversary

UN agency urges global action to protect human rights

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A UNAIDS anti-discrimination exhibit at Tocumen International Airport in Panama in 2018. (Washington Blade photo by Michael K. Lavers)

As the world marks the 10th anniversary of Zero Discrimination Day; UNAIDS is sounding the alarm on the increasing threats to human rights, calling for renewed efforts to protect the rights of all individuals as a fundamental step towards ensuring health for everyone.

Established by UNAIDS a decade ago, Zero Discrimination Day aims to promote equality and fairness regardless of gender, age, sexuality, ethnicity or HIV status. The progress achieved over the past years is now in jeopardy, however, due to rising attacks on the rights of women, LGBTQ people and other marginalized communities.

UNAIDS Executive Director Winnie Byanyima emphasized the critical link between protecting human rights and safeguarding public health. 

“The attacks on rights are a threat to freedom and democracy and are harmful to health,ā€ she said in a press release. ā€œStigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyoneā€™s rights that we can protect everyoneā€™s health.”

Despite challenges, there has been notable progress. 

At the onset of the AIDS pandemic more than 40 years ago, two-thirds of countries criminalized consensual same-sex sexual relations. They are now decriminalized in two-thirds of countries. An additional 38 countries around the world have pledged to end HIV-related stigma and discrimination, contributing to positive changes that include 50 million more girls attending school compared to 2015.

To sustain and enhance these advancements; UNAIDS urges global support for womenā€™s rights movements, LGBTQ rights, racial justice, economic justice, climate justice and peace initiatives. By standing with communities advocating for their rights, the U.N. aims to reinforce the collective effort towards a more inclusive and equitable world.

Zero Discrimination Day is observed on March 1.

Events and activities that will take place around the world throughout the month will serve as reminders of the essential lesson and call to action: Protecting everyoneā€™s health is synonymous with protecting everyoneā€™s rights.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals and secure a safer, fairer, kinder and happier world ā€” for everyone,” said Byanyima.

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New CDC report finds transgender women at higher risk for HIV

More than 1,600 people in seven cities surveyed

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The Centers for Disease Control and Prevention in Atlanta (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention issued a new study report this week that revealed that restricted by employment and housing discrimination and lack of access to needed gender-affirming healthcare for transgender women increasing the risk of contracting HIV. 

Researchers reviewed data from a 2019-2020 survey, theĀ National HIV Behavioral Surveillance Among Transgender Women, which found that the demographics of HIV/AIDS have been disproportionally high, especially among Black and Latina trans women, who had experienced employment and housing discrimination coupled with lack of access to gender-affirming healthcare.

The Jan. 25Ā Morbidity and Mortality Weekly Report was based on data studies of more than 1,600 trans women in seven major urban locales. Participants from Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle were chosen by referrals from people and community-based organizations who knew or were part of the local population of trans women.

The studyā€™s researchers noted: ā€œEmployment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.ā€

The study stated that trans womenā€™s inability to access quality healthcare, including gender-affirming treatment or access to PrEP, and can expose them to potential incarceration as many turn to ā€œsurvival sex workā€ and violence, which increases the risk of contracting HIV. 

The studyā€™s authorā€™s pointed out: ā€œWhen economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis ā€¦demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.ā€

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