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Parenting desires unchanged by HIV status

Some gay men on anti-retroviral therapy hope to have children

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have children, gay news, Washington Blade

Some gay men on anti-retroviral therapy hope to have children.

LONDON — Approximately 40 percent of HIV-positive adults starting antiretroviral therapy (ART) in the United States would like to have children in the future, a proportion that remained unchanged after two years of follow-up, investigators report in Open Forum Infectious Diseases. The findings were published in the journal AIDSmap.

There was no significant difference in the proportion of women, men who have sex with women (MSW) and men who have sex with men (MSM) who said they would like to have children. Younger people and black MSM were more likely to want to have children, AIDSmap reports.

The investigators believe their findings show the importance of regular assessment of the reproductive health and conception needs of HIV-positive patients.

“Our data showed that overall, MSM, MSW and W (women) have similar parenting desires,” the authors wrote. “Hence, all of these populations would benefit from preconception counseling, counseling about methods of contraception, and understanding how to prevent transmitting HIV to uninfected partners or to their future children.”

Investigators undertook the study because little is currently known about the parenting desires of people living with HIV. The only studies to examine this were conducted 20 or more years ago and did not include MSM. Because of ART, many HIV-positive patients have an excellent prognosis; moreover HIV is untransmissable by individuals with an undetectable viral load. In the U.S., pregnancy and live birth rates among women with HIV are close to those observed in HIV-negative women, AIDSmap reports.

Participants were recruited between 2009-2011 as part of a study of ART regimens for treatment-naïve individuals. Data were analyzed from adult men (over the age of 18) and adult women of reproductive age (18-45 years).

At baseline and after 96 weeks of therapy, participants were if they would like to have children in the future (yes/unsure/no). Men were stratified according to whether they were MSM or were exclusively straight, AIDSmap reports.

A total of 1,425 patients were recruited. Most (70 percent) were MSM, 13 percent were women and 17 percent were straight men. The median age was 36 years. Thirty-nine percent of patients were black and 36 percent were white. Two-thirds had some post-high school education and half were living on a low income (below $20,000 a year), AIDSmap reports.

At baseline, 86 percent of MSM reported having no children, with only 27 percent of both straight men and women reporting having no children.

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Health

MISTR announces it’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 MISTR’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.

“Despite 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,” said Tristan Schukraft, CEO and founder of MISTR. “I’m proud that MISTR is democratizing access to PrEP, HIV care, and now DoxyPEP.”

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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Health

UNAIDS to commemorate Zero Discrimination Day’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,” she said in a press release. “Stigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyone’s rights that we can protect everyone’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 women’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 everyone’s health is synonymous with protecting everyone’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 — 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, the 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. 25 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 study’s researchers noted: “Employment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.”

The study stated that trans women’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 “survival sex work” and violence, which increases the risk of contracting HIV. 

The study’s author’s pointed out: “When economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis …demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.”

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