New STD Rates “Shockingly High”

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Today, the Centers for Disease Control and Prevention (CDC) released its 2010 sexually transmitted disease (STD) surveillance data. This annual report of statistics and trends for the three reportable sexually transmitted diseases in the United States shows that STDs rates in this country are still shockingly high, particularly in communities of color and among gay men and other men who have sex with men (MSM).

“This new data shows a persistence of the same trends that we have been seeing for years—that MSM and communities of color are continuing to bear a disproportionate share of the STDs in this country,” said William Smith, Executive Director of the National Coalition of STD Directors. “We should also not lose sight of a number of new additional studies this past year on the link between STDs and acquiring HIV. The 2010 STD data released today shows that we need to look closely at further investments in STD prevention as a means to prevent HIV as well,” continued Smith.

While the 2010 data shows that overall rates for syphilis went down compared to 2009, the first decrease in in ten years, rates among Hispanics went up just over nine percent in the last year and MSM still account for two-thirds of the syphilis in this country. In addition, black men continue to have the highest rates of syphilis in the U.S., with young (20-24) black MSM seeing an increase of syphilis of a shocking 135 percent between 2006 and 2010. Co-infection of those with syphilis and HIV also continues; between 25-54 percent of those with primary or secondary syphilis were also HIV positive.

“The good news is that there was a drop of 8.5 percent in the rate of black men diagnosed with either primary or secondary syphilis in 2010 compared to the year prior,” said Smith. “While too early to definitely assess the cause for this drop, there has been a distinct appeal for several years now to help address the explosion of syphilis among black men, particularly among young black MSM, and we must keep up efforts to prevent increasing rates of STDs and HIV among this group,” concluded Smith.

Rates for Chlamydia continued to increase over the last year, as they have for twenty years. This is in part due to increased testing which is increasingly identifying positive cases, of which there were more than 1.3 million reported in 2010. Black women continue to have the highest rates for Chlamydia, as well as gonorrhea. While there was only a small increase in the overall rates of gonorrhea, the rates of gonorrhea in Hispanics went up 12 percent compared to 2009.

Across all three diseases, communities of color and young people overall continue to be most affected, though even for all ages of whites, increases were seen for all three diseases in 2010. Among whites in 2010, rates of chlamydia increased by 7.5 percent, 9.2 percent for gonorrhea, and 3.6 percent for syphilis in 2010 compared to 2009.

Smith concluded, “We hope the unacceptably high rates of STDs in this country continue to be clarion call for securing the sexual health of all people. This means that state and federal investments in STD prevention remain a critical need in these times of tight budgets and that as healthcare reform continues to move ahead, that partners in every sector ensure that the safety net for these services continues to exist.”

The full 2010 STD surveillance data can be found on the CDC website at: http://www.cdc.gov/std/stats10/default.htm.

Study: Incarceration Increases Risk Of STI’s, HIV Infection

Nov12 by D Gregory Smith

Something nobody ever seems to want to talk about: sex, prison and STD’s.

The study’s objective was to assess the link between incarceration and sexually transmitted infection, including HIV, from a social network perspective.

Data collected from a social network study in Brooklyn (n=343) were measured for associations between incarceration and infection with herpes simplex virus-2, chlamydia, gonorrhea and syphilis or HIV and sex with an infected partner, adjusting for characteristics of respondents and their sex partners.

“Infection with an STI or HIV was associated with incarceration of less than one year (adjusted prevalence ratio=1.33; 95 percent confidence interval=1.01, 1.76) and one year or longer (adjusted PR=1.37; 95 percent CI=1.08, 1.74). Sex in the past three months with an infected partner was associated with sex in the past three months with one partner (adjusted PR=1.42; 95 percent CI=1.12, 1.79) and with two or more partners (adjusted PR=1.85; 95 percent CI=1.43, 2.38) who had ever been incarcerated,” the results found.

There is a need for STI and HIV treatment and prevention for current and former prisoners, concluded the authors. The results provide preliminary evidence to indicate that incarceration may influence HIV and other STIs, “possibly because incarceration increases the risk of sex with infected partners.”

I love it when science follows common sense. Well, at least informed common sense…

Abstract here.

Secretary Clinton On HIV: “Embrace Treatment As Prevention”

Nov8 by D Gregory Smith

Secretary of State Hillary Clinton today called for a new approach to ending HIV– treatment as prevention.

Clinton said the answer was clear.

“If we take a comprehensive view of our approach to the pandemic, treatment doesn’t take away from prevention. It adds to it,” she said. “So let’s end the old debate over treatment versus prevention and embrace treatment as prevention.”

You said it sister.

This administration has made HIV treatment and prevention a priority- in a way no other administration ever had the courage or the moral fiber to do. Just another reason not to go back to the Draconian Health Nightmare that was the Bush Administration by electing another Republican administration….

Full text and video here

Hope for MT? : Commonwealth Countries Asked To Decriminalize Gays

Oct19 by D Gregory Smith

Leaders of Commonwealth countries will be asked to decriminalise homosexuality to help to stop the spread of HIV, an Australian official has said.

Forty-one of the 53 Commonwealth countries – including Uganda, Zimbabwe and Ghana – still criminalise gay sex and HIV campaigners say such laws are seriously hampering safe sex initiatives.

The 2011 Commonwealth Heads of Government Meeting (CHOGM) will be held in Perth, Australia from 28-30 October.

CHOGM 2011 will bring together more than 50 world leaders representing approximately one-quarter of the world’s countries and one-third of the world’s population. The meetings originated with the of the leaders of the self-governing colonies of the British Empire in 1887- and still has great influence in setting human rights policy throughout the world.

Sodomy laws in the US were invalidated by The U.S. Supreme Court in the ruling of Lawrence vs. Texas in 2003. However, several states- including Montana- still keep these shameful and impotent laws on the books- despite reasonable efforts to remove them– presumably as a slap in the face to the “Uppity Gays”. And yes, I will mention (Again!) that the Official Montana Republican Platform still calls for the criminalization of homosexual acts.

Will this meeting in Australia have an effect in Montana?

Probably not- at least not directly. I suspect this will not be seen as a discussion of human rights, but as a discussion of disease and epidemics- at least at first. And if the last legislative session is any indication, the zenophobes in charge of Montana’s legislative agenda will see it as unimportant (and non-applicable) world politics that don’t apply here.

But any progress is good progress- and this is progress- this discussion has never happened at this world level before- and it eventually filters through. Even to Montana.

I just hope I live to see it.

CDC: More Teenage Boys Using Condoms

Oct15 by D Gregory Smith

Birth control- it’s not just for girls anymore.
A study by the CDC indicates boys are taking a more proactive role in accountability when it comes to sex. Excerpt:

More teenagers are using a condom — by itself or along with a partner’s hormonal contraceptive — according to a new teen sex survey from the CDC.

The survey shows sexual activity and contraceptive use among U.S. teenagers have remained relatively stable over the last decade. But condoms gained among teenage boys as the preferred method.

Also, the teen birth rate has resumed a gradual decline that was briefly interrupted in 2005-2007.

“The slight increase from 2005 to 2007 generated concern that progress over the past two decades in reducing teen pregnancies could have stalled,” researcher Gladys Martinez, PhD, of the CDC’s division of vital statistics, and colleagues write in their report. “However, data for 2008 and 2009 show that the teen birth rate again declined from the rate in 2007.”

The study showed the teen birth rate for girls aged 15-19 was 39.1 births per 1,000 females in 2009. That’s 37% lower than its peak of 61.8 per 1,000 in 1991. Researchers say that is a historic low for the U.S., but still higher than many other developed countries, including Canada.

And that means that STD/HIV rates will be affected- for the better.

On a side note, I believe the surge in birth rates to be the direct result of Bush era abstinence-only education- something Denny Rehberg wants to bring back.

Sigh.

But a surge in personal responsibility on the part of people with penises? Applause.

Breakdown Of The House HHS Appropriations Bill

Oct10 by D Gregory Smith

Yep, it’s awful. They are funding $4 billion less than last year. $4 Billion.

From NASTAD:

The Republican majority of the House Appropriations Committee released their draft version of the FY2012 Labor-HHS-Education Appropriations bill with a budget that was $4 billion less than FY2011. There is no markup scheduled for this bill, thus members of the Subcommittee will not be able to weigh-in on the proposed bill. The funding levels contained in this bill will serve as the House marker when in conference negotiations on final spending levels with the Senate. As this is a draft bill, there is no report language, so some details on funding levels are not known. NASTAD has included an updated chart. (link is below)

The bill includes many policy riders, targeting funding for syringe exchange programs, the Affordable Care Act, and Planned Parenthood. The bill bans the use of federal funding for syringe exchange programs. The bill also includes language that prohibits funding for the implementation of the Affordable Care Act, including the elimination of the Prevention and Public Health Fund. In addition, Planned Parenthood and its affiliates can only receive funding after certifying that the organization will not perform abortions with non-federal funds.

Both the House and the Senate have voted on a continuing resolution that will fund government programs through November 18.

Some of the House draft bill highlights include:

Department of Health and Human Services:

Health Resources and Services Administration

Ryan White Program

The House bill flat funds all parts of the Ryan White Program, including ADAP. The Senate bill includes a $15 million increase to ADAP bringing the total to $900 million and it flat funds all other parts of the Ryan White Program.

Family Planning

The Title X Family Planning program was eliminated in the House bill. The program was flat funded at $299.4 million in the Senate version of the bill.

Community Health Centers

Community Health Centers received a decrease of $4.7 million from FY2011 in the House version of the bill. The Senate bill increased funding for Community Health Centers by $200 million from FY2011.

Centers for Disease Control and Prevention:

Center for HIV/AIDS, Viral Hepatitis, STD, and TB

In the House bill, funding for the Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention was reduced by $32.7 million. There is not detail about how these cuts will be divided among the Divisions or if DASH will be included in the Center.

The Senate bill level funds CDC’s HIV/AIDS and STD prevention programs, including HIV prevention by health departments, HIV surveillance, the Enhanced HIV Testing Initiative and Improving HIV Program Effectiveness Program. DASH was flat funded as well. The Division of Viral Hepatitis received an increase of $10 million for testing.

Needle Exchange

The House version of the bill bans the use of federal funds for syringe exchange programs, whereas the Senate version of the bill maintains current law on the use of federal funding for syringe exchange.

Immunization

The House bill does not provide detail about funding of the Section 317 Immunization Program. The program received a $50 million increase from FY2011 in the Senate bill.

Prevention Block Grant

The Preventative Health and Health Services Block Grant was funded at $100 million, a $19.1 million increase from FY2011 in the House version of the bill. The program was eliminated in the Senate version of the bill and the President’s budget proposal.

Prevention and Public Health Fund

In the House version of the bill, all funding for the Prevention and Public Health Fund was eliminated. In the Senate version of the bill, the Prevention and Public Health Fund received an increase of $135 million.

Agency for Children and Families

Teen Pregnancy Prevention Initiative

The House bill reduced funding for the Teen Pregnancy Prevention Initiative by $84.7 million to $20 million. In addition to this reduction, the House bill provides $20 million for the Community-Based Abstinence Education (CBAE) grant program, which was previously not funded and the bill removes language requiring the Teen Pregnancy Prevention Initiative programs to be evidence based.

The Senate bill level funds the Teen Pregnancy Prevention Initiative, maintains language requiring programs to be evidence based, and does not provide any funding for the CBAE program.

Substance Abuse and Mental Health Services Administration

The House bill’s funding of SAMHSA is still being determined. In the Senate bill, SAMHSA Primary and Behavioral Health Care Integration was level funded at $63 million. The Senate Committee also encouraged SAMHSA to develop a demonstration project on hepatitis education and testing for patients and providers.

National Institutes of Health

NIH received an increase of $1 billion in the House bill, bringing their total funding to $31.7 billion. The House bill also eliminates the transfer of $297 million from the NIH to the Global HIV/AIDS Fund. The Senate decreased NIH by $190 million from FY2011 levels and requested a transfer of $299 million to the Global HIV/AIDS Fund.

Department of Housing and Urban Development:

Housing Opportunities for Persons With AIDS

The House Transportation, Housing and Urban Development Appropriations bill flat funds the HOPWA program, while the Senate bill reduces the HOPWA program by $4.3 million, for a total of $330 million.

State Department:

Global HIV/AIDS

The House State-Foreign Operations Appropriations bill provided $7.1 billion for global health programs, but does not specify a funding amount for the Global Fund to Fight HIV, TB and Malaria. The House Labor-HHS-Education Appropriations bill eliminated the $300 million transfer from NIH to the Global HIV/AIDS Fund.

The Senate State-Foreign Operations Appropriations bill provided $5.6 billion for global HIV/AIDS programs. The Global Fund to Fight HIV, TB and Malaria was flat funded at $750 million (and $299 million in the Senate Labor HHS bill) and Bilateral HIV/AIDS received $50 million less than FY2011.

FY2012 Appropriations Chart 10-6-11

Rehberg’s Ridiculous Healthcare Bill: Resurrecting Non-Science-Based Prevention Policies

Oct3 by D Gregory Smith

Rehberg’s apparently not swayed by the people in his state affected by HIV. Nor is he swayed by science.

From The AIDS Institute:

“If ever passed, this spending bill would set back the progress we are making in preventing HIV and providing basic care and treatment for those who have HIV/AIDS in our country,” commented Carl Schmid, Deputy Executive Director of The AIDS Institute.

House Labor, HHS, Education and Related Agencies Appropriations Subcommittee Chairman Denny Rehberg (R-MT) introduced a fiscal year 2012 spending bill that guts many programs, including health reform, and resurrects non-science based prevention policies.

Most disappointing is how the bill would impede prevention. Rehberg’s bill would cut by nearly $33 million funding for the Centers for Disease Control and Prevention’s (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. This is despite an estimated 50,000 new HIV infections each year and over 230,000 people unaware of their infection. The U.S. government invests only about 3 percent of its HIV funding in prevention. The lifetime cost of caring and treating one person with HIV is approximately $360,000. In order to help achieve the goals of the National HIV/AIDS Strategy to reduce the number of new infections and increase testing levels by 2015, the President has proposed an increase of $57 million for HIV prevention in FY12.

On top of cutting CDC’s budget, the bill would ban federal funding of syringe exchange programs, a scientifically proven method to prevent HIV and other infections while not increasing drug use, and would resurrect failed abstinence only until marriage programs. Additionally, the bill would decimate the Teen Pregnancy Prevention Program by cutting its budget from $105 million to $20 million, eliminate all Title X spending, which funds HIV testing programs for women, and the entire Prevention and Public Health Fund.

The House bill proposes to flat fund the entire Ryan White HIV/AIDS Program, which provides care and treatment to over 550,000 low-income people with HIV/AIDS. It fails to address the crisis in the Ryan White AIDS Drug Assistance Program (ADAP). There are currently over 8,500 people in nine states on ADAP waiting lists and over 445 people in six states who have been disenrolled from the program due to budget constraints and growing enrollment. The AIDS Institute and its partners have been advocating for an increase of at least $106 million. The President has requested a $55 million increase. In order to address the current wait list, an increase of approximately $98 million would be required.

Chairman Rehberg’s bill also prevents implementation of much of the Affordable Care Act, which once fully implemented, would both bring many people with HIV/AIDS into lifesaving care and treatment for the first time and help to prevent HIV.

The one bright spot in the bill is Rehberg’s proposal to increase medical research spending at the National Institutes of Health by $1 billion.

“While we realize we are living in very difficult fiscal times, this bill is not just about making difficult funding decisions, but about resurrecting many controversial policies that will never pass the Congress nor be signed by the President,” commented Michael Ruppal, Executive Director of The AIDS Institute. “As Congress finalizes its FY12 spending bill, The AIDS Institute will work with the House, Senate and the Administration to increase, rather than cut funding for prevention and adequately fund all parts of the Ryan White Program, including ADAP. Additionally, we will work to defeat all extreme policy riders.

The bill (HR 3070) has not been formally considered by the House Appropriations Subcommittee. The Senate Appropriations Committee already has passed its own version of the bill. Since Congress has not passed any spending measures, the government is currently operating under a short term continuing resolution.

This schmuck is completely unwilling to listen to facts- or to believe that HIV is in Montana, and it poses particular problems for his constituents. Maybe it’s time to educate him.

Call his office: (202) 225-3211

Feds’ HIV Budget Rescues ADAP- But At A Price

Sep28 by D Gregory Smith

I’ve written that the Feds’ HIV budget has been released. It’s not all good news.

My Bilerico article here.

Feds to Release 1.89 Billion for ADAP, HIV Care

Sep27 by D Gregory Smith

From The Michigan Messenger:

The federal government Monday announced more than $1.89 billion in funding to states to fight the HIV epidemic with access to care and with more cash for the failing AIDS Drug Assistance Program.

According to an HHS press release, $813 million of that money will go directly to the ADAP programming. An additional $8,386,340 will be issued as a supplement to 36 states and territories currently facing a litany of unmet needs and access issues. The additional money is designed to help those programs reduce or eliminate their waiting lists. They also released an additional $40 million to assist states and territories currently refusing coverage for people in need to reduce the number of people waiting.

ADAP provides access to the costly anti-retroviral medications that have turned HIV into a more manageable disease since its appearance 30 years ago. The drugs can cost tens of thousands of dollars a year in the U.S. The program also assists in paying for drugs to treat opportunistic infections that HIV positive persons can suffer as a result of diminished immune functions.

The ADAP Advocacy Association shows that as of Sept. 22, 10 states had waiting lists totaling nearly 9,000 people awaiting access to the life saving medications:

ADAPs with Waiting Lists
(8,785 individuals in 10 states*, as of September 22, 2011)

Florida: 4,098 people
Georgia: 1,732 people
Idaho: 37 people
Louisana: 1,112 people
Montana: 28 people
North Carolina: 354 people
Ohio: 9 people
South Carolina: 367 people
Utah: 59 people
Virginia: 989 people

In addition to funding ADAP programming, the feds also announced millions in funding for direct medical care as well as programming to assist minorities — who are particularly hard hit by the epidemic — in accessing medical care for the infection.

Kudos to all the activists and HIV care advocates who worked hard for this- and for those of you who signed our petition….

ADAP Crisis Makes Local News

Sep9 by D Gregory Smith

An excellent story by Jessica Mayrer of the Missoula Independent highlights the National HIV Drug Crisis- and Montana’s link:

Montanans who can’t afford HIV drugs have recourse. The federally funded AIDS Drug Assistance Program provides medicine at no cost. What worries Smith and his clients is the fact that the program isn’t meeting demand. In January, 4,200 people nationally were waiting for entry into ADAP. At the end of August, that number grew to 9,200. ADAP now provides drugs to 107 of Montana’s 532 known HIV-positive patients, according to the state Department of Public Health and Human Services. In Montana, 28 people now await ADAP assistance. That’s up from 21 last year.

Full story here.

And if you haven’t signed the petition to Denny Rehberg, go here.