For Men Only- Your Sexual Health

From the National Association of State and Territorial AIDS Directors (NASTAD) and the National Coalition of STD Directors (NCSD) comes a new pamphlet aimed at helping men who have sex with men (MSM) take charge of their sexual heath:

“Whether you are gay, bisexual or any man who has sex with other men (MSM), there are certain health services that are important for you to talk about with your doctor to protect your sexual health. This brief pamphlet is designed to help you get the best sexual health care during your visit to the doctor.”

An amazing array of helpful information about special health concerns and working with your healthcare provider.

View “For Men Only- Your Sexual Health” here.

With Resistance to Treatment Rising, CDC Updates Gonorrhea Treatment Guidelines

From The National Coalition Of STD Directors:

Today, the Centers for Disease Control and Prevention (CDC) released updated guidelines for the treatment of the sexually transmitted disease gonorrhea, which is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility and can facilitate HIV transmission.[i]  CDC estimates there are more than 700,000 gonorrhea infections each year in the United States.  The updated guidelines were published in CDC’s Morbidity and Mortality Weekly Report. 

The change marks an end to CDC exclusively recommending oral antibiotic treatment as the first line of defense for gonorrhea, and now instead recommends that infections be treated with the injectable antibiotic ceftriaxone in combination with one of two other oral antibiotics, either doxycycline or azithromycin.  This change in treatment has significant implications for clinical service delivery and infected patients alike, as the simple act of taking pills is replaced by an administered injection by a certified health professional.

“We applaud the CDC’s preemptive strike of changing recommended treatment and with the intention of extending the life of the last effective drug,” said William Smith, Executive Director of the National Coalition of STD Directors (NCSD). “However, the rising resistance of gonorrhea to our last line of defense against it must be a clarion call to policymakers and private industry alike to invest in the research and development pipeline for new antibiotics and more sophisticated diagnostics…and quickly.  We desperately need additional options to meet the challenges of this infection,” continued Smith.

Last summer, the CDC sounded the alarm on gonorrhea’s rising resistance to antimicrobials. This report outlined that we are on the verge of a highly untreatable gonorrhea epidemic as   gonorrhea has developed resistance to every class of antibiotics put up against it and there is no new drug in the pipeline.  Documented increases in resistance throughout the U.S. are what has prompted the CDC to make the current recommended treatment change.

Full presser here.

Impact of Affordable Care Act On HIV/STD Prevention

Wondering about the Supreme Court’s decision on HIV/STD prevention and care? Some help from The National Coalition Of STD Directors:

Sexually transmitted disease

As you consider the impact of today’s Supreme Court ruling on the Affordable Care Act on different populations, I would like to share with you the impact of today’s ruling on our fight to prevent and treat sexually transmitted diseases.

Sexually transmitted diseases (STDs) remain a major epidemic in the United States.  Each year, there are approximately 19 million new cases of STDs, approximately half of which go undiagnosed and untreated[i], giving the  United States the highest STD rate in the industrialized world.[ii]

STDs cost the U.S. health care system $17 billion every year—and cost individuals even more in immediate and life-long health consequences, including infertility, higher risk of acquiring HIV, and certain cancers.[iii]

  • Young people will continue to have expanded coverage under their parent’s insurance.  Young people bear a disproportionate burden of STDs—those aged 15-25 make up half of the STDs contracted annually, but make up only one-fourth of the sexually active population.
  • Private insurance will continue to have to cover prevention services with no cost out-of pocket costs to patients.  Many of those who visit STD clinics are low-income and would not be able to receive prevention sexual health services without coverage by insurance.  While there is still work to be done for certain at-risk populations, such as men who have sex with men, expanded STD testing and  STI counseling will be covered by insurance under this expansion of preventative care in the law and it is a great start.
  •  The continued need for safety-net service providers is underscored.  With the narrowing of the Medicaid expansion provisions, the very real possibility exists that many low-income individuals will not have access to affordable health care coverage.  Patients at STD clinics are young, minority, and poor—populations that are bear a much higher burden of STD disease—and may be left without coverage in a state that may choose not to expand their Medicaid coverage.

HIV-specifics from Lambda Legal:

“This is a victory for all Americans, but in particular, the Court’s decision today will save the lives of many people living with HIV – as long as states do the right thing. The Affordable Care Act will finally allow people living with HIV to access medical advancements made years ago but that have so far remained out of reach of many. With continuing prevention education, early detection, and quality care for everyone living with HIV, we have the power to stem the HIV/AIDS epidemic.

“But this is not a complete victory, because today’s decision allows states to opt out of the Medicaid expansion that would provide insurance coverage for many low-income people who cannot otherwise afford it. Our continuing challenge will be to make sure that states opt to expand Medicaid so that more low-income people, and particularly those with HIV, can get the health care they urgently need.”

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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.

Joint Statement Regarding HIV Prevalence, Urgency For Gay/Bi Men

NEW HIV INCIDENCE ESTIMATES CONFIRM URGENCY TO ADDRESS CRISIS AMONG GAY MEN OF ALL RACES AND ETHNICITIES

Washington, DC – New HIV surveillance data released today by the Centers for Disease Control and Prevention (CDC) indicates that while the overall number of new HIV infections has remained fairly stable from 2006–2009, there continues to be cause for great concern about increasing numbers of new infections among gay men.

While the new HIV incidence estimates, published in the Public Library of Science Medicine, show that prevention activities in the United States have successfully held the number of new infections steady, the National Alliance of State and Territorial AIDS Directors (NASTAD)i and National Coalition of STD Directors (NCSD)ii, remain alarmed about the continued disproportionate impact of HIV and sexually transmitted disease (STD) infections among gay and bisexual men of all races and ethnicities in this country. New estimates indicate that the top most impacted populations include white gay men, Black gay men and Latino gay men, followed closely by Black women.

“An unacceptable increase of HIV incidence among gay men, particularly young Black gay men ages 13-29, requires an honest and critical examination of our prior efforts and a sharpening of our prevention-focused activities among gay men,” remarked Julie Scofield, NASTAD’s Executive Director. “We need to strengthen our communities by breaking down the silos across program and sector and by investing in targeted and innovative programming that promotes the health equity of gay and bisexual men of all races and ethnicities,” she added.

“Increasing HIV rates, coupled with increasing incidence of syphilis and a frequent neglect of rectal STD infections, underscore that we are not doing enough to prevent all STD infections and reduce their role in HIV acquisition,” said William Smith, NCSD’s Executive Director. “NASTAD and NCSD will continue to work with state and local health departments and other partners to develop and implement effective tools and initiatives to address all STDs among all gay and bisexual men,” he continued.In this peer-reviewed article, the CDC estimates 48,100 new infections occurred in the U.S. in 2009, with gay and bisexual men remaining the population most severely impacted by HIV and the only population in which new HIV infections have been increasing steadily since the 1990s. New infections among gay men of all races and ethnicities continue to increase as a proportion of all new infections, with those among young Black gay men ages 13-29 increasing by 48 percent since 2006. This new HIV surveillance data closely follows data released by CDC last month that showed a growing resistance of gonorrhea to antimicrobials, particularly in men who have sex with men (MSM). Gonorrhea is an STD that can facilitate HIV transmission.

In June 2010, NASTAD and NCSD released a Statement of Urgency expressing concern regarding the HIV and STD crises among gay men and other MSM of all races and ethnicities in the United States. Pursuant to the recommendations made in the National HIV/AIDS Strategy (the Strategy), the joint statement calls for greater investment (financial and human) and leadership to address the epidemic among gay men. Given CDC’s decision to cut $20 million from core HIV prevention funding, our federal partners must continue to work with state and local health departments to ensure that all existing resources are leveraged to improve HIV prevention and care and treatment.

NASTAD and NCSD, with support from MAC AIDS Fund, will soon launch a series of targeted activities within HIV and STD programs that will examine and address stigma in public health practice. These efforts will aim to increase comprehensive and appropriate access to prevention, care and supportive services for young Black and Latino gay men, particularly those at-risk for STD transmission. Additionally, these efforts will target social and sexual networks to promote positive sexual health messages and reduce stigma. NASTAD and NCSD will work with their respective members to establish and promote evidence-based practices and tools to educate state and local health departments, service providers and other key community stakeholders about the sexual health of gay men.
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i- Founded in 1992, NASTAD is a nonprofit national association of state and territorial health department HIV/AIDS program directors who have programmatic responsibility for administering HIV/AIDS and viral hepatitis health care, prevention, education, and supportive services programs funded by state and federal governments. For more information, visit www.NASTAD.org.

ii- The National Coalition of STD Directors (NCSD) is a partnership of public health professionals dedicated to the prevention of STDs. NCSD provides dynamic leadership that strengthens STD Programs by advocating for effective policies, strategies, and sufficient resources and by increasing awareness of their medical and social impact. For more information, visit www.NCSDDC.org.

Gonorrhea: Not So Easy To Kill Anymore

Not anymore. . .

Think if you get the clap, you can just go get a shot or take a pill to be cured?

Not so fast, bucko. There’s now another reason to protect yourself:

Today, the Centers for Disease Control and Prevention (CDC) outlined laboratory trends from 2000-2010 that show growing resistance of gonorrhea to antimicrobials.  Gonorrhea, a sexually transmitted disease (STD), is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility and can facilitate HIV transmission. (Press release, National Coalition of STD Directors)

Yep. Gonorrhea. It used to be a serious disease, before antibiotics made it easy to treat. Now that we’ve been taking antibiotics for everything, resistance is setting in and we’re running out of effective drugs to cure it.

…cephalosporin antibiotics are the last line of defense for treating the disease, as the bacteria has developed resistance to all other antibiotics.  The highest level of resistance to cephalosporins, regardless of sexual partner, was found in the Western region of the United States, particularly Hawaii and California, as well as in men who have sex with men in all regions.

“This new data outlines what state and local health departments have been seeing on the ground—that highly untreatable gonorrhea is near,” stated William Smith, Executive Director of the National Coalition of STD Directors. “There are currently no new drugs in development for this infection.  If this last class of drugs fails we will have no definitive treatment options for gonorrhea.  We call on researchers, government, and partners in industry to make the development of new, effective drug treatments for gonorrhea a public health priority,” continued Smith.

This is a big deal.

It’s important for sexually active persons to be screened for all STD/STI’s at least every six months, or more often if you have many sexual partners and/or have had unprotected sex- and that includes oral- gonorrhea can easily infect the throat. And, remember, any STD/STI increases the risk of contracting/spreading HIV. From the CDC:

Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea is a common cause of pelvic inflammatory disease (PID). About 750,000 women each year in the United States develop PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled “pockets” that are hard to cure) and long-lasting, chronic pelvic pain. PID can damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube.

In men, gonorrhea can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to infertility if left untreated.

Gonorrhea can spread to the blood or joints. This condition can be life threatening. In addition, people with gonorrhea can more easily contract HIV, the virus that causes AIDS. HIV-infected people with gonorrhea can transmit HIV more easily to someone else than if they did not have gonorrhea. (emphasis mine)

We’ve taken the cure for granted for too long. So- be careful out there.

Full article here.