Recently we got great news from a real-world study of HIV pre-exposure prophylaxis (PrEP).
Researchers at San Francisco's Kaiser Permanente Medical Center reported on the real-world experience of 657 people who started PrEP between 2012 and 2015. Over 99% were men who have sex with men, 84% reported multiple sexual partners, and 30% had HIV-positive partners. Together they were observed for over 388 person-years of PrEP use.
We're in the midst of an HIV prevention revolution. Over the past few years, we have gained new tools and knowledge to prevent HIV, from pre-exposure prophylaxis (PrEP) to the knowledge that an undetectable viral load dramatically reduces the risk of transmission.
By now, the fact that HCV treatment carries a high price is a fact as well known to the medical and non-medical public as 1) a million dollars doesn't get you much in Manhattan or Bay-area real estate; 2) a Rolex is an expensive way to know what time it is; and 3) even though a Tesla doesn't need gas, buying one won't save you money.
An email query from a colleague:
Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV+. Any post-exposure prophylaxis recommended?
Title of this post notwithstanding, the weather in Boston this summer has been great -- mostly warm days, cool nights, low humidity -- hence the energetic jumping pooch in the picture (not mine, click on it for full effect). I just love the phrase, "dog days of summer," and wanted an excuse to use it.
Here's a scintillating series of events that happened recently on our inpatient consult service.
Thirty-three million people are infected with HIV worldwide, but less than 50% receive antiretroviral therapy. This was the stark reality addressed in June at the 10th International Conference on HIV Treatment and Prevention Adherence (Adherence 2015), which is jointly provided by the International Association of Providers of AIDS Care (IAPAC) and the Postgraduate Institute for Medicine (PIM). Every aspect of the ubiquitous treatment cascade was addressed in an effort to stop the "leaks" of people not engaging in treatment, falling out of care or not maintaining viral suppression. While access to prevention and treatment has significantly improved worldwide, certain issues such as stigma still impact prevention and treatment, and gender, age, race and sexual orientation continue to make certain populations vulnerable and in need of interventions tailored to their specific needs.
Vancouver will always have a special place in HIV treatment history. It was here, in 1996, that many of us first saw the potential of combination antiretroviral therapy to control this disease.
Because current levels of HIV spending are unsustainable, HIV prevention and intervention efforts must become highly targeted in order to maximize their impact. This was the theme of many presentations at the 10th International Conference on HIV Treatment and Prevention Adherence. The conference, held June 28 to 30 in Miami, Florida, was jointly provided by the International Association of Providers of AIDS Care (IAPAC) and the Postgraduate Institute for Medicine (PIM).
Last month, I spoke at the closing plenary of the HIV Forum for Collaborative HIV Research National Summit in Arlington, Virginia. I began with a brief look back at how the fight against the HIV epidemic has evolved. I reflected on a time when there were only a few tools and even fewer resources available to make an impact on the disease. This is in direct contrast to the progress that we have made in today's fight, where we have many tools available to us that work to combat and bring an end to the HIV and HCV epidemics. But I am reminded, and wanted to remind everyone in attendance, that a challenge still remains. We need to work differently and more effectively to bring an end to both of these epidemics. The following is an excerpt from the presentation I gave, where I provided a top 10 list of things that we must consider and incorporate in our work to end both epidemics.
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