February 5, 2016
This week, we read a study that examines the association between recent smoking habits and viral load and CD4+ cell count. We also get some data on how men who have sex with men (MSM) assess whether to have condomless sex with potential partners on dating apps. And two new HIV vaccine delivery candidates are safe and well tolerated. To beat HIV, you have to follow the science!
Recent tobacco smoking was independently associated with detectable viral loads and lower CD4+ cell counts among HIV-positive New Yorkers who were enrolled in Ryan White Part A programs, according to a study published in the journal AIDS and Behavior.
The study analyzed data on 14,713 individuals living with HIV who had completed a substance use assessment, as well as viral load and CD4 testing at least three months prior. The researchers found that 40% of the participants reported recent tobacco smoking.
Compared with nonsmokers, recent smokers were significantly more likely to have a viral load over 200 copies/mL (AOR [adjusted odds ratio] = 1.38) and CD4+ cell count below 200 cells/mm3 (AOR = 1.12).
Additionally, recent smokers were more likely to be black, over 30 years old, living below 100% of the federal poverty level, born in the U.S., English speaking, and to not have stable housing, not have graduated high school, have consumed at least one alcoholic drink in the last three months, have an earlier HIV diagnosis, and not be prescribed antiretroviral therapy.
Hard drug use was also more commonly reported in recent smokers (28.5%) than non-smokers (5.6%).
"This information is critical for the development of policy and practice for HIV/AIDS care, including the prioritization and planning of effective tobacco use screening tools and smoking cessation interventions," the researchers concluded.
A new study provides insight into how frequently HIV-negative MSM disclose being on pre-exposure prophylaxis (PrEP) and how often HIV-positive MSM disclose having an undetectable viral load (UVL) -- and then overall how MSM assess whether to have condomless anal sex (CAS).
The study, published in JAIDS, recruited MSM online to answer a questionnaire. In total, 668 completed the PrEP survey and 727 completed the UVL survey. For each survey, the participants were broken down into two groups: HIV negative or HIV positive.
Disclosure of PrEP use through dating apps was common for both groups: 42.8% of HIV-negative MSM reported disclosure, as did 62.4% of HIV-positive MSM. Overall, 15.9% of HIV-negative MSM and 44.8% of HIV-positive MSM reported meeting up and having CAS with a partner on PrEP.
Disclosure of having an undetectable viral load through dating apps was also high for both groups: 67.9% of HIV-negative MSM reported disclosure while 90% of HIV-positive MSM did. Overall, 8.7% of HIV-negative MSM and 60% of HIV-positive MSM reported meeting up and having CAS with a partner who had an undetectable viral load.
In terms of risk assessment, "HIV risk is lower with biomedical prevention," was the most frequently endorsed theme, but more so in HIV-negative MSM.
In terms of attitudes toward condom use, "condoms interfere with sexual functioning," and, "condomless sex is more pleasurable," were the two main themes endorsed.
Two new HIV vaccine vectors (a weakened bacterium or virus that acts as a carrier to deliver the genetic material into the body) appear to be relatively safe and elicit significant immune responses, according to a study published in the journal Annals of Internal Medicine.
Previous vaccine research commonly uses adenovirus (a virus that, when not weakened, can cause colds and sore throats) as a vaccine vector. In this study, researchers tested two new adenovirus serotypes, 26 and 35, in 217 individuals across sites in the U.S. and Africa.
Overall, the vaccines elicited both humoral immune responses (protection provided by antibodies against freely circulating pathogens) and cellular immune responses (protection provided by cells such as killer T cells and T helper cells) in all populations, regardless of baseline immunity to the adenoviruses, and with injection site reactions being mild to moderate.
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
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