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Blog

San Francisco Leathermen's Discussion Group

HIV, PrEP, and STI Resources

Erik Will

Our friend Race Bannon collected this list of info, and I think its important enough to share.  

HIV (including PrEP) and STI Resources

March 15, 2013: Condoms 70% effective at HIV transmissions and low condom usage: http://www.hivandhepatitis.com/hiv-aids/hiv-aids-topics/hiv-prevention/4038-croi-2013-consistent-condom-use-stops-70-of-hiv-infections-says-cdc

Remove Weinstein Petition: https://www.change.org/petitions/ahf-remove-weinstein

May 1, 2014 Weinstein Blog Post in FrontersLA: http://www.frontiersla.com/frontiers-blog/2014/05/01/ahfs-michael-weinstein-deconstructs-stigma

Condoms not approved for anal sex: http://www.imstilljosh.com/fda-condoms-not-approved-anal-sex/?fb_action_ids=10152361933016435&fb_action_types=og.likes

Rather have HIV than diabetes: http://www.spectator.co.uk/features/9185591/why-id-rather-have-hiv-than-diabetes/

The following article from BETA makes reference to some of the latest studies that show that people with HIV viremia consistently suppressed to undetectable levels (that is, not spiked by long-untreated GC or chlamydia, or by use of hyperstimulants or large doses of alcohol) do not transmit HIV to ininfected partners. http://betablog.org/zero-hiv-transmissions-with-condomless-sex/

Condom usage efficacy: http://www.ncbi.nlm.nih.gov/pubmed/9141163

Research team at The Hunter College Center for HIV Educational Studies and Training ( CHEST ) against Weinstein's PrEP stance: http://www.windycitymediagroup.com/lgbt/LETTERS-PrEP-rally-/47315.html

Clinton Fein comes out as a Truvada Whore: http://thenewcivilrightsmovement.com/yep-im-another-truvada-whore/news/2014/05/10/86540

Michael Kaplan's Leatherati deconstruction of Michael Weinstein and Eric Paul Leue: http://www.leatherati.com/2014/05/leatheratis-deconstruction-of-michael-weinstein-and-eric-paul-leue-truvada-is-a-party-drug/

67 HIV groups back PrEP: http://myprepexperience.blogspot.com/2014/05/67-leading-hivaids-groups-endorse-cdc.html

Facebook Post on my wall May 15, 2014:

Regarding the AHF and Weinstein Controversy: From my friend Keith Folger:

"AHF provides substandard care, has no hospital privileges for any of its physicians, no referral network to speak of. Please someone tell he how they are doing a good service, in spite of their leader. AHF came into SF 10+ years ago and were told then, we have adequate enough HIV services in the City. They said FU, we are going to set up shop anyway, using part time physicians and start stealing your limited Ryan White dollars. Oh, did I mention the reason they are limited? MW went before congress and persuaded them to redo the formula for how communities HIV services are funded. He cost SF alone something like $12M dollars annually which the City has backfilled since. He is worse than egotistical, he is dangerous and his clinic's are not needed. He poached Mom's pharmacy so that he could gain a foothold in the Castro. Let him have what he already has but quit trying to force your way into a community that does not want you."

The Sword AB1576 commentary: http://thesword.com/i-have-something-to-say-about-ab1576.html

NYTimes article on HIV Sexual Revolution: http://mobile.nytimes.com/2014/05/24/opinion/sunday/ready-for-hivs-sexual-revolution.html?_r=0&referrer

Peter Staley on HIV prevention today: http://www.slate.com/blogs/outward/2014/05/22/peter_staley_talks_about_truvada_hiv_and_stigma.html

Damon L. Jacobs blog post about PrEP not being for cowards: http://www.bilerico.com/2014/05/getting_my_rocks_off_prep_isnt_for_cowards.php#iolgbs4HM6tF1XMB.99

AHF not paying Maitri: http://www.ebar.com/news/article.php?sec=news&article=69384

Why I'm a Truvada Whore: http://www.towleroad.com/2014/05/outcom-editorial-why-i-am-a-truvada-whore.html

Dr. Judy Auerbach interview: http://hivelimination.uchicago.edu/spotlight/detail/judy_auerbach

Dr. Judy Auerbach on people not using condoms: http://www.towleroad.com/2014/05/outcom-editorial-why-i-am-a-truvada-whore.html

YouTube video regarding AHF and money practices: http://youtu.be/I9MOWF94_II

AB1576 change.org peititon: http://www.change.org/petitions/tell-ca-legislators-to-keep-adult-performers-legal-and-safe-stop-ab1576

PrEP efficacy based on adherence study: http://www.aidsmap.com/Daily-dosing-key-to-the-efficacy-of-tenofovir-based-HIV-PrEP/page/2851315/

Condomless Sex and Gay Men, http://www.psychologytoday.com/blog/gay-and-lesbian-well-being/201406/condomless-sex-and-gay-men

From Adam Zeboski: Thank you BioCentury TV, for this awesome debate. Dr. Richard Elion from Whitman-Walker Health in DC has his #PrEPfacts down! I'm super impressed. The guy from AHF seems to be making it up as he goes on. No thank you Weinstein for continuing to spread your moralistic misinformation with the world. We all know you're the "Tea Party" of the HIV/AIDS world.,  http://www.biocenturytv.com/player/3659820884001/3657514416001?utm_medium=web&utm_source=video_link&utm_campaign=bctv_twitter

WHO recommends PrEP, http://cir.ca/news/pill-cuts-hiv-risk

Project Inform PrEP Doctor Discussion Pamphlet, http://www.projectinform.org/pdf/prep_docvisit.pdf

99% efficacy, plus PrEP effective if taken just 4 days a week, http://www.natap.org/2012/CROI/croi_10.htm

Dr. starting PrEP, http://www.thebodypro.com/content/74724/im-an-hiv-physician-and-im-starting-prep.html?ap=1100

Eric Paul Leue's response to Vince Andrews' Leatherati article, http://www.leatherati.com/2014/07/the-enlightenment-of-prevention/

Historical rise and fall of Gonorrhea rates, http://www.cdc.gov/std/stats12/figures/11.htm

Facebook Comment by Eric Paul Leue July 12, 2014: I am just going to say it: HIV is incurable and other STIs are not. Only 16.7% of 7000 people use condoms for every anal/vaginal intercourse. Syphilis, Gonorrhea and Chlamydia can all be transmitted through oral sex too. The goal of preventing one STI can not stand in the way of preventing a second one and vice versa. This has absofuckinglutely nothing to do with Big Pharma or Big Government, this is about ending an epidemic. I disapprove of the high prices of Truvada, but the cost has nothing to do with the efficacy that BY FAR outweighs the efficacy of condoms AND prevents transmission not only on the dick, hole and vagina but in the ENTIRE body.

Race Bannon's and Luke Adam's Test, Treat, and PrEP 2011 article, http://www.ebar.com/columns/column.php?sec=guest_op&article=347

Al Jazeera interview with Damon Jacobs and Dr. Fauci, http://america.aljazeera.com/watch/shows/america-tonight/2014/7/new-hiv-pill-facesunlikelyfoepartone.html

AHF Board: rwright@montefiore.org, cyntyhiadavis@cdrewu.edu, diana.hoorzuk@aidshealth.org, tom.myers@aidshealth.org, scott.carruthers@aidsheatlh.org, peter.reis@aidshealth.org, laura.boudreau@aidshealth.org, michael.wohlfeiler@aidshealth.org, donna.stidham@aidshealth.org

AHF revenue growth graphic from Peter Staley, AHF Revenue Graphic from Peter Staley.jpg in my files, data comes from AHF's 990's (deep inside, where they report audited numbers), along with Weinstein's publicly stated budget claim for 2014. It's almost all from their pharmacies.

PrEP Adherence Curbs HIV Transmission in Straight Couples, http://www.aidsmeds.com/articles/PrEP_Adherence_1667_24515.shtml

Kink.com starting to shoot in Las Vegas due to SB 1576, http://sfist.com/2014/07/15/exclusive_kinkcom_begins_shooting_i.php

AIDS Conference and the promotion of PrEP, http://www.usatoday.com/story/news/health/2014/07/20/20th-international-aids-conference-hiv-pandemic/12913667/

iPrEx OLE found that PrEP is highly effective at preventing HIV in MSM/TGW, even when some doses of the daily regimen are missed. No study participant who took PrEP 4 or more times per week became HIV-infected. The study measured participant use of PrEP in dried blood spots (DBS), a novel and highly sensitive biomarker of long-term PrEP use discovered and developed at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences.

Among those receiving PrEP in iPrEx OLE, HIV incidence was 4.7/100PY if drug was not detected in DBS, 2.3/100PY if drug concentrations indicated use of fewer than 2 tablets per week, 0.6/100PY for use of 2 to 3 tablets per week, and 0/100PY for use of 4 or more tablets per week (P<0.0001). There were no infections at visits where DBS sampling indicated use of 4 to 7 tablets per week. The DBS concentration associated with 90% reduced risk of HIV acquisition was consistent with use of 2 to 3 tablets per week.

"Daily dosing of PrEP is recommended, because it helps foster the habit of consistent PrEP use and increases drug levels in the body, providing the best safety cushion for individuals who occasionally miss doses," said Dr. Grant. "At the same time, these results demonstrate that PrEP remains highly effective, even in real-world circumstances in which adherence may not be perfect."

http://www.prnewswire.com/news-releases/268053491.html

Biomedical and behavior treatment suggestions from JAMA, http://jama.jamanetwork.com/article.aspx?articleid=1889145

From Damon Jacobs on Facebook about condom use in PrEP studies: Yes - variations in condom use was considered. 2499 men in six countries (including U.S.) were selected for enrollment iPrex in 2007 because they were not using condoms consistently and were at high-risk for HIV. Half were give given Truvada, and half were given placebo, no one knew who receive which. Condom use was inconsistent amongst participants, as it had been prior to the study - meaning some said they used them, some said they didn't. But having such a large sample helps to mitigate individuals variants in condom usage. This is one of the slides presented to the FDA on 5/10/12 while Truvada was being considered for approval. It demonstrates variations in adherence amongst the group that received Truvada, but shows that adherence was higher with the participants that were "URAI" - Unprotected Receptive Anal Intercourse. In other words, people who didn't use condoms in iPRex were more likely to take Truvada consistently than those who reported condom use. Not a single person who took Truvada 7 days a week became HIV+ . [graphics referenced saved as Damon Jacobs Graphic.jpg]

From Damon Jacobs on Facebook: And according to the new information this week from iPRex OLE... "Adherence was 69% higher in participants reporting receptive anal sex without a condom, 57% higher in participants reporting more than five sexual partners in the previous three months, and 40% higher in participants with a known HIV-positive partner, indicating that people were adjusting their PrEP use according to their perceived risk of acquiring HIV." http://www.aidsmap.com/Overall-PrEP.../page/2892435/

From Damon Jacobs on Facebook: On the resistance issue: Not a single HIV negative person in any research study, nor real-world setting, has become resistant to Truvada. The only instances of resistance have occurred when someone who didn't know they were already HIV+ began using Truvada without using in combo with other meds. This is why it is SO important that people begin using Truvada for PrEP with a medical professional who can screen for HIV first. http://www.aidsmap.com/No-significant-risk.../page/2849061/

 

My Facebook comment on someone's thread about PrEP: Ugh, I hate that many of these opinions are mired in misinformation and, frankly, wishful thinking. In a well known and respected study only 16.7% of 7000 people used condoms for every anal/vaginal intercourse. And as was pointed out, almost no one uses condoms for oral sex during which the S/G/C assortment of STIs can all be transmitted. There is this odd assumption that condom usage is widespread and consistent. It is not. None of the data shows that. What the data does show is that a very large percentage of people do not use condoms at all and another large percentage use them only occasionally. To drone on with the message that the only way to address prevention is to use condoms is to push a whole bunch of folks into a model that has frankly begun to fail rather than succeed (see my past article from 2011 for a bit of an explanation why the biomedical is succeeding where the behavioral model was failing). Every time someone shouts to the rooftops that condoms are the only viable option for prevention they simultaneously send a misguided message to all those people who don't or won't use condoms that they are not protected. That's just bullshit. PrEP, for example, has a higher rate of efficacy at reducing HIV transmissions than condoms (yes, higher). So who is more protected? HIV is not curable. Everything else mentioned is curable. Why is it so difficult for people to realize that the use a condom every time message is not right for everyone. If it's right for you, awesome. Keep doing it and I and others will support you. But judge others for making alternative, well reasoned decisions and you will be called out as part of the problem and not part of the solution. [including link to my Test, Treat, PrEP article]

 

Zero HIV Infections When PrEP Is Taken 4 or More Times a Week, http://www.thebodypro.com/content/74799/zero-hiv-infections-when-prep-is-taken-4-or-more-t.html

 

Truvada: It's Time To Take the Fucking Pill, http://gawker.com/truvada-its-time-to-take-the-fucking-pill-1612386701

 

AB1576 B.A.R. article, http://www.ebar.com/bartab/article.php?sec=karrnal&article=411

 

Christian Walters' PrEP checklist post, http://www.thechristianwrite.org/prep-checklist-what-you-should-know/2014/7/23/prep-checklist-what-you-should-know