🏳️‍🌈✝️ Increased coronary artery disease found in men with HIV

Researchers use CT scans to detect signs of subclinical coronary artery disease. (Photo/Multicenter AIDS Cohort Study)

USC leads research into link between high inflammation and narrowing of the arteries

By Mary Dacuma

http://keck.usc.edu

__________________________________________________________________________________ 

A cardiac imaging study showed a correlation between higher inflammatory biomarkers and an increased prevalence of coronary artery disease (CAD) in men infected with human immunodeficiency virus.

CAD is a narrowing of the arteries, likely due to the presence of calcified and non-calcified plaque. The findings were published in the Journal of the American Heart Association.

Researchers examined nearly 925 men, 575 of whom were infected with HIV, from the Multicenter AIDS Cohort Study. The researchers used computed tomography (CT) angiography to detect signs of subclinical CAD, such as narrowed arteries and the amount, density and calcification of plaque.

Participants were also measured for the presence of seven inflammatory biomarkers. This study, which was funded by the National Institutes of Health, is the largest coronary CT scan imaging study on men infected with HIV to date.

“We found that men infected with HIV had higher levels of inflammatory biomarkers than men who were not infected,” said Hossein Bahrami, assistant professor of cardiovascular medicine at the Keck School of Medicine of USC, who led the study along with six other institutions. “There was a strong, independent association between the presence of these inflammatory biomarkers and subclinical CAD detected by CT scan. Although this study does not definitely prove the causal relationship between these markers and heart disease, it is suggestive of a possible role that persistent inflammation [even in HIV-infected patients that are under appropriate treatments] may play in increasing the risk of heart disease in these patients.” 

At greater risk

HIV-infected individuals are at an estimated twofold higher risk of CAD compared to those who are not infected with HIV. The development of antiretroviral therapy has significantly prolonged the life spans of those living with HIV infection. However, they are more prone to chronic illness, such as cardiovascular disease and CAD, and they present at a younger age. These factors combined have made research into treating chronic illness in men with HIV all the more important.

The CT imaging was crucial to this study, as researchers were able to detect subclinical CAD in a younger population rather than waiting until participants exhibited clinical symptoms. Moreover, researchers were using a broader set of inflammatory markers than in past studies, which provides more information about inflammatory pathways involved and potential causes for inflammation.

“Inflammation has only recently been studied as a possible reason for chronic heart disease,” Bahrami said. “Confirming the relationship between HIV-related inflammation and the marked increase of CAD among men infected with HIV allows us to move forward in our attempts to better manage the health of these patients according to their specific medical needs.”

In ongoing research efforts at the Keck School of Medicine, Bahrami and others are also using cardiac magnetic resonance imaging to study the changes in heart muscle, as well as details of coronary artery function in men affected by HIV. This advanced form of imaging evaluates several features of the heart that could not be evaluated with cardiovascular CT scans. This ongoing project is significant, as HIV-infected patients appear to have even higher risk of abnormalities in the heart muscles compared to their increased risk of coronary artery disease.

Bahrami’s research hopes to illuminate what causes HIV-related inflammation, as well as identify specific pathways involved and the best means of treatment or management of heart diseases in HIV patients.

 

Article from Keck School of Medicine of USC 

🏳️‍🌈✝️ Stopping a silent killer

Know the facts about heart disease and HIV

BY KATHLEEN FITCH, MSN, FNP

____________________________________________________________________________________ 

“I had no idea that since I have HIV, I may be twice as likely to have a heart event compared to the general population,” said Frank Carroll, a 63-year-old man who has been living with HIV for over two decades.

 Unfortunately, that is the case for the majority of people who are living with HIV. Up to this point, there has been very little research conducted regarding heart disease and HIV, but here is what we do know:

People with HIV often have what is known as “inflamed non-calcified plaque” buildup in the heart.  

This plaque is considered “high risk” plaque because it is a leading risk factor for heart disease. This is important to know because “inflamed non-calcified plaque” is extremely vulnerable to rupture and that can lead to a sudden heart event, such as a heart attack. Traditional risk factors, including high blood pressure and high cholesterol, are well-known contributors to heart disease for those with HIV and the general population. However, an additional and significant HIV-related risk factor for developing heart disease is constant activation of the immune system; this happens even with antiretroviral therapy and when the virus is undetectable.

Heart disease rates among people living with HIV are elevated compared to the general population. If you add to that the fact that heart disease is often a silent killer with atypical symptoms, it is easy to understand why more research needs to be conducted on this subject.

It is important that health care providers gain a better understanding of the intersection of HIV and heart disease to inform how they educate, treat, and monitor patients. It is equally important that heart disease prevention tools are developed and tested, specifically among people living with HIV, to determine the most effective ways to treat and prevent heart disease events in these patients.

 “We know that people with HIV are living longer and aging. The HIV community has worked very hard for these successes; they have participated in research studies for the past 30 years to help develop antiretroviral therapy that works to suppress HIV. It is our goal now to find ways to keep people with HIV healthy as they age and help them achieve a full and healthy lifespan,” said Dr. Steven K. Grinspoon, Director of Massachusetts General Hospital Program in Nutritional Metabolism and Professor of Medicine at Harvard Medical School.

Gaining a better understanding of how HIV may contribute to heart disease and determining effective prevention strategies will enable health care providers and patients to act before significant damage and co-morbidities develop. The time to take action is now, before this silent killer strikes. 

 

Be proactive about heart health

“I never really thought I would live to be an old man, so it was not until a few years ago that I made the decision to take control of my overall health. I quit smoking and am now more conscious of my diet and exercise activities than in the past. Research has come a long way in helping people with HIV, but there are many things we can do as patients to help ourselves as well,” said Mr. Carroll.

Members of the HIV community should make it a priority to talk with their health care provider about additional ways to remain heart healthy. There are always helpful resources available at local HIV clinics such as smoking cessation programs, exercise groups, nutrition services, and research studies.

A “whole-body” approach to living longer with HIV is critical. HIV patients and their health care providers alike should understand that there are many pieces to the puzzle when it comes to keeping those living with HIV heart healthy.

 “I have treated many patients who were overweight, who smoked, and rarely exercised. In these instances, I always made it a point to explain the risk factors associated with heart disease and the concerns regarding inflamed non-calcified plaque unique to the HIV population. In future visits, many of these patients made lifestyle changes that, in the long run, led to increasingly positive health outcomes,” said Dr. Grinspoon.

Although smoking cessation, eating a healthy diet, and exercising are excellent ways to stay healthy, clearly, there are more tools needed to prevent heart disease among people living with HIV.

Could statins be the ideal heart disease prevention tool?

“Recent studies show that statins may reduce immune activation and shrink dangerous plaques in the blood vessels in the heart. Statins may therefore be a potentially useful treatment to prevent heart disease in the HIV population,” said Dr. Grinspoon.

Statin medications are a validated strategy with the potential to prevent heart disease, and target traditional and nontraditional risks in people living with HIV. In small studies examining the effects of statins among HIV-positive study participants, statins significantly decreased low-density lipoprotein (LDL) cholesterol, a known risk factor for heart disease. Statins also reduced blood markers of immune activation, inflammation, and inflamed non-calcified plaque in the coronary arteries of these study participants.

However, at this time, it remains unknown if statins will prevent heart disease events in people living with HIV. Although statins have proven safe and are widely prescribed, it is not fully understood how they will be tolerated in the HIV population. For example, some studies suggest older statins may cause an increase in blood sugar. However, newer statins, broken down by the body differently than those in the past, have not been shown to cause an increase in blood sugar. In fact, a 2013 study explored the effects of a newer statin called pitavastatin in over 200 HIV-positive study participants and results proved there was no effect of pitavastatin related to increased blood sugar levels. This study was reassuring to researchers because it indicated that newer statins are well tolerated among people living with HIV.

 Given the crucial need to find a heart disease prevention tool for the HIV community, investigators from the AIDS Clinical Trials Group (ACTG) Network and Massachusetts General Hospital sought funding from the National Institutes of Health (NIH) to conduct the largest heart disease prevention research study to date among people living with HIV.

About the REPRIEVE Trial

“I chose to participate in the REPRIEVE Trial because I want to do everything I can to prevent developing heart disease. It is also a way for me to give back to the researchers, the HIV community, and those amazing HIV study participants who came before me. Basically, it is a win-win situation for me,” said Mr. Carroll.

The REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) Trial launched in April 2015 and will test whether pitavastain prevents heart disease events in people living with HIV. REPRIEVE study participants will be randomized to take one pill, once a day of pitavastatin or a placebo, for an average of 4-5 years. REPRIEVE will enroll 6,500 HIV-positive study participants who are considered to have low to moderate traditional known risk factors for developing heart disease, but are likely at an increased risk due to HIV. Trial sites are located throughout the United States, Canada, Thailand, South America, and Africa.

A unique aspect of REPRIEVE is that there are several sub-studies incorporated into the clinical trial design. In one of the sub-studies, study participants will have a picture of their heart vessels taken by a CT scanner; the picture will be taken before the study medication is started and two years after to see if there are changes in inflamed non-calcified plaque with pitavastatin. Other sub-studies will explore if, by decreasing inflammation, pitavastatin improves kidney function and measures of quality of life.

Women also have a special place in REPRIEVE. To encourage women’s participation in REPRIEVE, there is a campaign just for women called Follow YOUR Heart. Follow YOUR Heart has an interactive website with helpful resources on HIV, heart disease, and women’s health and was developed to focus on including and educating women living with HIV about the clinical research process.

Until we know the results of REPRIEVE, people with HIV should follow the important steps outlined to prevent heart disease, such as not smoking, exercising regularly, and eating nutritiously. People living with HIV need to talk to their health care provider about heart health and consider joining the REPRIEVE trial. Joining REPRIEVE is a way for patients to learn more about their own bodies, while helping to determine a successful prevention strategy for the greater HIV community. 

Learn more about REPRIEVE; go to reprievetrial.org.

Kathleen Fitch, MSN, FNP, is the Project Manager for the Clinical Coordinating Center of the REPRIEVE Trial located at Massachusetts General Hospital. Kathleen has conducted several research studies that have increased the understanding of metabolic complications of HIV including lipodystrophy syndrome, diabetes, and cardiovascular disease. She has also explored different treatment strategies for these abnormalities, including lifestyle modification. In addition, she is a volunteer community educator at several HIV/AIDS service organizations throughout New England.

Read more articles from Positively Aware, here.

 

🏳️‍🌈✝️ Widespread Defective HIV in Immune Cells Undermines Efforts to Kill Viable HIV

This finding identifies yet another hurdle to finding effective therapies to clear the viral reservoir and ultimately cure HIV.

April 25, 2017


____________________________________________________________________________________ 

Defective copies of HIV that are integrated into long-living immune cells distract the immune system, complicating the effort to track down and kill viable copies of the virus. This finding identifies yet another hurdle to finding effective therapies to clear the viral reservoir and ultimately cure HIV.

When HIV infects an immune cell, the virus integrates its genetic materials into the cell’s own DNA, yielding what is known as an HIV provirus. However, the majority of proviruses cannot produce new, intact copies of HIV because of flaws in the reproduction process. Consequently, until recently, researchers believed that proviruses amounted to a biological dead end and that cells latently infected (meaning they are not replicating and are therefore invisible to standard HIV treatment) with defective provirus could not prompt a repopulation of the virus in the body.

Publishing their findings in Cell Host & Microbe, scientists studied memory CD4 cells drawn from HIV-positive individuals as well as reconstructed defective proviruses drawn from people with HIV. Latently infected memory CD4 cells, which can live a very long time, are a major component of the viral reservoir, the presence of which frustrates attempts to cure the virus.

The investigators concluded that the presence of the defective proviruses promotes the survival of the overall HIV infection by serving as a decoy. The immune system, recognizing the viral proteins that serve as signs of infection in the cells infected with defective proviruses, wastes resources attacking those cells.

In its effort to seek out and destroy proviruses, the immune system is confronted with a needle-in-a-haystack effort because people with HIV have about 1,000 times more defective proviruses than viable ones, and the immune system apparently cannot detect the difference between them.

This decoy effect also complicates the effort to measure the viral reservoir because most current tests also cannot distinguish between defective and viable provirus.

To read a press release about the study, click here.

To read the study abstract, click here.

Read more articles from POZ, here.

  

🏳️‍🌈✝️HIV Levels Before Treatment Can Predict This Immune System Indicator

Researchers may have answered a bedeviling chicken-or-egg question about the persistence of HIV during antiretroviral treatment.

April 24, 2017


____________________________________________________________________________________ 

 

Researchers may have finally answered a bedeviling chicken-or-egg question about the relationship between the persistence of HIV in the body during antiretroviral (ARV) treatment and the virus-related immune system activation and inflammation that also continues while people are on ARVs. This finding likely adds further weight to the urgency of diagnosing and treating HIV as soon as possible following infection.

HIV hides its genetic material in cells or locations in the body that remain out of reach of ARVs. This result of this overall effect is known as the viral reservoir, the existence of which prevents standard HIV treatment from curing the virus.

Publishing their findings in PLOS Pathogens, researchers from the AIDS Clinical Trials Group (ACTG) studied 101 people with HIV who had plasma and blood-cell samples taken before they started ARVs, one and four years after beginning HIV treatment, and once more between years six and 15 of treatment. All the participants achieved a viral load considered undetectable by standard laboratory measures and maintained this level of viral suppression for an average of seven years, with some doing so for more than a decade.

The participants experienced the steepest decline in measures of HIV’s genetic material (detected with highly sensitive tests) during their first four years on ARVs; afterward, they still experienced a decline, albeit at a slower pace.

Looking at the samples taken before the participants started ARVs, the researchers identified a correlation between levels of HIV and indicators of immune system activation and inflammation. 

However, this association ceased after the individuals started treatment for the virus. More specifically, the low levels of HIV found in the samples taken while people were on ARVs did not seem to influence the levels of immune system activation and inflammation during that time.

The investigators ultimately concluded that the levels of both immune system activation and HIV in the pretreatment samples predicted the levels of persistence of the virus and immune activation seen in the samples taken when the participants were on ARVs.

“Our findings suggest that damage to the immune system that occurs before people are started on [HIV] treatment leads to continued immune activation, even though the medicines are keeping the virus in check,” the study’s lead author, Rajesh Gandhi, MD, of the Massachusetts General Hospital Division of Infectious Diseases, said in a press release. “This suggests that diagnosing HIV and starting antiretroviral therapy as soon as possible may prevent the elevated immune activation that can lead to health problems, such as heart disease. The results also suggest that new strategies focused on reducing immune activation may need to be added to novel interventions designed to reduce and eventually eliminate HIV.”

To read the study, click here.

To read a press release about the study, click here.

Read more articles from POZ, here.

🏳️‍🌈✝️ You Might Have Less HIV In Your Body Than Your Doctors Think

While defective forms of HIV were thought to be harmless, studies show they're tricking our immune systems into thinking we have more HIV in our bodies than is the case.

By David Artavia

 

April 24 2017

 

 

___________________________________________________________________________________ 

 

 

New evidence coming out of John Hopkins and George Washington Universities suggest that defective forms of HIV are creating proteins that are interacting with our immune system, making it think we have more HIV in our bodies than we actually do.

The proteins that are released by defective HIV are monitored by specific T-cells called cytotoxic T-Cells. And while scientists previously thought defective HIV was harmless, research now suggests otherwise.

According to the study published in Cell Host and Microbe, while defective HIV proviruses cannot create functional (and by that we mean infectious) HIV once they’re defective, they create a specific subset called “hyper mutated” HIV proviruses, which then births new types of proteins.
From there, the cytotoxic T-cells mistakenly recognize these proteins as HIV, even though they’re — they’re simply a result of defective HIV proviruses. Our immune system then starts to think it’s becoming infected by more HIV cells than are actually present.

As a result of the confusion, it also makes things more complicated when doctors try to measure our viral loads, exhaust immune systems, or shield functional HIV from attack by natural means or drugs. It may also complicate the development of a cure for HIV, reports Medical News Today.
But lead lead study investigator and instructor of medicine at the John Hopkins University School of Medicine, Dr. Ya Chi Ho, still has hope.

"The virus has a lot of ways, even in its defective forms, to distract our immune systems, and understanding how they do this is essential in finding a cure," Ho said to MNT. "The fact that defective proviruses can contribute to viral RNA and protein production is concerning, because it means that the measurements of HIV load in infected patients may not be as accurate as we thought. Part of the count is coming from defective viruses.”

After doing additional studies, it was found that cells containing “hyper mutated” HIV can be recognized by an HIV-positive patient’s cytotoxic T-cells.

This makes Ho confident that new research might lead to a cure. That is, if researchers know where to look.

"If we identify and find a way to use the right protein, perhaps one of those expressed by the ‘hypermutated’ HIV we found in this study, we could create a potent vaccine which could boost the immune system enough to eliminate HIV altogether," said Ho. "The cytotoxic T lymphocytes' ability to identify and target the real threat appears to be greatly impaired, because they may attack proteins from defective proviruses instead of the real thing.” 

Read more articles from PLUS, here.

 

🏳️‍🌈✝️The Unmet Sexual Health Rights of LGBT Youth

This National Youth HIV & AIDS Awareness Day, Advocates for Youth spent the day educating and spreading awareness. There's still a long road ahead.

By Pepis Rodriguez

 

April 20 2017

 

 

__________________________________________________________________________________ 

 

 

At the last Creating Change, a session on the sexual health care rights of young people gave me hope. Amidst all the strategizing and anxiety of the weekend — on the eve of a new administration taking office—young queer activists were sharing their remarkable experiences of advocacy in their own communities.

I thought back to this session last Monday, on National Youth HIV&AIDS Awareness Day (NYHAAD), a day to educate the public about the impact of HIV on young people and the important work young people are doing in response. I remembered feeling that, despite the uncertainty of a new administration, there was reason for optimism with these young activists so passionately engaged.

It’s the other part of NYHAAD — increasing public awareness about the impact of HIV and AIDS on young people — that also gives me pause. Awareness is not enough. What are we telling young people when we say we want to make the public aware of a problem directly affecting them, but then do nothing concrete about it? What message do we convey when we highlight transmission rates and the fact that, for many young people — mostly young Black gay men — things are actually getting worse, but then we not only provide no solutions or help, we actively obstruct their attempts to remedy the situation?

NYHAAD highlights the need for comprehensive, shame-free, medically- and culturally-competent sexual health care to address the HIV epidemic. Treatment alone is not enough, though. Waiting until a young person receives a diagnosis is too expensive in human terms alone; it increases risk of poor health outcomes, even early death, and eliminates their agency.

Prevention must play a key role as well. Young people need free, broad access to sexually transmitted infection (STI) and HIV screenings and treatment, safer sex tools like condoms and pre-exposure prophylaxis (PrEP). The key ingredient, however, is sexual health literacy—an essential part of informed use of these services and individual, sexual autonomy.

Sexual health literacy includes guidance on topics like STI and HIV transmission, prevention, and care; healthy relationships, consent, and recognition of abuse; the continuum of sexual orientation and gender identity and expression (SOGIE); and the harmful effects of SOGIE-based stigma and violence. Some young people receive “sex ed.” in schools, but it’s rarely comprehensive, many states have no requirement that information provided be medically accurate, and some states even require students receive negative information on non-heterosexual sexual activity.  For queer kids in detention, it’s even worse: much higher risks of STIs and other health issues, much lower possibility that any form of sexual health care and literacy services will be available.

Sexuality is a fundamental part of who we are, and sexual health care is a medical issue we all share. This is no less true for young people, regardless of whether or not we choose to give them the support and services they need. Young people have an inalienable right to comprehensive and affirming sexual health; it’s not just something that would be nice to have. Can you imagine helping young people manage their diabetes without explaining to them the significance of diet, nutrition, and a healthy lifestyle, how they can take charge of staying alive and healthy? We should treat sexual health no differently, and, health departments should be taking the lead on this public health issue – particularly in places where the state has custody of our young people and a corresponding obligation to provide for all aspects of their care. That is why The Center for HIV Law and Policy has launched a campaign to demand these services.

If we don’t demand comprehensive sexual health care for all young people, NYHAAD can be a cruel joke. Awareness signals the creation of responsibility. But we should not set young people up to fail.

Pepis works at the Center for HIV Law & Policy to uphold the sexual health rights of young people in state custody and to end HIV criminalization. He received his J.D. from the Georgetown University Law Center.

Read more articles from PLUS, here.
 

🏳️‍🌈✝️ Health Care Gains Made Under Obamacare Remain at Risk

Although Republicans were not able to repeal the Affordable Care Act, the future remains unclear with LBGT and people of color likely to lose out the most.

By Eric Brus

 

April 19 2017

 

 

__________________________________________________________________________________

Now that Congress is no longer considering the American Health Care Act (AHCA), a bill filed by House Speaker Paul Ryan to replace the Affordable Care Act (ACA), the future of efforts to repeal and replace the ACA, also known as Obamacare, are unclear. What is clear, as a policy brief by The Fenway Institute on the AHCA explained, is that the AHCA would have harmed LGBT people, persons living with HIV, and Black and Latino Americans.

“This bill holds potentially devastating consequences for low-income LGBT people, people living with HIV, and Black and Latino people,” according to Sean Cahill, director of health policy research for The Fenway Institute. “The rates of uninsurance among LGBT people and people living with HIV have dropped dramatically since 2013, when the Affordable Care Act’s Medicaid expansion was implemented. While people of all races benefitted from the expansion of insurance access, on a per capita basis Black and Latino people benefitted disproportionately. Those gains could be completely erased if this bill becomes law.”

 

Although Obamacare remains in place for now, the President, Congress, and federal agencies can choose whether to take action to stabilize and strengthen the program or to undermine it either through direct action or inaction. In an article on March 27, Vox.com’s health policy reporter Sarah Kliff highlighted several decisions the Trump administration will make that affect the future of Obamacare and the U.S. health care system. These include:

Should it run a very active outreach campaign to encourage uninsured persons to buy coverage? If it doesn’t, fewer healthy people might enroll, which could drive up insurance premiums.

How should the administration handle counties where no companies want to sell coverage on the Obamacare insurance marketplace? Will it negotiate with insurers, as the Obama administration did, to convince them to provide coverage in such areas?

Will the federal government continue to pay cost-sharing subsidies that make health coverage affordable for low-income enrollees?

Some Congressional Democrats have indicated they are willing to work with the Republican majority and President Trump to safeguard Obamacare’s gains and fix its problems. Speaking on ABC’s This Week, U.S. Senate minority leader Chuck Schumer said, “We Democrats, provided our Republican colleagues drop [repeal and replace] and stop undermining the ACA, are willing to work with our Republican friends—as long as they say no more repeal.” Schumer also noted that, “We have ideas, they have ideas to try to improve Obamacare. We never said it was perfect. We always said we'd work with them to improve it—we just said repeal was off the table.”

Potential impact of Trump’s 2018 Budget

The Trump administration’s “America First” budget blueprint for fiscal year 2018 (FY18), released on March 16, would increase defense spending $54 billion, but would impose deep budget cuts to many federal agencies and programs, including the Department of Health and Human Services (HHS), the Environmental Protection Agency (EPA), and the State Department. Funding for HHS would be reduced approximately 18%, from $84.1 billion in FY17 to $69.0 billion in FY18. 
The budget blueprint says these changes would be achieved by eliminating “programs that are duplicative or have limited impact on public health and well-being. The Budget allows HHS to continue to support priority activities that reflect a new and sustainable approach to long-term fiscal stability across the Federal Government.”

Included in the HHS budget cuts are:

A $5.8 billion cut in funding for the National Institutes of Health (NIH) to $25.9 billion in FY18. This would be achieved largely through “a major reorganization of NIH’s Institutes and Centers to help focus resources on the highest priority research and training activities . . . and other consolidations and structural changes across NIH organizations and activities,” according to the blueprint.

The elimination of discretionary programs within HHS’s Office of Community Services, including the Low Income Home Energy Assistance Program (LIHEAP) and the Community Services Block Grant (CSBG) – reducing the HHS FY18 budget by $4.2 billion compared to the previous year. 

The blueprint contends that, compared to other income support programs serving similar populations, “LIHEAP is a lower-impact program and is unable to demonstrate strong performance outcomes. CSBG funds services that are duplicative of other Federal programs, such as emergency food assistance and employment services, and is also a limited-impact program.”

The elimination of health professions and nursing training programs totaling $403 million, “which lack evidence that they significantly improve the Nation’s health workforce,” the blueprint contends. The proposed budget would, however, continue funding activities that provide scholarships and loan repayments in exchange for service in areas of the U.S. where there is a shortage of health professionals.

Shortly after the budget blueprint was released, five HIV/AIDS and STD organizations issued a joint statement that was largely critical of the proposal. Noting that the blueprint “severely cuts funding to agencies responsible for protecting the public health and responding to infectious diseases, including HIV,” the statement called on the U.S. Congress to reject the budget and ensure that funding for non-defense discretionary programs is maintained. The five groups issuing the joint statement are: AIDS United, the National Alliance of State and Territorial AIDS Directors, the National Coalition of STD Directors, NMAC, and The AIDS Institute.

“We appreciate that the administration recognizes the importance of the Ryan White providers, other safety-net providers, and global health, including PEPFAR [President’s Emergency Plan for AIDS Relief],” commented Michael Ruppal, Executive Director of The AIDS Institute. “However the cuts to the National Institutes of Health, Department of Housing and Urban Development, and other parts of HHS, including public health infrastructure, will reverse our progress on ending the HIV epidemic. If enacted, the budget would be devastating to our nation’s public health infrastructure and would harm people living with and/or at risk for HIV and STDs. HIV and STD programs are critical to the public health of our nation and must not be cut.”

FEATURED HEALTH RESOURCES

Materials for National Youth HIV and AIDS Awareness Day (April 10)

The fifth annual National Youth HIV and AIDS Awareness Day (NYHAAD) is being observed this year on Monday, April 10. Many national, state, and private organizations are partners or supporters of NYHAAD. The day’s founding partners include: Advocates for Youth; AIDS Alliance for Children, Youth, and Families; AIDS United; National Alliance of State and Territorial AIDS Directors; National Coalition of STD Directors; NMAC; and Sexuality Information and Education Council of the United States.

According to Advocates for Youth, the establishment of NYHAAD is a step toward acknowledging and addressing the needs of young people in the HIV and AIDS response. Each year, young activists in high schools and at colleges and universities across the country use the day to organize and educate about HIV and AIDS. They promote HIV testing, fight stigma, and start the necessary conversations to deal honestly and effectively with the challenges of fighting HIV/AIDS among youth.

To support activities commemorating NYHAAD, we have compiled an annotated list of online resources focusing on HIV/AIDS among children, adolescents, and young adults.

Fact Sheets from Advocates for Youth

Young People and HIV in the United States
 
Young People Living with HIV Around the World
 
Understanding Disparities in the HIV Epidemic
 
Young Women of Color and the HIV Epidemic
 
Young Women of Color and Their Risk for HIV and Other STIs
 
Young African American Women and HIV
 
HIV and Young American Indian/Alaska Native Women
 
HIV/STD Prevention and Young Men Who Have Sex with Men. Also available in Spanish.
 
Young Men Who Have Sex with Men: At Risk for HIV and STDs. Also available in Spanish.

Materials for National Transgender HIV Testing Day (April 18)

The second annual National Transgender HIV Testing Day (NTHTD) will be observed on Tuesday, April 18. The event is being organized by the University of California-San Francisco’s Center of Excellence for Transgender Health (CoE). According to the CoE, “NTHTD is a day to recognize the importance of routine HIV testing, status awareness, and continued focus on HIV prevention and treatment efforts among transgender people. This initiative encourages community-based organizations, health jurisdictions, and HIV prevention programs to participate by hosting local trans HIV testing community events (HIV testing, visibility campaign, community forums) and/or develop trans-specific HIV testing campaign materials and resources, As part of the NTHTD initiative, the CoE has developed a Transgender HIV Testing Toolkit, which includes five modules “designed to reflect the most current HIV prevention research and best practices for serving trans and gender non-binary people.” The modules are: 1) Get the Facts about Trans People and HIV; 2) Testing and Enhanced Communication Approaches with Trans People; 3) Building Capacity to Increase HIV Testing Efforts for Trans People; 4) Community Engagement and National HIV Transgender HIV Testing Day; and 5) NTHTD and Toolkit Resources. The CoE has also produced a number of other resources for the testing day, including a condensed toolkit for health departments, testing placards in English and Spanish, and a series of flyers to promote testing.

To support activities commemorating NTHTD, we have compiled an annotated list of online resources focusing on HIV/AIDS among transgender people.

General Information

Center of Excellence for Transgender Health – Website that includes many resources on transgender health

Transgender Persons – CDC’s compilation of resources and fact sheets related to transgender health

Transgender Health – Resource page from Fenway Health

National LGBT Health Education Center – Program of The Fenway Institute

Services and Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE) – Organization that provides services and advocacy for LGBT elders

LGBT Education and Training – Resource with a list of articles, training, and educational materials from the LGBT Resource Center at UCSF

All Children-All Families: Benchmarks of LGBTQ Cultural Competency – from the Human Rights Campaign

Eric Brus writes about HIV policy. His HIV/AIDS Disparities Report is produced by the New England AIDS Education and Training Center Minority AIDS Initiative Project. The full version is available online.
 

Read more articles from PLUS, here.