Medicare now covers the expense of medication used to prevent HIV—PrEP (pre-exposure prophylaxis). The announcement came from the Centers for Medicare & Medicaid Services (CMS).
“Effective immediately, PrEP will be available at no cost to older adults and individuals with disabilities on Medicare—no cost-sharing, co-pays or deductibles,” reported Terri L. Wilder, MSW, HIV/Aging policy advocate for SAGE, the national advocacy organization for LGBTQ+ elders, on September 30. GO TO sageusa.org.
According to CMS, “Specifically, CMS has determined that PrEP using antiretroviral drugs to prevent HIV is reasonable and necessary for the prevention of an illness or disability; is recommended with a grade of A by the United States Preventive Services Task Force (USPSTF); and is appropriate for individuals entitled to Medicare benefits under Part A or enrolled under Part B.”
Medicare coverage includes up to eight individual counseling visits every 12 months, up to eight HIV screening tests every 12 months and a single screening for hepatitis B virus (HBV).
The CMS announcement included PrEP on-demand scheduling (around the time of sex) and PrEP used to prevent HIV during injection drug use. The three PrEP medications currently on the market are the oral medications Descovy and Truvada and the long-acting injectable Apretude, taken as one injection every two months.
The document also acknowledges potential problems with accessing PrEP from both people seeking to take it as well as healthcare providers. These challenges include a lack of knowledge of its availability (especially among primary care providers), misperceptions around the potential for HIV acquisition, distrust of providers and stigma.
GO TO https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&ncaid=310.
Updated U.S. statistics on HIV testing, prevention and treatment in MSM
The 2023 update on HIV testing, treatment and prevention with PrEP in men who have sex with men (MSM) was released in September by the U.S. Centers for Disease Control and Prevention (CDC). The update came from the CDC’s National HIV Behavioral Surveillance (NHBS) research.
Between 2017 and 2023:
- HIV testing within 12 months of the survey went up 1%
- Awareness of PrEP increased by 8%
- PrEP use expanded 20%
- HIV treatment went up 4%
All in all, 78% of all the gay and bisexual men surveyed reported being tested for HIV within 12 months of the survey. The surveillance report called testing “the first step toward engaging in HIV prevention or treatment services.”
A greater percentage of the men, 93%, were aware of pre-exposure prophylaxis (PrEP) for the prevention of HIV, with 45% of the men saying they had used it. But, the CDC reported, racial and ethnic disparities continued to exist in PrEP awareness and use.
“Understanding and addressing barriers to PrEP use among Black and Hispanic/Latino gay and bisexual men are needed,” the report stated.
As for HIV treatment, nearly all of the men who reported a positive status said they are currently taking antiviral medication (96%).
To read HIV Infection Risk, Prevention and Testing Behaviors Among Men Who Have Sex with Men, National HIV Behavioral Surveillance 19 U.S. Cities, 2023, GO TO cdc.gov/hiv-data/nhbs/index.html. Other surveillance reports conducted by NHBS include people who are “heterosexually active.”
Zimbabwean journalist joins AVAC’s advocacy
Health journalist and gender rights advocate Anna Miti has joined AVAC’s The Choice Agenda (TCA) as its new co-moderator.
“Based in Harare, Zimbabwe, Anna is a seasoned journalist, advocate for gender equality, an AVAC Cure Fellow, former AVAC Advocacy Fellow and co-convener of the Zimbabwe Media Science Cafe, who brings her passion for amplifying community voices to this role,” AVAC announced in September.
The U.S.-based HIV prevention advocacy group started TCA in 2022 as “a global forum for advocacy on the latest in HIV prevention. With monthly webinars hosting informed discussions and a moderated listserv of nearly 3,000 subscribers from 40+ countries, TCA offers the HIV prevention community a platform to come together, learn from one another and chart the way forward.”
“As a long-time member of the TCA, I have valued it as a place for robust discussions and a vital platform to access new, timely and relevant information,” Miti said. “I am excited to now contribute to this platform as co-moderator. Together with other advocates, I aim to strengthen the TCA’s impact and contribute even more to HIV and science advocacy.”
She joins co-moderator Jim Pickett, of the U.S., who like her is a journalist. Pickett is a longtime advocate for HIV microbicides.
GO TO avac.org/project/choice-agenda.
Proposal to expand HIV-positive transplants outside of research
A proposed rule change would affect the transplantation of kidneys and livers from donors living with HIV to recipients who are also living with HIV. The U.S. Department of Health and Human Services is proposing to lift the requirement that such transplants only be done in a clinical research environment and under an institutional review board. Instead, transplantation of a kidney or liver from an HIV-positive donor would be allowed for people living with HIV who are not involved in research. The proposed change to the HOPE Act (HIV Organ Policy Equity Act), issued September 12 in the Federal Register, was based on a favorable review of transplants involving HIV that was conducted by the Organ Procurement and Transplantation Network (OPTN).
Wellness Chronicles: short videos focus on health for Black women and girls
You can gain a world of wisdom in less than five minutes from a new short video series, the Wellness Chronicles. Community-based experts discuss the needs of Black women and specific girls in matters related to sexual health, STIs and HIV.
In the first video, dropped November 1, Robbin Alexander of Sinai Hospital of Baltimore offers the insight she’s gained and the knowledge she’s learned from three decades of work as a case manager and community health worker. Alexander calls the increasing numbers of HIV cases in Black women “a crisis fueled by a lack of education, fear, judgment and stigma.”
“This causes many women to hesitate in getting tested, returning for their results, or disclosing their status,” she explains. “Misconceptions and stereotypes about HIV continue to persist… And there are many misconceptions.
“Misconception number one is that HIV only affects men. HIV can affect anyone and everyone.
“Misconception two: only people who use drugs get HIV. HIV can spread through many ways…
“Misconception three, that HIV is a death sentence. With the right treatment, people living with HIV can live long and healthy.”
Alexander lists several steps that can be taken to help women, calling them “strategies we can use to reduce the stigma and empower Black women.”
“Educate and advocate,” she says. “We must educate ourselves and our communities about HIV by participating in training programs, keeping up with the latest prevention and treatment and sharing what we learn with others. Also, provide support. Create spaces for women to share their experiences without judgment, to foster genuine connection and healing. It’s very important. We must do something like formalize support groups and something more casual than just organized by friends and colleagues, being able to support and talk to each other. Also, promote an open dialog. Invite women with lived experiences to share with other women in their communities. Share their insights and their experiences. That will inspire action and engage with the community. Influences—involve trustworthy health organizations, faith leaders and advocates to speak openly about HIV and help normalize the conversation, to reduce stigma.
“Together, we can change the narrative,” Alexander said in her conclusion. “Let's commit to breaking the silence and building supportive environments for all women.”
The Wellness Chronicles was created through the Empower program of the non-profit organization HealthHIV in collaboration with Howard University, an HBCU (historically Black college and university).
“Racism, poverty and lack of access to quality care significantly impact Black women's health,” HealthHIV writes about the Empower project. “Higher rates of sexually transmitted infections (STls), lower rates of testing and higher rates of stigma continue to make Black women vulnerable to poorer health outcomes, including acquisition of HIV or STIs. As a traditionally marginalized group, and for many multi-layered reasons, educational and engagement opportunities and health data for and by Black women is limited.”
Calling Howard University “a champion of Black women,” HealthHIV said the collaboration will “conduct research, provide education, spark community engagement and embrace the arts to create a path to empowerment for Black women.”
GO TO healthhiv.org.
To view the first video, GO TO bit.ly/4fTOvEJ. Episode 2 discusses STI awareness. Episode 3 reviews prenatal strategies to prevent HIV and syphilis.
New HIV cases drop in San Francisco
There’s good news from San Francisco: new cases of HIV in the city dropped by 20% from 2022 to 2023. That was a decrease from 167 new cases last year to 133 this year.
For Latine individuals the decrease was even greater, 46% (from 74 new cases in 2022 to 40 in 2023).
The San Francisco Department of Public Health (SFDPH) released its 2023 HIV Epidemiology Annual Report in September. SFDPH reported that the city has experienced a 59% decrease in new HIV cases since 2014, compared to a 3% decrease nationally.
Moreover, 95% of people diagnosed in 2023 were linked to care within a month. Of the people diagnosed in the first nine months of 2024, 80% reached undetectable viral load within six months.
The news for individuals without stable housing was not as good, however. SFDPH reported that these individuals “comprise an elevated proportion of new diagnoses each year, accounting for 23% of 2023 diagnoses” and “only two-thirds [66%] were virally suppressed in 2023.”
Additionally, SFDPH said that while people living with HIV continue to live longer, drug overdoses accounted for 19% of their deaths between 2019 and 2022.
Overall, San Francisco had 15,543 individuals living with HIV last year.
The department has opened what it calls Health Access Points (HAPs) in collaboration with community partners to provide easier access to prevention, care and treatment. The newest HAP, The Lobby, prioritizes people who are unstably housed or who use recreational drugs. It is located on the first floor of building 80 (UCSF’s Ward 86 clinic).
Other HAP locations include the Latino Wellness Center, Trans Thrive, LYRIC drop-in center, 1930 Market Street and 470 Castro Street. GO TO sf.gov.
SFDPH also noted that the “renowned San Francisco City Clinic provides comprehensive prevention and care HIV services with bilingual staff.”
According to the annual report, the use of HIV prevention medication (PrEP, pre-exposure prophylaxis) increased for all ethnic and racial groups of men who have sex with men (MSM), from 22–27% in 2015 to 71–78% by 2023.
“To ultimately succeed in our fight against HIV, it is critical for people to know and understand the many services that are available to them, and that services continue to evolve and improve, which cannot be done without continued planning and coordination with community, academic and health system partners,” said Susan Philip, MD, MPH, health officer for the City and County of San Francisco and director of the Population Health Division for SFDPH, in a press release.
“This report gives us many reasons to be encouraged and shows that our efforts are making a difference,” said SFDPH director of health Grant Colfax, MD. “Incredible advancements have been made in HIV prevention and care, and we must continue to make sure that communities across San Francisco have access to high-quality, culturally competent services so that this report is part of a sustained trend that marches us towards a day when there will be no new HIV infections.”
According to the report 11% of the people living with HIV in California live in San Francisco.
READ the report: sf.gov/resource/2024/hiv-epidemiology-unit-reports.
Latino HIV summit hosted by ONAP director Francisco Ruiz at the White House
Appointed in May by President Joseph Biden as director of the White House Office of National AIDS Policy (ONAP), longtime HIV advocate Francisco Ruiz came with a background in national outreach work, which Ruiz used to quickly mobilize a community summit that took place in September.
Writing for HIV.gov, Ruiz said, “The ¡Adelante! Summit seeks to unite leaders from across the federal government, civic and social organizations, the private sector, the arts and entertainment industries, healthcare professionals and communities throughout the nation. The intention of the convening is to raise greater awareness of HIV among Latinos and foster multidisciplinary collaboration, coordination and commitment to strengthen efforts addressing the HIV epidemic in Latino communities through a comprehensive and holistic approach.
“The health inequities within Latino communities remind us of the urgent work that still lies ahead, particularly in our efforts to address HIV in this country,” Ruiz continued. “This Summit is intended to galvanize new and existing partners in this vital work, engaging everyone to do their part to drive progress forward.”
Ruiz noted that as a group, Latino gay men represent the highest number of new HIV cases in the country, according to the most recent surveillance reports from the Centers for Disease Control and Prevention (CDC). “Other data indicate suboptimal rates of knowledge of HIV status, linkage to HIV care and viral suppression, as well as high rates of HIV stigma among Latinos,” he added.
GO TO hiv.gov/blog/white-house-to-convene-summit-on-response-to-hiv-in-latino-communities.
TO VIEW a brief interview with Ruiz about the summit, with Miguel Gomez of HIV.gov’s YouTube channel, GO TO youtube.com/watch?v=pR1HMJVDmUg. (In the video, Ruiz rocks a great mariachi look.)
Before heading up ONAP, Ruiz spent a decade at the CDC as the senior advisor for Program Innovation and Coordination within the Division of HIV Prevention. Previously, he worked at NASTAD (National Alliance of State and Territorial AIDS Directors), coordinating with public health departments to address HIV among groups most affected, specifically Black, Latine and LGBTQ+ communities.
ONAP was first established in 1994 by President Bill Clinton. The office was shuttered in 2021 during the Trump administration. Ruiz succeeds Harold J. Phillips, who was appointed director when President Biden reopened ONAP.
A profile of Ruiz by Mathew Rodriguez was published September in POZ magazine, AVAILABLE in English (poz.com/article/power-story-told and Spanish (poz.com/article/el-poder-de-una-historia-bien-contada-francisco-ruiz).
Una cumbre sobre la respuesta al VIH en las comunidades Latinas de La Casa Blanca
En respuesta a los datos preocupantes sobre los diagnósticos de VIH entre las comunidades latinas en los Estados Unidos, la Oficina de Política Nacional sobre el SIDA (ONAP, por sus siglas en inglés) de la Casa Blanca [hizo] un llamado a participar en la Cumbre ¡Adelante!: una convocatoria de la Casa Blanca para acelerar la respuesta nacional al VIH en las comunidades latinas. Para garantizar una amplia participación, la ONAP ofrece una opcion virtual para las partes clave de la cumbre el 23 de septiembre de 2024.
Esta reunión llega en un momento crucial. Si bien los latinos representan aproximadamente el 19% de la población de EE. UU., representaron casi un tercio de todos los nuevos diagnósticos de VIH en 2022.
En particular, los hombres homosexuales latinos ahora representan el número más alto de nuevos casos de VIH en el país, según los informes de vigilancia más recientes de los Centros para el Control y la Prevención de Enfermedades (CDC, por su sigla en inglés) de EE. UU. Otros datos indican tasas subóptimas de conocimiento sobre el estado del VIH, la vinculación con la atención del VIH y la supresión viral, así como tasas elevadas con respecto al estigma del VIH entre los latinos.
La Cumbre ¡Adelante! busca unir a líderes de todo el gobierno federal, organizaciones cívicas y sociales, el sector privado, las industrias de las artes y el entretenimiento, profesionales de la salud y comunidades de todo el país. La intención de la convocatoria es crear una mayor conciencia sobre el VIH entre la población latina y fomentar la colaboración, la coordinación y el compromiso multidisciplinario para fortalecer los esfuerzos para abordar la epidemia del VIH en las comunidades latinas a través de un enfoque integral y holístico.
Las inequidades en salud dentro de las comunidades latinas nos recuerdan el trabajo urgente que aún queda por hacer, particularmente en nuestros esfuerzos para abordar el VIH en este país. El objetivo de esta cumbre es movilizar a los socios nuevos y a los ya existentes en esta labor vital, comprometiendo a todos a poner de su parte para impulsar el progreso.
AGRADECIMIENTO ESPECIAL al fuente de contenido: Francisco Ruiz, MS, director de la Oficina de Política Nacional sobre el SIDA de la Casa Blanca. Un perfil de Ruiz por Mathew Rodríguez fue publicado en septiembre en la revista POZ, disponible en español (poz.com/article/el-poder-de-una-historia-bien-contada-francisco-ruiz) y inglés (poz.com/article/power-story-told).
NATIONAL LATINX AIDS AWARENESS DAY 2024
Start Treatment. Stick to It. Get Better.
This year’s National Latinx AIDS Awareness Day (NLAAD), October 15, focused on health care for living with HIV. This includes dealing with challenges to good health, such as stigma. This year’s theme was Start Treatment. Stick to It. Get Better.
“NLAAD is an opportunity to help address the disproportionate impact of HIV in Hispanic/Latinx communities, promote HIV testing and stop HIV stigma,” noted HIV.gov. GO TO hiv.gov/events/awareness-days/latino.
This year is the 21st anniversary of NLAAD, which was first launched in 2003 by the Hispanic Federation and the Latino Commission on AIDS (LCOA). Today, LCOA continues to coordinate NLAAD efforts and events across the country.
“In 2024, NLAAD wants to focus on HIV treatment and address HIV stigma,” said LCOA in a press statement. “Not only do we want the community to have a better knowledge of the options available to treat HIV and to have a healthy life, reaching undetectable levels of viral load, but also bring attention to the obstacles that the Latinx community must confront to access treatment, which includes among several factors HIV stigma. This year’s campaign is directed at the entire community but focused on people who live with HIV. The campaign urges them to choose one of the many treatment options to maintain their health, reach undetectable viral load and not pass the virus to others (treatment as prevention).”
LCOA reported statistics from the Centers for Disease Control and Prevention (CDC) showing that in 2022, Hispanic/Latinx people made up 32% of the 37,891 new HIV diagnoses in the country and dependent areas, though they represent only 19% of the U.S. population. The agency highlighted the need to focus particularly on young gay men and individuals living in the South, who made up more than half of the new HIV diagnoses that year.
“Southern states continue to confront rising HIV diagnoses and alarming social stigma, and discrimination faced by our most vulnerable communities,” said Judith Montenegro, director of LCOA’s Latinos in the South initiative. “NLAAD is an opportunity for all of us to bring visibility to the resources available in our communities for testing, prevention and care.”
GO TO nlaad.org and latinoaids.org.
EL DÍA NACIONAL LATINO DE CONCIENTIZACIÓN SOBRE EL SIDA 2024
Empieza tu Tratamiento. Mantenlo. Vive Mejor.
El 15 de octubre es el Día Nacional Latino de Concientización sobre el SIDA (NLAAD por sus siglas en inglés). NLAAD promueve las pruebas diagnósticas, la prevención y el tratamiento del VIH dentro de diversas comunidades para abordar los desafíos de salud que enfrenta la comunidad hispana/latina. La campaña de NLAAD 2024 reúne a comunidades, proveedores de servicios y organizaciones que brindan servicios a hispanos/latinos en todo Estados Unidos y territorios bajo un lema: “Empieza tu Tratamiento. Mantenlo. Vive Mejor”.
NLAAD fue observado por primera vez en 2003 por la Comisión Latina sobre el SIDA y la Federación Hispana. El año pasado, en 2023, NLAAD cumplió 20 años y se centró en las diferentes medidas para prevenir el VIH haciendo posible que la población viva y disfrute de la vida con menos preocupaciones.
En 2024, NLAAD quiere centrarse en el tratamiento del VIH. No solo queremos que la comunidad tenga un mejor conocimiento de las opciones disponibles para tratar el VIH y tener una vida saludable, alcanzando niveles indetectables de carga viral, sino también llamar la atención sobre los obstáculos que debe enfrentar la comunidad latina para acceder al tratamiento, lo que incluye entre varios factores, el estigma del VIH. La campaña de este año está dirigida a toda la comunidad, pero se centra en las personas que viven con el VIH. La campaña les insta a elegir una de las muchas opciones de tratamiento para mantener su salud, alcanzar una carga viral indetectable y no transmitir el virus a otras personas (Tratamiento como Prevención).
Según los Centros para el Control y la Prevención de Enfermedades (CDC), las personas hispanas/latinas representaron el 32% de los 37,891 nuevos diagnósticos de VIH en los Estados Unidos y áreas dependientes en 2022, a pesar de representar solo el 19% de la población estadounidense. Este porcentaje aumenta continuamente año tras año. Es necesario abordar el estigma, las barreras lingüísticas y las barreras a la atención médica que contribuyen a la epidemia del VIH entre las personas hispanas/latinas, particularmente entre los jóvenes homosexuales y la región sur de nuestro país, que representó más del 50% de los nuevos casos.
“Los estados del sur continúan enfrentando un aumento en los diagnósticos de VIH y un alarmante estigma social y discriminación que enfrentan nuestras comunidades más vulnerables. NLAAD es una oportunidad para que todos nosotros demos visibilidad a los recursos disponibles en nuestras comunidades para la realización de pruebas, la prevención y la atención clínica”, declaró Judith Montenegro, directora de Latinos en el Sur, un projecto de la Comisión.
“Para nuestra 22ª campaña NLAAD, notamos que existe aún una gran necesidad de continuar promoviendo las pruebas de diagnóstico, la prevención y el tratamiento del VIH entre nuestra comunidad, y una mayor necesidad de educar a la población sobre los recursos con los que contamos en estos días para prevenir y tratar el VIH, junto con educar a nuestros funcionarios electos sobre las disparidades que enfrenta nuestra comunidad latina para acceder a las pruebas, prevención y tratamiento del VIH”, dijo Luis Mares, director de Movilización Comunitaria de la Comisión. “Hay un largo camino por recorrer hasta llegar al final de esta epidemia”.
VISITE A nlaad.org/es y latinoaids.org.
AGRADECIMIENTO ESPECIAL al la Comisión Latina sobre el SIDA por este artículo.