Health care experts have been informed of a US man contracting HIV despite being on PrEP. He’s thought to be the first man in California – and only the third in the US – to contract HIV while adhering to a daily PrEP regime.
PrEP is a medication that minimizes the chances of someone acquiring HIV, even if they do not use condoms.
News of the case was presented at the annual IDWeek conference in San Francisco, which concluded over the weekend. The conference is run by the Infectious Diseases Society of America.
The man was HIV negative when he began taking PrEP in San Francisco in late 2016. He continued to diagnose HIV negative when testing at three, six and ten months. Blood tests also demonstrated he continued to take his medication consistently.
HIV positive after being on PrEP for a year
After just over a year on PrEP, he received an HIV positive diagnosis in early 2018. He was immediately placed on HIV drugs and has maintained a suppressed viral load since that time.
Doctors were able to accurately diagnose the exact strain of HIV he picked up. It’s one identified with people who have taken HIV medication in the past but no longer take it. It was then revealed that the patient’s main male partner was HIV positive but no longer taking medication.
The partner was tested and found to have a high viral load of the resistant strain. He has resumed taking medication.
Researchers say it was the fact the patient came into contact with a resistant strain that led to him acquiring the virus. They believe he stuck to his PrEP regime well. They could tell this from analyzing his hair, which he happened to grow long.
Dr. Robert Grant, of the University of California San Francisco, said, ‘[The patient’s] long hair allowed us to test by centimeters, which allowed us to go back and read drug levels from six months ago.’
Previous cases of men becoming HIV positive while on PrEP
There have been five previous reports on men acquiring HIV while on Pre-Exposure Prophylaxis (PrEP). The first two occurred in Toronto and New York in 2016. In 2017, there were three more cases. One involved a man in North Carolina, one in Australia, and a fifth a man in Amsterdam.
The first four cases are believed to be due to the person on PrEP having sex with someone with a high viral load of a rare, resistant strain of HIV.
The fifth case is not believed to be linked to a drug-resistant strain of HIV. The Amsterdam man had an ‘unusually high number’ of sexual partners – averaging 50-70 a month – and several other sexual infections. Researchers have speculated he may have repeatedly exposed himself to HIV, which took a hold in his body after a slight dip in Truvada levels.
‘Greater than 99% effective’
Health experts say despite these rare cases, PrEP remains highly effective. The medication is taken by more than 350,000 people worldwide.
Dr. Grant said, ‘We know PrEP is greater than 99% effective. There are some cases where HIV will break through. We only have a handful of cases now, and next year, we’ll probably have a handful more. Fortunately, these cases are caught early, treated, and suppressed quickly. The person goes from taking one pill a day to one pill a day. The biggest difference is the stigma.’
Matthew Hodson, Chief Executive of HIV information organization NAM, agrees. 'We estimate that PrEP is more than 99% effective at preventing HIV. By comparison, a recent meta-analysis of the efficacy of condoms found that they prevented nine out of ten cases, this was a better result than previous analyses.
‘PrEP is still better than condoms at preventing HIV. PrEP failure makes the news. Condom failure doesn’t.
He said that in the UK, 93% of people diagnosed with HIV have suppressed the virus to a point where it cannot be passed on ‘in any circumstance.’ This is regardless of whether it’s a drug-resistant strain or not.
‘It’s vital to acknowledge that PrEP, just like other safer sex strategies isn’t 100% effective. It is also vital not to let isolated cases obscure how effective it is. PrEP has played a significant role in bringing down new HIV infections in London, Sydney, New York, San Francisco and other cities around the world.’
H/T: The Body Pro
Source: Hudson, David. California man on PrEP medication acquires HIV.9 October 2018. Gay Star News.
Grindr is trying to handle the negative publicity over sharing users' HIV data. The popular hookup app has announced plans to remind users to get tested for HIV and has offered free advertising to clinics and LGBT centers that provide free testing.
HIV is still considered a global epidemic, there has been a rise in sexually transmitted infections that can be tracked to the uses of PreP (pre-exposure prophylaxis), a drug taken once a day and when property used is almost 100% effective in preventing HIV transmission. Doctor's still caution patients to use condoms while on PreP, however, many gay men treat it as license to throw caution to the wind and just have bareback sex.
A stark report completed by the University of California of Los Angeles (UCLA) found a direct link between the use of PreP and a drastic increase in STI's. To make matters worse most gay men believe that STI's and HIV can be easily cured. For example, herpes cannot be treated with antibiotics, and some infections are now developing resistance to antibiotics, such as "super gonorrhea," or multidrug-resistant gonorrhea.
So if Grindr is interested in the health of the LGBT community then shouldn't they focus on STI's as a whole and not just HIV? The plain fact remains that while people will get tested for HIV and community centers many gay and bi men still define 'disease" in terms of HIV, while the STI's issue just remains in the background.
But issues with Grindr don't just stop there (along with other hook-up apps), as most of these apps pride themselves on shirtless (sometimes nude) photos men, might contribute to high rates of depression, body sysmorphia, and eating disorders to 3.6 million users (Grindr).There are a few professional studies that have been conducted to offer analysis and the effects of gay social media sites on mental health. But since most funding goes to HIV research very little finds it's way to other LGBT public issues. Grindr could in effect pressure medial professionals to study LGBT health on a broader scope.
With millions of users worldwide, Grinder has positioned itself to broaden the framework of LGBT health and address issues that might never receive attention.
SO, will Grindr step up to the plate and open honest dialog about STI's within the LGBT community or will the app just ignore it?
Three porn actors two men, and one female have claimed in a Federal law suit that they contracted HIV in 2014 while filming scenes for Kink. U.S. District Judge Dames Donato granted the insurance company a summary judgment saying a physical-sexual abuse exclusion "exempts the insurer from covering claims arising from sexual activity," according to a report in the Courthouse News. The three actors are being represented by Atain Specialty Insurance.
According to one of the actors now retired stated he was infected while filming "Bound in Public" in 2013. Another performer claims that while filming at the Armony in San Francisco, he was blindfolded and required to perform oral sex with dozens of men of the general public - "they were untested, unidentified members of the general public." He tested positive two week later. However does admit he had a cut in his mouth at the time of filming.
“The language of this exclusion is not ambiguous in the context of this policy and the circumstances of this case,” Donato wrote in his 6-page ruling. “Because the contractual language is clear and explicit, it governs.”
In a statement to Courthouse News Karen Tynan attorney for Kink.com in 2015 “None of these claims were made at the time of the shoots, and are easily refuted both by detailed shoot records, our testing protocols, and the video footage itself."
I am sure there are many points of view regarding "bareback", "risky" porn. What are your thoughts?
h/t: Courthouse News