All you need to know about HIV

[surv000]

Thanks so much for sharing!

[Big Sexy]

UN hails new therapy to prevent HIV in women
https://www.msn.com/en-us/health/med...en/ar-BB1aRIDM

The new anti-retroviral therapy cabotegravir could be a "game changer" as a study shows it is many times more effective in preventing HIV in women as PrEP, the UNAIDS body said Monday.

Injected in women every two months, cabotegravir is 89 percent more effective in preventing HIV than daily pills of PrEP, pre-exposure prophylaxis, the UNAIDS body said. "UNAIDS has long been calling for additional, acceptable and effective HIV prevention options for women, and this could be a real game-changer," its chief Winnie Byanyima said in a statement. "If donors and countries invest in rolling out access of injectable PrEP to women at higher risk of HIV, new infections could be dramatically reduced." The trial involved more than 3,200 women between 18 and 45 years old who were at higher risk of acquiring HIV, the virus that causes AIDS, in Botswana, Kenya, Malawi, South Africa, Eswatini, Uganda and Zimbabwe, UNAIDS said. It said expert monitors stopped the trial earlier than planned because there was "clear statistical evidence showing that the injectable medicine is more effective than a daily pill," the body said. It added that four women who received injections became infected with HIV, as opposed to 34 women who took the pills, with all the treatments administered in a random fashion. "The risk of HIV was ninefold lower with cabotegravir injections than with daily oral PrEP," it said. UNAIDS said the test results were important in boosting the fight against AIDS by offering women new ways to protect themselves beyond using daily pills, ensuring condoms are worn or abstaining from sex. "Like with a COVID-19 vaccine, we now must work to ensure that these life-changing injections are accessible, affordable and equitably distributed to people who choose to use them," Byanyima said.

[Big Sexy]

Trial results reveal that long-acting injectable cabotegravir as PrEP is highly effective in preventing HIV acquisition in women

https://www.who.int/news/item/09-11-...ition-in-women

9 November 2020 Departmental news Reading time: 5 min (1444 words)
The HIV Prevention Trials Network study (HPTN 084) on the safety and efficacy of the long-acting injectable antiretroviral drug cabotegravir (CAB LA), for pre-exposure prophylaxis (PrEP) in HIV-uninfected women, was stopped early by the trial Data and Safety Monitoring Board (DSMB) as results showed CAB LA to be highly effective in preventing HIV acquisition.

Study Design
The HPTN 084 enrolled 3,223 women aged 18-45 years old who were at risk for acquiring HIV infection in 20 sites across seven countries in sub-Saharan Africa (Botswana, Kenya, Malawi, South Africa, eSwatini, Uganda and Zimbabwe).

The study randomized participants to one of two arms:

Arm A – CAB LA (as an intramuscular injection every 8 weeks) and daily oral TDF/FTC placebo.
Arm B – Daily oral TDF/FTC and intramuscular CAB LA placebo every 8 weeks.
Results
Thirty-eight women in the trial acquired HIV. Four were randomised to the long-acting cabotegravir arm and 34 were randomised to the daily, oral FTC/TDF arm. This translated to an HIV incidence rate of 0.21% (95% CI 0.06% – 0.54%) in the cabotegravir group and 1.79% (95% CI 1.24%-2.51%) in the FTC/TDF group. While both methods were highly effective at preventing HIV acquisition, long-acting cabotegravir was 89% (95% CI 68-96%) more effective than FTC/TDF. These results show that CAB LA is significantly more effective in preventing HIV acquisition than oral PrEP in an intention-to-treat analysis from this trial.

CAB LA and oral FTC/TDF were both well tolerated and most adverse events were mild or moderate in severity and largely balanced between both treatment arms. Injection site reactions were low in both groups, though higher in the CAB LA arm and gastrointestinal disorders and nausea were more common in the FTC/TDF arm. There were no discontinuations due to injection site reactions or injection intolerance in either arm of the study.

Implications of the results
Women in the countries where the trial was conducted and across East and southern Africa continue to experience high HIV incidence. More effective and acceptable HIV prevention choices for women are needed. While oral PrEP is highly effective in preventing HIV in women when taken as prescribed, some women find it difficult to take a daily tablet, and inconsistent use of oral PrEP reduces the prevention effect. A long-acting injectable formulation has the potential to improve the prevention effect without relying on adherence to a daily oral PrEP regimen, and to increase prevention choices and acceptability among women.

A long-acting PrEP product could offer a better choice for women at substantial HIV risk who either do not want to take or struggle with taking a daily tablet. These results do not contradict evidence showing that consistently using oral PrEP is highly effective as has been demonstrated in several trials. However, adhering to the daily dosing schedule is important. Even short lapses in taking oral PrEP can reduce the protection from HIV acquisition.

CAB LA availability
Now that the trial in women has been stopped, the participants will be informed of the trial results and CAB LA will be made available to them. Participants who were in the FTC/TDF arm will be offered CAB LA and participants in the CAB LA arm will be able to continue to receive it. Participants who do not want to receive CAB LA will be offered FTC/TDF until the originally planned study end.

Before CAB LA becomes available to people outside the HPTN 084 study, the trial results will have to be fully reviewed and submitted to a stringent regulatory authority for approval. CAB LA and manufacturing capacity will have to be developed. There are also other safety and implementation issues that need to be considered prior to a broader roll-out. Safety studies in adolescents and among pregnant and breastfeeding women will be needed and open-label extension (OLE) studies will need to be considered to understand the most effective and acceptable implementation approaches.

Outstanding issues
CAB LA for adolescent girls
As the study participants were all aged 18 years or older, a bridging study (HPTN084/01) has started to enrol adolescent girls. This will assess safety and acceptability in 50 adolescent girls < 18 years at three sites. Additional information on delivery approaches and ways to support uptake and continuation could be gained through OLE studies.
Safety during pregnancy and breastfeeding
When information was made available in May 2018 regarding Dolutegravir (DTG), which is an integrase inhibitor in the same class of drug as cabotegravir, that there was a possible association with foetal neural tube defects (NTDs) when taken periconceptually, a protocol amendment was made requiring all women enrolled in HPTN 084 to also take long-acting reversible contraceptives. Since this safety signal was raised in May 2018, recent data has noted a decline in the risk. As of July 2020, data show a non-significant difference in risk of NTDs with DTG at conception exposure compared with other ARVs.i However, because of the protocol change very few women in HPTN 084 became pregnant while taking CAB-LA. Monitoring for adverse foetal and pregnancy outcomes will have to be done during OLEs.
Real-world implementation issues
Where and how CAB LA—which requires an injection every eight weeks—could be delivered, implementation adjustments that may be needed in HIV prevention programmes and health systems, and acceptability issues, will all need to be evaluated and considered. Other implementation assessments are planned or underway.
The pharmacokinetic tail—will this be a significant risk for drug resistance?
Injectable cabotegravir has a long half-life, which is why it provides long-acting (8 weeks) protection. It also has a long pharmacokinetic tail, meaning that there is detectable drug that remains in the body for months after an injection. These small amounts of drug may not be enough to protect against HIV infection and could result in development of drug resistant HIV following exposure during this time. It has been previously reported in the Phase II study (HPTN 077)ii that the median time to undetectable cabotegravir is longer in women at 66.3 weeks (range 17.7 to 182) when compared to 42.7 weeks (range 20.4 to 134) in men. It is not yet understood if this long pharmacokinetic tail will have any significant effect on drug resistance.
The current recommendation for the HPTN 084 trial participants who discontinue CAB LA is to take FTC/TDF to ‘cover’ this tail with an oral regimen. This may not be feasible, desired, or necessary in real-world settings. The importance of covering the tail with oral PrEP and the risk of subsequent HIV drug resistance are issues that will have to be considered and monitored carefully in future OLE studies.
A similar study (HPTN 083) in HIV-uninfected cisgender men who have sex with men and transgender women who have sex with men, was also stopped early by its DSMB in May 2020, after it also demonstrated that CAB LA was highly effective in preventing HIV acquisition in this group. Final analysis demonstrated the superiority of CAB LA compared to FTC/TDF for PrEP in the HPTN 083 study population. The results from HPTN 084 now mean that CAB-LA has been shown to be highly effective across populations.

Key messages:
It is encouraging to learn that a long-acting injectable PrEP option has been shown to be highly effective in women. CAB LA has the potential to increase choice and overcome some of the barriers related to adherence for long-term use of biomedical HIV prevention.

But, it is also important to temper expectations—there are still some important safety and implementation issues to address. It is likely to be more than a year before CAB LA will be more widely available. However, now that these results showing its effectiveness in women are available, alongside the results for men who have sex with men and transgender women, plans for regulatory approval will move forward.

Planning for open label extension studies is a priority to understand the outstanding safety issues and implementation approaches for populations who urgently need effective prevention choices.

Oral daily PrEP remains an effective prevention option for anyone at substantial HIV risk, and it has been recommended by WHO since 2015.iii WHO has developed implementation tools to support safe, effective, and acceptable implementation.iv

[Big Sexy]

220 new cases of HIV reported in Singapore between January and October
https://www.channelnewsasia.com/news...-aids-13675574


SINGAPORE: A total of 220 new HIV cases were reported among Singapore citizens and permanent residents in the first 10 months of this year, said the Ministry of Health (MOH) on Tuesday (Dec 1).

Singapore reported 323 HIV cases for the whole of 2019 and 313 the year before.

The health ministry said it analysed 125 of the new cases, which were reported between January and June.

The majority – 90 per cent – were men. Most were below 60 years old, with 42 per cent aged between 40 and 59 and 37 per cent aged between 20 and 39.

About 54 per cent had late-stage HIV when they were diagnosed, an increase from 49 per cent for the same period last year.

Sexual intercourse accounted for 96 per cent of the 125 cases. About 46 per cent were from homosexual transmission, 40 per cent from heterosexual transmission and 10 per cent from bisexual transmission.

About 58 per cent of all cases were detected by HIV tests done during medical care, said MOH. Only 15 per cent of cases were discovered through self-initiated HIV screening.

"A higher proportion of homosexuals/bisexuals (21 per cent) had their HIV infection detected via self-initiated HIV screening compared to heterosexuals (8 per cent)," said the ministry.

The ministry urged those at risk of HIV infection to go for regular tests.

HIV testing is available at polyclinics, private clinics and hospitals. It can also be done at 10 anonymous HIV test sites located across Singapore, where personal details are not required when signing up.

"Early diagnosis allows for early treatment and care, and provides the opportunity for those infected to learn about protecting their partners from infection," said MOH.

“With early and effective treatment, persons living with HIV can delay the onset of acquired immune deficiency syndrome (AIDS) for many years and continue to lead an active and productive life.”

MOH said the most effective way to prevent HIV infection was to remain faithful to one's spouse or partner, avoid casual sex and sex with sex workers.

Those who engage in high-risk sexual behaviour, such as having multiple sexual partners or engaging in casual or commercial sex, should use condoms to reduce their risk of HIV or other sexually transmitted infections, said the ministry.
Source: CNA/ad(cy)

[pipipupupi]

can normal health checkup blood test detect HIV?

[LooksLikeJesus]

Originally Posted by pipipupupi

can normal health checkup blood test detect HIV?

No, you need specific test

[Big Sexy]

u can always ask for it to be included in your annual health check.
just pay an additional fees for it.

Originally Posted by pipipupupi

can normal health checkup blood test detect HIV?

[soonbeng]

https://www.nytimes.com/2020/09/25/w...d-condoms.html

Don't buy or use any condoms from Vietnam!

[DoctorTan]

Originally Posted by soonbeng

https://www.nytimes.com/2020/09/25/w...d-condoms.html

Don't buy or use any condoms from Vietnam!

Scary stuff. Thanks for sharing

[Penguin23]

Originally Posted by soonbeng

https://www.nytimes.com/2020/09/25/w...d-condoms.html

Don't buy or use any condoms from Vietnam!

Heng ah, every time I go Vietnam I always fuck raw......phew

[licepep225]

Omg.. I didn't know such detail about HIV. Thanks everyone for sharing these articles.

[soonbeng]

https://www.thesun.co.uk/health/1934...yond-grateful/

[Muhahaha]

What is the chance % of infection if both party has unprotected sex after both tested negative after performing rapid antigen testing?

[DoctorTan]

Originally Posted by Muhahaha

What is the chance % of infection if both party has unprotected sex after both tested negative after performing rapid antigen testing?

You cannot get HIV from someone who does not have HIV

Unless what you are asking is what if the rapid antigen test is wrong.

There are many factors that influence the accuracy of rapid antigen testing. Side note: Nobody I know does just rapid antigen testing anymore. Most would do antigen + antibody testing. Anyways, the factors include:

1. When the test is done after exposure (window period)
This is particularly sensitive in rapid tests for antigen alone. Because the antigen level takes time to rise then drops after antibodies develop. So the window for testing is small.
2. Performance characteristics of the test kit
3. Whether or not the test is conducted properly

[ELancerX]

I’d like to share my experiences to help those who want to test. I’ve been feeling unwell with cough , flu, etc. for 3 weeks plus, stayed home and didn’t chiong. When I chiong, it’s always safe sex.

I went to Anteh at Geylang. Parking isn’t convenient, and there’s already a long queue before opening hours.I waited 1 hour for my turn.

There’s no need to scan any QR code (for Health declaration and contact tracing), and thr admin will ask what service you require before stepping foot into the clinic.

Requested for anonymous HIV testing, and was quoted Gen 3 ($50) and Gen 4 ($100). Paid and entered into clinic , name became a number.

Doctor gave you a survey form to fill, it’s just a gov report to know your age group , sexual orientation, etc.

She then used a disposable pin to prick index finder and placed blood on the strip. It doesn’t hurt.

After 20 mins of nerve-wreaking waiting for results, number was called and entered the room. She informed me that I’m negative and I can leave.

It cleared my doubts and it’s good money spent, especially if you chiong but fall sick easily (maybe low immune system ?)

Hope my experience can clear some stigma and promote more brothers to have safe sex and test frequently !