Donald Trump’s victory in the U.S. presidential election this week has left many lesbian, gay, bisexual and transgender (LGBT) advocates fearing a backlash against their community.
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An experimental HIV vaccine from Johnson & Johnson combined with an immune system booster from Gilead Sciences Inc showed promise at keeping the virus at bay in monkeys even after treatments had stopped, marking yet another step towards the development of a so-called functional cure for HIV.
This July the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) at UCLA) hosted a conference on Alcohol and the Elimination of HIV in Durban, South Africa. While attending the conference with my mother, I was also able to visit several research projects in both rural and urban sites in South Africa at which studies were being conducted to improve outcomes for people living with HIV. I was able to learn about this HIV and substance use issue and how these problems are being addressed locally and worldwide.
Our first destination was Mthatha, a rural town in the country’s Eastern Cape. We met with representatives from the Philani Maternal, Child Health and Nutrition Project based in Mthatha. Philani strives to improve community and family health, especially in poor, rural areas. The organization’s Mentor Mother Program focus is guiding local mothers through healthy pregnancies, HIV prevention, and rehabilitation of underweight babies by designating South African female volunteers to help these women. 
We toured Zithulele Hospital, a 147-bed district hospital located in the Eastern Cape. I met with the Medical Director, Ingrid le Roux, who provided us with a tour of the facility. In addition to helping maintain affordable, local health care in the cape, Philani Mentor Mothers are trained at Zithulele.
I also volunteered at children’s play groups, a program organized by Philani to allow parents to work during the day while their children are being cared for. I noticed how competent these young children were with English words and phrases, but also observed that many of the children suffered from stunted growth, probably due to unsanitary conditions or malnutrition.
Next, we flew to Cape Town, where I was able to meet Mentor Mothers in person at a Philani Center and Nursery School and hear their firsthand experiences battling HIV, among other health issues, in the homes of disadvantaged women. Hearing these stories was a powerful reminder of the dramatically different issues faced by families in third-world countries, in comparison to those in the United States. We subsequently connected with Philani representatives as well as researchers and data collectors from Stellenbosch University in South Africa to learn about their interactions with HIV and its links with alcohol.
The trip culminated in the conference in Durban, South Africa, on alcohol as an obstacle to HIV prevention. The first of three conferences, this meeting provided a space for HIV researchers from all over the world to come together for the common cause of alcohol-related HIV analysis.
According to CHIPTS, “one of the main outcomes of the conference will be the publication of a set of research priorities in alcohol-related HIV research.” With this first conference behind them, these researchers hope to set the stage for future work related to the interaction between alcohol and the HIV virus.
Co-Sponsored by Los Angeles LGBT Center and APLA Health, AB 2640
Ensures HIV-Negative Individuals Receive Information about PrEP and PEP
During HIV Post-Test Counseling
Landmark legislation to boost awareness of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) to prevent HIV infection was signed into law today by California Gov. Jerry Brown, becoming the first statewide legislation of its kind.
Co-sponsored by the Los Angeles LGBT Center and APLA Health and introduced by Assemblymember Mike A. Gipson (D-Carson), AB 2640 will ensure high-risk HIV-negative individuals receive information about methods that reduce the risk of contracting HIV, including PrEP and PEP, during HIV post-test counseling.
“We are extremely pleased that Governor Brown has signed this bill into law,” APLA Health Chief Executive Officer Craig E. Thompson said. “This is one of several proposals the governor has supported to increase information about and the availability of PrEP and PEP, and we thank him for his continued leadership on this issue. AB 2640 is a crucial step toward raising awareness about effective HIV prevention tools, reducing new infections, and ending the epidemic in California.”
PrEP is an HIV prevention strategy in which HIV-negative individuals take a daily medication to reduce their risk of becoming infected. PrEP has been shown to be up to 99% effective at preventing HIV transmission. PEP involves taking anti-HIV medications as soon as possible after a potential exposure to reduce the risk of becoming HIV-positive. According to a 2015 survey of gay and bisexual men by the California HIV/AIDS Research Program, only 1 in 10 respondents had ever used PrEP and nearly 85% had never talked to their doctor about PrEP.
“With the stroke of his pen, Governor Brown has played a significant and groundbreaking role in helping to fight HIV in the state that ranks second in the nation in cumulative AIDS cases,” Los Angeles LGBT Center Medical Director Dr. Robert Bolan said. “Those most at risk of HIV infection deserve to know about all the options to stay negative, including PrEP and PEP. By signing AB 2640, Governor Brown is helping to promote options that have the potential to change the course of the epidemic in California and significantly reduce the HIV infection rate here.”
The West Hollywood City Council recently voted to require that the city’s contracted providers of HIV testing provide information about PrEP during pre- and/or post-test counseling. However, there is currently no statewide requirement to provide information about any HIV prevention methods, including PrEP and PEP, during HIV post-test counseling.
“It is estimated that 1 in 2 Black gay men and 1 in 4 Latino gay men will be diagnosed with HIV in their lifetime if infection rates continue to rise. This is unconscionable. Women of color and transgender individuals are also among the groups at greatest risk for HIV,” Assemblymember Gipson said. “We now have effective tools like PrEP and PEP that can help end the HIV epidemic, but that won’t happen unless people know about them. With the signing of AB 2640, we are now doing more to make sure that people know about the tools available to protect themselves.”
In India, it is estimated two million lorry drivers regularly use prostitutes – but barely 10% of them are using condoms. Health officials say there is a strong correlation between HIV infections and the routes used by truckers.
Certain bacteria put some women at greater risk of infection and make treatment less effective
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FOR IMMEDIATE RELEASE
August 3, 2016
PH16-045
Meningococcal Disease Outbreak Continues in Southern California
Vaccinations Urged for Gay, Bisexual Men, HIV-Infected Persons
SACRAMENTO – Due to an ongoing outbreak of meningococcal disease in Southern California, the California Department of Public Health (CDPH) is urging all gay and bisexual men and HIV-infected persons in Los Angeles, Orange and San Diego counties be vaccinated against meningococcal disease.
Since March, 22 cases of meningococcal disease have been confirmed in an outbreak in Los Angeles and Orange Counties, including several cases in the past week. Two other cases are currently under investigation. To date, two patients have died as a result of their infections. Most of the patients have been gay or bisexual men, and while no cases have been reported in San Diego County, health officials are advising gay and bisexual men there to also be vaccinated.
Meningococcal disease is a serious bacterial infection that can cause meningitis and bloodstream infections (sepsis). Although rare, meningococcal disease is very serious and potentially fatal.
“Vaccination is the best protection against meningococcal disease,” said CDPH Director and State Public Health Officer Dr. Karen Smith. “It is important that all gay and bisexual men and people living with HIV in the affected counties take action to protect themselves to reduce their risk.”
All gay and bisexual men and HIV-infected persons in Los Angeles, Orange and San Diego Counties are recommended to receive MenACWY vaccine. HIV-infected persons should receive two doses of the vaccine and uninfected men should receive one dose. Those who were vaccinated more than five years ago should be revaccinated. Vaccination clinics can be located using CDC’s Adult Vaccine Finder.
Meningococcal bacteria are transmitted through close personal contact and can be spread from person to person by respiratory droplets from the nose and throat. Individuals who are in close or intimate contact with multiple people, regularly visit crowded venues such as bars and parties, or use illegal drugs, smoke cigarettes, marijuana, hookahs or spend time in smoky settings may be at increased risk of infection.
Symptoms of meningococcal disease may include fever, vomiting, severe headache, stiff neck, confusion, rash and generalized muscle pains. The time from exposure to the start of symptoms is typically just a few days. People experiencing these symptoms should seek medical care immediately.
LOS ANGELES—The Los Angeles County Department of Public Health (Public Health) is taking critical steps to expand access to biomedical prevention options for Los Angeles County residents at highest risk for HIV infection. On Tuesday, August 2, the Los Angeles County Board of Supervisors approved contracts to fund 14 Pre-Exposure Prophylaxis (PrEP) Centers of Excellence in areas with the highest rates of HIV infection.
PrEP is a once-daily medication (Truvada®) taken by persons who do not have HIV but who are at substantial risk of getting it to prevent HIV infection. When taken daily, this HIV prevention method is up to 99% effective. Despite its effectiveness and growing popularity, there remains a need to increase PrEP use nationally and in Los Angeles County in order to make significant progress in the fight against HIV.
“LA County continues to experience the second largest HIV epidemic in the country,” said LA County Supervisor Sheila Kuehl. “No single prevention program will completely curtail the spread of HIV, but expanding the use of PrEP could significantly reduce new infections. I am very glad to see our efforts go beyond the County’s own Public Health clinics, to engage our community-based health providers who can effectively reach the populations at greatest risk, including those who lack insurance.”
Financial barriers to PrEP present a barrier to access; it is cost-prohibitive for uninsured persons and many individuals with insurance still face high co-payments and deductibles. The PrEP Centers of Excellence will provide medical services related to PrEP for uninsured and underinsured patients and offer health insurance navigation and enrollment for individuals eligible for Medi-Cal and Covered California. These clinics will also offer post-exposure prophylaxis, or PEP, and refer patients with substance abuse and mental health service needs to appropriate providers.
“Public Health is excited to fund our community partners to make PrEP more accessible to low-income and uninsured Los Angeles County residents,” said Jeffrey Gunzenhauser, MD, MPH, Interim Health Officer for Los Angeles County.
Public Health-funded PrEP Centers of Excellence will be provided by these community-based partners:
- AltaMed Health Services Corporation
- Anthony Mills, MD
- APLA Health and Wellness
- Children’s Hospital Los Angeles
- JWCH Institute
- LA LGBT Center
- St. John’s Well Child and Family Center
- St. Mary’s Medical Center
- Tarzana Treatment Centers
In addition, residents can also access PrEP services at the following Public Health clinics:
- Central Health Center
- Curtis Tucker Health Center
- Dr. Ruth Temple Health Center
- North Hollywood Health Center
For more information about PrEP, please visit Public Health’s website at www.getprepla.com.
The Department of Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, Public Health oversees environmental health, disease control, and community and family health. Public Health comprises nearly 4,000 employees and has an annual budget exceeding $900 million. To learn more about the LA County Department of Public Health and the work they do, visit PublicHealth.LACounty.gov, and follow Public Health on social media at twitter.com/LAPublicHealth, facebook.com/LAPublicHealth, and youtube.com/LAPublicHealth.
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Los Angeles County Department of Public Health works to protect health, prevent disease, and promote health and well-being.