HIV Treatment Helps Prevent HIV Transmission

Great news from the most recent data of The Partners Study that looked at rates of HIV transmission between couples where one partner is living with HIV and the other is not.

This study has shown that when a HIV positive person is on treatment that suppresses the HIV virus to a “non detectable level”, that is < 200 copies of virus per ml of blood, there have been no cases of HIV transmission.

This demonstrates that HIV treatment not only offers great health benefits for people living with HIV but also helps reassure that even if sex happens without condoms the HIV virus is not able to be transmitted.

To me this demonstrates a few key points:

  • HIV transmission is most likely occurring in people who have not yet had access treatment. This may be because they are not aware of their HIV status due to recent infection or they not have been tested in some time. All sexually active people should have a full sexual health screening every year.
  • I hope this data will help reduce discrimination against people living with HIV. People who are able to access treatment are taking a strong role in control of their own health but also have a vital role when it comes to our goal of zero new HIV cases by 2020.

Bottom Line From The Partners Study:

Key Points
Question: What is the risk of HIV transmission though condomless sex from an HIV-positive person taking suppressive ART?

Findings: In this observational study in HIV-serodifferent heterosexual and MSM couples having ongoing condomless sex over 1238 couple-years of follow-up, there were no cases of within-couple HIV transmission (upper 95% confidence limit of 0.30/100 couple-years of follow-up).

PrEP For HIV Prevention

Great Video On PrEP With Dr Raphael Landovitz

It’s always great to see when a doctor is clearly enthusiastic and motivated about a topic. In this video Dr Raphael Landovitz is clearly a wonderful PrEP advocate.

I love how he not only covers “the PrEP Standards” i.e. risks, side effects and risk reduction, but he goes further. He tackles the more difficult topics such as addressing heterosexual HIV risk, condom fatigue and the endemic slut shaming that occurs not only by “community” groups but even worse, doctors.

I urge you to take this message to heart. Talk to people about this amazing technology that is reducing HIV risk. Don’t let the silence continue.

Have you considered PrEP as part of your HIV prevention toolkit?

Dr George

PrEP For HIV prevention

Great PrEP Video

PrEP For HIV prevention

PrEP medication for HIV prevention

Hey there Guys, Just wanted to share this video from the Victorian AIDS Council explaining PrEP or “pre exposure prophylaxis”, a daily tablet taken to help prevent HIV infection.

Currently Melbourne is preparing for a greatly increased study on PrEP and has 2,700 spaces available for any person who might be a high risk of contracting HIV.

Some high risk situations may include:

  • partners who are currently living with HIV
  • inconsistent use of condoms for anal sex
  • diagnosis of a sexually transmitted infection in the recent 3 months (in particular rectal gonorrhoea, chlamydia or syphilis)

If you feel PrEP may be a useful tool for you to help stay HIV negative you can pre-register for the PrEPx Trial here: PrEPx Study Interest Register

Dr George Forgan-Smith

You Are In Control Of Your HIV Status

Hey there Guys (and Gals). Today I was witness to a thread on Facebook where a “warm” discussion (I don’t think it was quite heated) discussion evolved around HIV disclosure as well as responsibilities around disclosure when it comes to sex and a person’s HIV status.

The following video is a distillation of my thoughts on this thread and matter.

You are in control for your HIV status.

I suppose my main points are:

  • In almost all cases you have 100% control of your ability to not become infected with HIV.
  • One third of people living with HIV don’t actually know they have been infected.
  • Whether a person tells you their HIV status, negative or positive, this information should not sway your decision on how *you* plan on controlling your HIV risk.
  • Sero-sorting, the choosing of sexual partners based on their status, does not work as noted above: 1/3 of people infected with HIV are unaware of their status.

Guys we are all able to control our HIV risk profile whether that be via choosing low risk sexual acts, use of barrier methods like condoms or medical methods of HIV prevention like PrEP.

Sex is great, sex is wonderful, sex can be free of worry about HIV no matter the status of our sexual partners.

Please, I urge you, don’t discriminate. Instead, get educated with a good understanding of how you can control your own sexual health.

Dr George Forgan-Smith

Should Your Full Name Be In A HIV Register?

As reported in the Star Observer, the NSW Health Department Australia is looking to change the way that people who have recently had a positive HIV test have their information reported to the health department.

In the past a coding system was used to “de-identify” the person so if  a lay person was to access the data they would not be able to work out who the individuals are.

Changes are being made to change this so a person’s full name would be used in the register to make epidemiologist data collection an easier task.

Sadly many people living with HIV are already living with discrimination as a result of this infection. I have personally seen many patients who are too fearful to have HIV testing done for fear of their name being added to any sort of register.

HIV stigma is real. There are people genuinely fearful of loss of privacy of an already stigmatized diagnosis. Some people would rather not get tested if it means they won’t be put on a register.

Having a person’s full name on a government record is creating a barrier to people getting tested. Without testing in a safe and confidential manner we are not able to help people seek the highly effective treatments available for HIV.

If you are living in HIV I strongly urge you to talk with your local member about the importance of privacy in all medical data. Not just HIV.

I urge you to submit your thoughts via post or email here:

Health Protection NSW, NSW Ministry of Health
Locked Bag No. 961
North Sydney NSW 2059
Email: [email protected]

Yours in good health.

Dr George Forgan-Smith

 

NHS Blocks PrEP Funding in UK

It is sad news today to read via the BBC that the UK’s national health scheme, the NHS, has blocked the funding of HIV prevention drug Truvada also know as PrEP.

NHS England has reiterated it will not fund a “game-changer” drug treatment that can prevent HIV, angering HIV charities which had been campaigning to reverse the decision.

The NHS is standing firm and says it has no responsibility to provide the treatment, known as Prep…

Ian Green, chief executive of the Terrence Higgins Trust, said: “Today is a shameful day for HIV prevention.

“This country used to lead the way in the fight against the HIV epidemic, but today, our national health service has washed its hands of one of the most stunning breakthroughs we’ve seen – a pill which, if taken correctly, is almost 100% effective in preventing HIV. A pill which is already available in America, Canada, France, Kenya and soon to be Australia.

Thankfully for Australian’s PrEP has been approved for HIV prevention and there are a number of studies that are happening in Victoria, New South Wales as well as Queensland:

VIC: PrEPx Study
NSW: The EPIC Study
QLD: QPrEP Study

If you are outside these states or not eligable for the studies but still wish to learn more about HIV prevetion with Truvada you can learn more here:

For my friends in the UK, I urge you to keep the political pressure on. Help bring HIV prevention to all people of the UK that would benefit.

Dr George Forgan-Smith

New Zealand Opens to PrEP

For many years the only option for preventing HIV infections had been condoms. As noted in the video with only 80% of people using condoms there needs to be way to help protect those who are not able to reliably use condoms with each sexual encounter.

PrEP is a fantastic new technology that separates the prevention activity with sexual activity. When taken daily Truvada, the drug used as PrEP HIV prevention can reduce risk of HIV infection by up to 98%.

I also appreciate the note of the importance of getting HIV testing. Currently in Australia approximately 1/3 of people living with HIV are yet to be tested to learn of their infection.

Early diagnosis enables treatment which greatly improves the health outcomes as well as reducing the pool of HIV virus in the community as a whole.

An excellent video on the key strategies New Zealand has adopted to help stop HIV infections.

A Quick guide to PrEP for HIV Prevention

This is a great video that shows you the basics of use of Truvada or PrEP to help prevent HIV infection.

Remember that PrEP is an important tool to helping reduce HIV within out community and it’s important if you feel you may be at risk of HIV infection to talk with your doctor to see if Truvada is a good choice for you.

Ideal candidates for PrEP include:

  • People in serodiscordant relationships: Ie One partner is HIV positive, the other is HIV negative.
  • People who find they are unable to reliably use condoms during sex
  • Person’s who have been diagnosed with any sexually transmitted infection in the past 6 months.

Before starting PrEP it’s vital your doctor has organised testing to make sure it’s safe for you to start. These tests include:

  • HIV and other STI testing
  • Kidney function
  • Checking for Hepatitis infection

If you are looking for a doctor in Melbourne who prescribes PrEP I’d be more than happy to talk you thought the process. I can be contacted here: Contact Dr George Forgan-Smith

Truvada for PrEP Shows To Be Less Dangerous Than Daily Aspirin

A study published in the Oxford journal of Medicine shows that Truvada, the medication used for PrEP HIV infection prevention is much safer than originally thought:

We conclude that FTC-TDF for PrEP for HIV infection favorably compares to aspirin in terms of user safety. While long-term studies are needed, providers should feel reassured about the safety of short- and medium-term PrEP for HIV infection with FTC-TDF.

Translation? Truvada, the combination tablet of Tenofovir and Emtricitabine has a better risk and side effect profile than aspirin a tablet used daily in the prevention of heart disease.

This is a good news for people who are concerned about the side effects of PrEP such as kidney issues or bone density issues.

Dr George

How PrEP Is Changing The Sexual Landscape

In an interesting article on the impact PrEP has on HIV positive community and how it’s removing fear from the table.

There’s no doubt PrEP is changing the landscape of how we hookup, love or fuck as people living with HIV. Some people have said for the first time PrEP takes the anxiety out of sex. With PrEP they’ve discovered a sexual freedom they’ve not experienced ever in their life.

Sex has multiple dimensions including intimacy, pleasure, spontaneity and adventure. Experiencing these dimensions becomes much less likely if we are fearful or anxious about either transmitting HIV or acquiring it. The removal of fear and feeling safe when having sex with a partner on PrEP gives a new sense of sexual liberation and freedom that many HIV positive and negative people have never known.

We know that treatment as prevention works and we know that PrEP works when taken as prescribed. As this understanding becomes more widely appreciated in Australia, it will change the way we community, relate to one another, have sex and form relationships. We hope that PrEP will start to break down and dismantle the HIV-poz/neg divide, which will be a quantum shift in our psyche and lived realities.

We’re moving to a new and exciting paradigm. One where we have the chance to form stronger and more satisfying sexual and emotional relationships without the fear and anxiety of HIV. In this new environment, we have the potential to embrace renewed conversations to explore our options openly and honestly with our sexual partners. And that’s a game changer for HIV poz and negative people.