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3 more dead from bacterial meningitis strain

Michael Weinstein, AIDS Healthcare Foundation, gay news, Washington Blade

Michael Weinstein, executive director of the AIDS Healthcare Foundation, said the L.A. Department of Public Health was ‘insensitive’ in responding to a meningitis outbreak.

LOS ANGELES — The strain of bacterial meningitis that infected 22 gay men and killed seven in New York City starting in 2010, continues to be a small but lethal public health risk with eight more having contracted it this year in Los Angeles County. Three died and all were men who had sex with men, the Associated Press reports.

Last week, the county’s Department of Public Health urged gay men who have had HIV or multiple partners to get vaccinated against invasive meningococcal disease, the AP said.

However, the department said the three men who died didn’t have any direct contact with each other. The disease still is considered rare and sporadic and the department is shying away from declaring any outbreak in the gay community, the AP said citing authorities.

Four of the eight people who came down with the illness had sex with other men and three were HIV positive. The three who died in February and March were 27 or 28 years old and two were HIV positive, according to the department.

Of the other five people who fell ill, four are out of the hospital and one is hospitalized but recovering, the AP said.

The agency was “insensitive” for failing to announce the deaths earlier, Michael Weinstein, executive director for the AIDS Healthcare Foundation, told the Los Angeles Daily News.

About a third of the 32 bacterial meningitis cases reported in the county since October 2012 involved men who had sex with men, the Daily News reported.

That population is most at risk right now, said Dr. Robert Bolan, medical director for the Los Angeles Gay and Lesbian Center.

The county health department is “paying attention” and acting “in a timely manner” by urging vaccinations for members of the gay community, he told the newspaper.

10
Apr
2014

Truvada’s use as HIV prevention drug raises concerns

Truvada, Gilead, gay news, Washington Blade

Drug resistance to established regimens can be a major concern. (Photo courtesy of Gilead)

NEW YORK — Debate persists in the gay community over the use of Truvada, a drug hailed as a lifesaver for many with HIV, about its use and effectiveness as a prevention technique for uninfected men who have gay sex without condoms, the AP and other news outlets report.

Many doctors and activists see immense promise for such preventive use of Truvada, and are campaigning hard to raise awareness of it as a crucial step toward reducing new HIV infections, which now total about 50,000 a year in the U.S., the AP reports.

Yet others — despite mounting evidence of Truvada’s effectiveness — say such efforts are reckless, tempting some condom users to abandon that layer of protection and exposing them to an array of other sexually transmitted infections aside from HIV.

“If something comes along that’s better than condoms, I’m all for it, but Truvada is not that,” Michael Weinstein, president of the AIDS Healthcare Foundation, was quoted as having said by the AP. “Let’s be honest: It’s a party drug.”

Truvada, produced by California-based Gilead Sciences, has been around for a decade, serving as one of the key drugs used in combination with others as the basic treatment for people who have HIV. However, the drug took on a more contentious aspect in 2012 when the Food and Drug Administration approved it for pre-exposure prophylaxis, or PrEP — in other words, for use to prevent people from getting sexually transmitted HIV in the first place, the AP said.

Since then, critics have warned that many gay men won’t heed Truvada’s once-a-day regimen and complained of its high cost — roughly $13,000 a year. Truvada’s proponents say most insurance plans — including Medicaid programs — now cover prescriptions for it, and they cite studies showing that the blue pill, if taken diligently, can reduce the risk of getting HIV by more than 90 percent, the AP said.

A town hall panel discussion on PrEP is planned for April 28 from 7-9 p.m. at the GLBT Community Center of Baltimore. Visit glccb.org for details.

10
Apr
2014

Anti-gay public health director in Pasadena confronted

Eric Walsh, Pasadena, gay news, Washington Blade

Dr. Eric Walsh (Photo public domain)

PASADENA, Calif. — Dozens of gay rights advocates from the AIDS Healthcare Foundation flooded Pasadena City Council chambers Monday to express concern about recently surfaced comments made by Public Health Director Dr. Eric Walsh in religious sermons posted online according to an article by Pasadena Star News.

Six people spoke against Walsh’s statements, which condemn gays, single mothers, Muslims and popular culture, among other groups.

“As an HIV positive homosexual man, I find Dr. Walsh’s remarks frightening and extremely offensive,” AIDS Healthcare Foundation activist Joseph Jimenez was quoted as having said. “I believe Dr. Walsh is not able to provide compassionate care for patients like myself and others. I beseech all of you to consider appointing a director who has more understanding of the LGBT community.”

AIDS Healthcare Foundation President Michael Weinstein also decried Walsh’s anti-gay sentiments, saying they went against the kind of city Pasadena should strive to be.

Walsh is on paid administrative leave during an investigation into whether his religious views impacted his job performance, the Star News reports.

Links to his sermons, many of which were from before he came to Pasadena in 2010, were distributed to the media last week after Walsh was announced as the commencement speaker for Pasadena City College, the article said.

07
May
2014

Use of HIV prevention pill ‘sluggish’ in D.C. area

Truvada, Gilead, gay news, Washington Blade

Truvada (Photo courtesy of Gilead)

An official with Whitman-Walker Health, D.C.’s largest AIDS treatment and service organization, said that similar to current nationwide trends, a relatively small number of people at risk for HIV infection in the D.C. area are taking a drug approved for preventing them from contracting HIV.

Dr. Richard Elion, Whitman-Walker’s director of clinical research, told the Washington Blade that fewer than 50 Whitman-Walker clients have signed up so far for the prescription drug Truvada, a daily pill approved by the U.S. Food and Drug Administration as a pre-exposure prophylaxis, or “PrEP,” to greatly reduce the chances of becoming infected with HIV.

“So the uptake on PrEP is that the District has been sluggish at most places,” Elion said in discussing the local demand for taking Truvada as a prevention pill.

“It’s important to have a lot of educational efforts on this because this is a prevention strategy that to me has not really gotten the recognition and the press that it deserves,” he said.

Officials with at least three other local organizations that provide AIDS-related services and prevention programs targeting gay and bisexual men – Us Helping Us, SMYAL, and Metro Teen AIDS – said they, too, believe PrEP is an important new prevention strategy that should be encouraged for people deemed at high risk for HIV, especially young gay and bisexual men.

“Us Helping Us fully supports PrEP and will publicize it to our clients through meetings and social media,” said Ron Simmons, the group’s executive director. Us Helping Us reaches out to black gay and bisexual men in the D.C. area on AIDS prevention and other AIDS-related programs.

Adam Tenner, executive director of Metro Teen AIDS, and Andrew Barnett, executive director of SMYAL, each said they are encouraged over the potential PrEP has for their clients, who range in age from 13 to 21. But the two said they have yet to determine whether PrEP is appropriate for youth as young as 13 through 17.

“We are encouraged over the effectiveness of the treatment in preventing infection,” Tenner said. “But we are going to be very cautious about PrEP for adolescents. For kids 18 and older there are fewer questions,” he said.

Tenner and Barnett each said they are awaiting guidance from experts, including pediatricians, on the advisability of prescribing Truvada to people as young as 13 or 14. According to Tenner, youth of that age often are sexually active and at risk for sexually transmitted diseases, including HIV.

He said Metro Teen AIDS sponsors HIV prevention programs targeting youth in that age range but has yet to embrace PrEP for young teens without having access to more information.

The U.S. Centers for Disease Control and Prevention, which earlier this month issued new guidelines advocating the wider use of PrEP for HIV prevention, and the American Academy of Pediatrics didn’t immediately respond to an inquiry from the Blade about the advisability of PrEP for youth between 13 and 17 years old.

The Los Angeles-based AIDS Healthcare Foundation, the nation’s largest AIDS service and treatment organization, which has facilities in D.C. and Maryland, has expressed strong opposition to PrEP, saying it has the potential to discourage condom use.

Michael Weinstein, the organization’s CEO, has pointed to studies showing that large numbers of people enrolled in the studies failed to take the Truvada pill on a daily basis as prescribed, placing them at risk for HIV infection.

Weinstein told the Blade that although AIDS Healthcare Foundation opposes the widespread use of PrEP, it believes it should ultimately be up to a patient and his or her doctor as to whether to enroll in PrEP. He said his organization’s medical clinics, including the one in D.C. and Temple Hills, Md., would not refuse to prescribe Truvada to people who specifically request to go on PrEP.

Sex workers who choose to have intercourse without using a condom would be especially suited for enrolling in PrEP, he said.

Elion disputes claims by AIDS Healthcare Foundation that large numbers of people on PrEP, men who have sex with men, are likely to stop using condoms.

“In the studies that have looked at over 12,000 patients we’ve not seen an increase in STDs in any of the people on PrEP,” Elion said. “And so I think that lack of an increase in STDs is indicative that they are not doing more risky behaviors once they start taking PrEP.”

Weinstein said a lack of an increase in sexually transmitted diseases in people on PrEP doesn’t necessarily mean they aren’t engaging in risky behaviors. He said sexually transmitted diseases other than HIV are at epidemic proportions in the U.S. for gay and bisexual men or MSM.

“The baseline is already very high,” he said.

28
May
2014

GWU hosts LGBT Health Forum

The George Washington University, gay news, Washington Blade

(Photo by Denkmal Brunswyk via Wikimedia Commons)

The “inextricable” link between human rights and the health of LGBT people throughout the world was the lead topic of discussion Tuesday night at the annual LGBT Health Forum organized by George Washington University’s Graduate Program in LGBT Health Policy and Practice.

Close to 200 people turned out to listen and ask questions to a panel of experts on LGBT rights and public health and discuss the topic of “Global LGBT Health and Human Rights” at the university’s Morton Auditorium at 21st and H streets.

“Around the world, lesbian, gay, bisexual and transgender individuals face worse health outcomes than the general population,” said Stephen Forssell, founding director of the GW LGBT Health Policy and Practice graduate program in a welcoming statement to the gathering.

“Research reveals that disparities are due to social injustice and human rights violations – stigma, discrimination, denial of care, substandard care, a patient’s fear of seeking care, and, in some countries, discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity, Forssell said in a written statement.

Among the experts speaking on the panel during the forum were Nils Daulaire, a physician and former Assistant Secretary for Global Affairs at the U.S. Department of Health and Human Services; Michael Weinstein, president of the AIDS Healthcare Foundation, which provides medical services for people with HIV in the U.S. and abroad; Julie Dorf, senior adviser to the Council for Global Equality and founder and former director of the International Gay & Lesbian Human Rights Commission; and Javier Vasquez, Human Rights Law Adviser for the Pan American Health Organization.

Also addressing the forum was Jack Andraka, a 16-year-old gay high school student in Maryland who, at age 15, developed a test shown to detect pancreatic, ovarian and lung cancer at an early stage. He told the forum that among his current priorities is to encourage LGBT youth to consider perusing an education and career in science related fields.

Dorf and Weinstein said their organizations have monitored and in some cases closely observed growing instances of anti-LGBT persecution in countries in Africa and other areas. Despite what appears to be a worsening outlook for LGBT people in many parts of the world, the two said they were optimistic that worldwide recognition of LGBT equality as a part of international human rights norms would soon play a role in ending anti-LGBT persecution in countries like Uganda, Russia and Jamaica.

A video of the LGBT Health Forum was expected to be posted on forum’s website 

16
Jul
2014

High price for Hep C drug sparks controversy

Carl Schmid, Hep C, drug, Gilead, the AIDS Institute, gay news, Washington Blade

Carl Schmid, deputy director of the AIDS Institute, said Sovaldi is expensive, ‘but this is remarkable progress and the cure rate is extremely high.’ (Photo courtesy of Schmid)

The pharmaceutical company Gilead Sciences received praise earlier this month for bringing to market a newly approved drug capable of curing the potentially fatal liver disease Hepatitis C without the serious and debilitating side effects caused by the existing drug used to treat the disease.

Experts say 20 percent of people with HIV are co-infected with Hepatitis C, which over a period of years can lead to death through liver cancer and liver failure. Physicians treating people with HIV, including Whitman-Walker Health’s medical director, Dr. Richard Elion, have called Gilead’s new drug a major breakthrough.

But at least two organizations that advocate for people with HIV and Hepatitis C have denounced Gilead for setting the wholesale price for its new drug Sovaldi at a level they consider exorbitant and which they say could lead to further escalating prices for AIDS drugs.

The AIDS Healthcare Foundation, the nation’s largest private organization providing medical services for people with HIV/AIDS, and the Fair Pricing Coalition, which advocates for affordable prices for prescription drugs for people with serious illnesses, called Gilead’s decision to set a wholesale acquisition cost of $84,000 for a 12-week treatment regimen of Sovaldi unprecedented.

“There can be no better example of the unbridled greed of the pharmaceutical industry than Gilead’s latest move: pricing its new hepatitis drug at $84,000 per 28-tablet bottle or $1,000 per pill,” said Michael Weinstein, president of AHF.

Lynda Dee, co-chair of Fair Pricing Coalition, called Sovaldi a “very safe and highly effective drug” but noted that it must be used in combination with other drugs to treat different Genotypes, or strains, of Hepatitis C.

She said that although the other drugs – pegylated interferon and ribavirin – are not as expensive as Sovaldi, the price tag for combination therapy with Sovaldi comes to $93,000 and $168,000 for various treatment regimens for a single person living with Hepatitis C.

“Gilead has set the bar dangerously high as other companies determine prices for similar Hepatitis C drugs as they enter the market,” Dee said.

In a statement released at the time the U.S. Food and Drug Administration approved Sovaldi for patient use on Dec. 6, Gilead said it had put in place a patient assistance program to ensure that people with Hepatitis C have access to Sovaldi regardless of their ability to pay for it.

The statement said the program provides assistance to “patients who are uninsured, underinsured or who need financial assistance to pay for the medicine.” The program, called Support Path, will provide Sovaldi “at no charge for eligible patients with no other insurance options,” according to the statement.

While praising Gilead for offering such a program, which is common within the pharmaceutical industry, critics say the high price for Sovaldi would likely prompt other companies to put in place similarly high pricing policies for other promising drugs about to be released for the treatment of both Hepatitis C and HIV/AIDS.

Some Wall Street analysts suggested Gilead’s price for Sovaldi may be justified when taking into consideration the amount it spent to bring such a beneficial drug to market. Bloomberg business news service reported that Gilead, which didn’t invent Sovaldi, paid $11 billion in 2011 to buy Pharmasset, Inc., the company that developed Sovaldi and other Hepatitis C drugs expected to be approved soon.

Bloomberg cited pharmaceutical industry observers who said the Hepatitis C drugs Gilead obtained through this purchase could pull in as much as $20 billion by 2020.

Clinical trials with patients monitored by the Food and Drug Administration demonstrated that Sovaldi had a cure rate of more than 90 percent for patients with the Genotype 2 strain of Hepatitis C following a 12-week regimen with the drug ribavirin. Patients with Genotype 3, another strain of Hepatitis C, had a similarly successful cure rate following a 24-week regimen of Sovaldi and Ribavirin, the trials showed.

For patients with Genotype 1 or 4 of the Hepatitis C infection, the Sovaldi treatment needed to be combined with pegylated alfa interferon, the drug of choice for Hepatitis C before the development of Sovaldi and other new drugs nearing completion of clinical trials, statements by Gilead and the FDA said. Interferon causes serious and debilitating side effects for most patients, forcing some to stop using it before the Hepatitis C virus can be eliminated, according to medical experts.

The good news, according to those monitoring Hepatitis C treatment developments, is that Gilead and other pharmaceutical companies are close to releasing other new drugs capable of effectively curing patients with the Genotype 1 and Genotype 4 strains without the need for Interferon.

“I believe that Sovaldi will have a major impact on public health by significantly increasing the number of Americans who are cured of Hepatitis C,” said Dr. Ira Jacobson, chief of the Division of Gastroenterology at Weill Cornell Medical College in New York City, who served as a principal investigator in the clinical trials of Sovaldi.

Carl Schmid, deputy director of the AIDS Institute, which advocates for people with HIV, said the ability of Sovaldi to actually cure patients with Hepatitis C makes it different from HIV drugs on the market, which keep most patients healthy but cannot cure HIV/AIDS.

“Yes, it’s expensive,” he said of Sovaldi. “But this is remarkable progress and the cure rate is extremely high.”

23
Dec
2013

Price of new once-daily AIDS drug draws criticism

Truvada, Gilead, gay news, Washington Blade

(Photo courtesy of Gilead)

SAN FRANCISCO — Gilead’s new once-daily AIDS drug Stribild provides an attractive option for those with HIV who have never started a meds regiment before, but activists say the $33,000 a year price-tag will make it unattainable for most who need it.

“In the long run, the cost to Gilead to actually produce [Stribild] will be a small fraction of its selling price, which means Gilead can show restraint on…pricing and still make an enormous profit,” AIDS Healthcare Foundation president Michael Weinstein told the Huffington Post, after a massive ACT UP San Francisco demonstration at the drug maker’s headquarters over the price.

Activists are putting pressure not just on Gilead, but on lawmakers to intervene and making HIV drugs more affordable for more people.

03
Jan
2013