Using Knowledge of HIV Status As an HIV Prevention Strategy
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Sex, Crime, and Serostatus
Washington and Lee Law Review Volume 78 Issue 1 Article 4 Winter 2021 Sex, Crime, and Serostatus Courtney K. Cross University of Alabama School of Law, [email protected] Follow this and additional works at: https://scholarlycommons.law.wlu.edu/wlulr Part of the Criminal Law Commons, and the Health Law and Policy Commons Recommended Citation Courtney K. Cross, Sex, Crime, and Serostatus, 78 Wash. & Lee L. Rev. 71 (), https://scholarlycommons.law.wlu.edu/wlulr/vol78/iss1/4 This Article is brought to you for free and open access by the Washington and Lee Law Review at Washington & Lee University School of Law Scholarly Commons. It has been accepted for inclusion in Washington and Lee Law Review by an authorized editor of Washington & Lee University School of Law Scholarly Commons. For more information, please contact [email protected]. Sex, Crime, and Serostatus Courtney K. Cross* Abstract The HIV crisis in the United States is far from over. The confluence of widespread opioid usage, high rates of HIV infection, and rapidly shrinking rural medical infrastructure has created a public health powder keg across the American South. Yet few states have responded to this grim reality by expanding social and medical services. Instead, criminalizing the behavior of people with HIV remains an overused and counterproductive tool for addressing this crisis—especially in the South, where HIV-specific criminal laws are enforced with the most frequency. People living with HIV are subject to arrest, prosecution, and lengthy prison sentences if they fail to disclose their HIV-positive serostatus before engaging in sexual or needle-sharing activities. -
STI Screening Timetable
Patient Education Information from University Health Center’s STI Screening Clinic Page 1 of 1 STI Screening Timetable How long until STI (sexually transmitted infection) screening tests turn positive? How long until STI symptoms might show up? The time between infection and a positive test, or between infection and symptoms, is variable and depends on many factors, including the behavior of the infectious agent, how and where the body is infected, and the state of a person’s immune system and personal health. Many STIs don’t have any symptoms. The incubation period times listed in the chart below are averages only. If you have further questions or concerns, you can schedule an appointment with a clinician at 541-346-2770. STI screening test Window period (time from exposure until Incubation period (time between exposure and screening test turns positive) when symptoms appear) Chlamydia (urine specimen or swab of 1 week most of the time Often no symptoms vagina, rectum, throat) 2 weeks catches almost all 1-3 weeks on average Gonorrhea (urine specimen on swab of 1 week most of the time Often no symptoms, especially vaginal vagina, rectum, throat) 2 weeks catches almost all infections usually within 2-8 days but can be up to 2 weeks Syphilis (blood test, RPR) 1 month catches most Often symptoms too mild to notice 3 months catches almost all 10-90 days average 21 days HIV (oral cheek swab) 1 month catches most Sometimes mild body aches and fever within 1-2 3 months catches almost all weeks then can be months to years HIV (blood test, antigen/antibody -
Hepatitis B and C Testing: Why? Who? How? a Guidance Paper on Testing in Community and Harm Reduction Settings 1 Colophon
Hepatitis B and C testing: why? who? how? A guidance paper on testing in community and harm reduction settings 1 Colophon This paper is a product of the Correlation Hepatitis C Initiative. You can access the paper at www.hepatitis-c-initiative.eu Author: Danny Morris Review: M. Harris, A. Kautz, A. Leicht, H. Lochtenberg, E. Schatz Copyright © 2016 Copyrights remains with the publisher Correlation Network PO Box 10887 1001 EW Amsterdam The Netherlands Phone.: +31 20 5317600 Fax.: +31 20 4203528 [email protected] Correlation Network is a part of the international activities of the Regenboog Groep. For more information: www.deregenboog.org The production of this paper has been supported by an unrestricted grant from Gilead Sciences Europe Ltd 2 Acknowledgements We want to thank the author Danny Morris and all who helped to draft this paper and the Regenboog Group, Abbvie and GILEAD for their financial support of the Hepatitis C Initiative. Eberhard Schatz Correlation Hepatitis C Initiative Amsterdam, December 2016 “The Hepatitis C Initiative aims to enhance the momentum of current HCV treatment opportunities and strives for universal access to essential HCV prevention and treatment for the most affected and under-served communities: people who use drugs.” 3 Content Chapter 1: Introduction 6 1.1 Hepatitis B and C infect one in fifty adults in the European Region 9 1.2 Higher rates of hepatitis among vulnerable groups 9 1.3 A public health approach to hepatitis 9 1.4 Harm reduction as prevention 10 1.5 Diagnosing hepatitis B and C 10 1.6 Awareness raising - key recommendations 11 1.7 Testing and diagnosis - key recommendations 13 Chapter 2: Who should be tested 14 2.1 Barriers to testing 16 2.2 Barriers to testing and treatment may include 16 2.3 Overcoming barriers to testing 17 2.4 Testing as standard practice 18 2.5 Pre and post-test discussion 18 2.6 Serological testing for viral hepatitis 20 4 Chapter 3: Screening technologies and development of non-invasive techniques 22 3.1 Venapuncture 23 3.2 Dried blood spot testing 24 3.3. -
Donor Testing and Risk: Current Prevalence, Incidence, and Residual Risk of Transfusion-Transmissible Agents in US Allogeneic Donations
Donor Testing and Risk: Current Prevalence, Incidence, and Residual Risk of Transfusion-Transmissible Agents in US Allogeneic Donations Shimian Zou, Susan L. Stramer, and Roger Y. Dodd Over the past 20 years, there has been a major increase virus (HIV) and human T-cell lymphotropic virus did in the safety of the blood supply, as demonstrated by not. The incidence (/100 000 person-years) of HIV and declining rates of posttransfusion infection and reduc- HCV among repeat donors showed apparent increases tions in estimated residual risk for such infections. from 1.55 and 1.89 in 2000 through 2001 to 2.16 Reliable estimates of residual risk have been possible and 2.98 in 2007 through 2008. These observed within the American Red Cross system because of the fluctuations confirm the need for continuous monitor- availability of a large amount of reliable and consistent ing and evaluation. The residual risk of HIV, HCV, and data on donations and infectious disease testing human T-cell lymphotropic virus among all allogeneic results. Among allogeneic blood donations, the pre- donations is currently below 1 per 1 million donations, valence rates of infection markers for hepatitis C virus and that of hepatitis B surface antigen is close to 1 per (HCV) and hepatitis B virus have decreased over time, 300 000 donations. although rates for markers of human immunodeficiency © 2012 Elsevier Inc. All rights reserved. HE BLOOD SUPPLY in the United States DEMOGRAPHY OF DONOR POPULATIONS T and many other countries has become safer In 2008, a total of 3 830 094 volunteer blood than ever, thanks to continuing improvements in donors successfully made 6 638 877 blood dona- donor selection and testing, along with broad tions to ARC Blood Services, with whole blood and improvements in public health. -
Sexually Transmitted Infection Prevention and Treatment
Sexually Transmitted Infection Prevention and Treatment Kevin L. Ard, MD, MPH Massachusetts General Hospital, The Fenway Institute Disclosures I have no financial disclosures. Doxycycline PEP is not FDA-approved. Learning objectives 1. Describe the epidemiology of syphilis, chlamydia, gonorrhea, and other STIs among LGBTQ populations 2. Summarize optimal screening strategies for STIs. 3. Outline approaches to STI control that can be integrated into primary care. 3 Caveats ▪ Many (most?) LGBTQ people do not face a high risk of STIs. ▪ Clinical care must be individualized, not based on group risk. ▪ Data about STIs among cisgender WSW are limited. ▪ Terms that describe identity and behavior are imperfect and change over time. The rate of chlamydia diagnosis is increasing. Sexually Transmitted Disease Surveillance 2017, CDC Proportion of STI clinic patients testing positive for chlamydia Sexually Transmitted Disease Surveillance 2017, CDC The rate of gonorrhea diagnosis is increasing. Sexually Transmitted Disease Surveillance 2017, CDC MSM face an increasing disparity in the rate of gonorrhea. Sexually Transmitted Disease Surveillance 2017, CDC Antimicrobial resistance in gonorrhea is increasing. Resistanc e Elevated MICs Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2017. Atlanta: U.S. Department of Health and Human Services; 2018. Neisseria gonorrhoeae — Percentage of Urethral Isolates with Elevated Azithromycin Minimum Inhibitory Concentrations (MICs) (≥2.0 µg/ml) and Elevated Ceftriaxone MICs (≥0.125 μg/ml) by Reported Sex of Sex Partners, Gonococcal Isolate Surveillance Project (GISP), 2011–2017 A. Azithromycin B. Ceftriaxone * No cases of elevated ceftriaxone MICs were reported among MSM in 2017. ACRONYMS: MSM = Gay, bisexual, and other men who have sex with men (collectively referred to as MSM); MSW = Men who have sex with women only. -
Frequency and Implications of HIV Superinfection
Review Frequency and implications of HIV superinfection Andrew D Redd, Thomas C Quinn, Aaron A R Tobian* HIV superinfection occurs when an individual with HIV is infected with a new distinct HIV viral strain. Superinfection Published Online has been reported throughout the world, and studies have recorded incidence rates of 0–7∙7% per year. Use of next- May 31, 2013 generation sequencing has improved detection of superinfection, which can be transmitted by injecting drug use and http://dx.doi.org/10.1016/ S1473-3099(13)70066-5 sexual intercourse. Superinfection might have incidence rates comparable to those of initial HIV infection. Clinicians Division of Intramural should encourage safe sexual and injecting drug use practices for HIV-infected patients because superinfection has Research, National Institute of detrimental eff ects on clinical outcomes and could pose a concern for large-scale antiretroviral treatment plans. The Allergy and Infectious Diseases, occurrence of superinfection has implications for vaccine research, since it seems initial HIV infection is not fully National Institutes of Health, protective against a subsequent infection. Additional collaborative research could benefi t care of patients and inform Bethesda, MD, USA (A D Redd PhD, future vaccine design. Prof T C Quinn MD); Department of Pathology, Introduction Detection of HIV superinfection School of Medicine, Johns HIV superinfection occurs when an individual with The investigators in initial studies that identifi ed indi- Hopkins University, Baltimore, MD (A A R Tobian MD) HIV becomes infected with a new, phylogenetically distinct viduals dually infected with HIV-1 and HIV-2 used Correspondence to: viral HIV strain. -
Distribution of CCR5-Delta32, CCR5 Promoter 59029 A/G, CCR2-64I And
Nkenfou et al. BMC Research Notes 2013, 6:288 http://www.biomedcentral.com/1756-0500/6/288 RESEARCH Open Access Distribution of CCR5-Delta32, CCR5 promoter 59029 A/G, CCR2-64I and SDF1-3’A genetic polymorphisms in HIV-1 infected and uninfected patients in the West Region of Cameroon Céline Nguefeu Nkenfou1,2*, Linda Chapdeleine Mouafo Mekue3, Christelle Tafou Nana4 and Jules Roger Kuiate3 Abstract Background: Genetic variants of the genes encoding Human Immunodeficiency Virus-1 (HIV-1) co-receptors and their ligands, like CC-Chemokine Receptor 5 delta 32 mutation (CCR5-Delta32), CCR5 promoter A/G (Adenine/Guanine), CC-Chemokine Receptor 2 mutation 64 isoleucine (CCR2-64I) and the Stromal cell-derived Factor 3’A mutation (SDF1-3’A), are involved in the susceptibility to HIV-1 infection and progression. The prevalence of these mutations varies by Region. However, little is known about their distribution in the population of Dschang, located in the West Region of Cameroon. The prevalence of HIV in the West Region of Cameroon is lower than elsewhere in Cameroon. The objectives of this study were to determine the distribution of four AIDS Related Gene (ARG) variants in HIV-infected and non-infected population of Cameroon especially in the West Region and to estimate the contribution of these variants to the susceptibility or resistance to HIV infection. We also aimed to evaluate the effectiveness of genotyping using dried blood spot (DBS) samples. Methods: A total of 179 participants were recruited from two hospitals in Dschang in the West Region of Cameroon. Their genotypes for CCR5-Delta32, CCR5 promoter 59029A/G, CCR2-64I and SDF1-3’A were analyzed using polymerase chain reaction (PCR) and restriction fragment length polymorphisms. -
RISK REDUCTION STRATEGIES AMONG URBAN AMERICAN INDIAN/ALASKA NATIVE MEN WHO HAVE SEX with MEN Cynthia R
AIDS Education and Prevention, 25(1), 25–37, 2013 © 2013 The Guilford Press PEARSON ET AL. RISK REDUCTION AMONG AIAN MSM A CAUTIONARY TALE: RISK REDUCTION STRATEGIES AMONG URBAN AMERICAN INDIAN/ALASKA NATIVE MEN WHO HAVE SEX WITH MEN Cynthia R. Pearson, Karina L. Walters, Jane M. Simoni, Ramona Beltran, and Kimberly M. Nelson American Indian and Alaska Native (AIAN) men who have sex with men (MSM) are considered particularly high risk for HIV transmission and acquisition. In a multi-site cross-sectional survey, 174 AIAN men reported having sex with a man in the past 12 months. We describe harm reduc- tion strategies and sexual behavior by HIV serostatus and seroconcordant partnerships. About half (51.3%) of the respondents reported no anal sex or 100% condom use and 8% were in seroconcordant monogamous partnership. Of the 65 men who reported any sero-adaptive strategy (e.g., 100% seroconcordant partnership, strategic positioning or engaging in any strategy half or most of the time), only 35 (54.7%) disclosed their serosta- tus to their partners and 27 (41.5%) tested for HIV in the past 3 months. Public health messages directed towards AIAN MSM should continue to encourage risk reduction practices, including condom use and sero-adaptive behaviors. However, messages should emphasize the importance of HIV testing and HIV serostatus disclosure when relying solely on sero-adaptive practices. HIV/AIDS is an increasing threat to the health and well-being of American Indians and Alaska Natives (AIAN) across the United States (U.S.). According to the Na- tional HIV/AIDS Surveillance System, through 2009 an estimated cumulative total of 3,700 AIDS cases among AIAN were reported to the CDC (Centers for Disease Control and Prevention, 2011a), with a 2009 estimated AIDS case rate of 6.6 per Cynthia R. -
Coevolution of HIV-1 and Broadly Neutralizing Antibodies
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Curr Opin Manuscript Author HIV AIDS. Author Manuscript Author manuscript; available in PMC 2020 October 13. Published in final edited form as: Curr Opin HIV AIDS. 2019 July ; 14(4): 286–293. doi:10.1097/COH.0000000000000550. Coevolution of HIV-1 and broadly neutralizing antibodies Nicole A. Doria-Rosea, Elise Landaisb aVaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland bIAVI Neutralizing Antibody Center, Immunology and Microbiology Department, The Scripps Research Institute, La Jolla, California, USA Abstract Purpose of review—Exploring the molecular details of the coevolution of HIV-1 Envelope with broadly neutralizing antibodies (bNAbs) in infected individuals over time provides insights for vaccine design. Since mid-2017, the number of individuals described in such publications has nearly tripled. New publications have extended such studies to new epitopes on Env and provided more detail on previously known sites. Recent findings—Studies of two donors – one of them an infant, the other with three lineages targeting the same site – has deepened our understanding of V3-glycan-directed lineages. A V2- apex-directed lineage showed remarkable similarity to a lineage from a previously described donor, revealing general principles for this class of bNAbs. Understanding development of CD4 binding site antibodies has been enriched by the study of a VRC01-class lineage. Finally, the membrane-proximal external region is a new addition to the set of epitopes studied in this manner, with early development events explored in a study of three lineages from a single donor. -
Lessons from Viral Superinfections for HIV-1 Vaccine Design Stephanie Jost* Ragon Institute of MGH, MIT and Harvard, USA
C S & lini ID ca A l f R o e l s Journal of a e n a r r Jost, J AIDS Clinic Res 2013, S3 c u h o J DOI: 10.4172/2155-6113.S3-005 ISSN: 2155-6113 AIDS & Clinical Research Review Article Open Access Lessons from Viral Superinfections for HIV-1 Vaccine Design Stephanie Jost* Ragon Institute of MGH, MIT and Harvard, USA Abstract Superinfection refers to a second viral infection in the context of a pre-existing adaptive immune response to prior infection with a viral strain that has not been cleared, the two viruses being genetically distinct yet belonging to the same genus. As such, this phenomenon provides unique settings to gain insights into the immune correlates of protection against HIV-1. The focus of this review is to discuss the current knowledge about immune responses to HIV-1 and to other viruses that are associated with partial or complete immunity to superinfection, or lack thereof, and how that could be applied to future HIV-1 vaccine strategies. Keywords: HIV-1; Superinfection; Vaccine; Co-infection; Viral HIV-1 Rapid Evolution and Diversity: A Challenge for infection; Recombination Vaccine Design Introduction The extremely rapid evolution of the virus probably largely contributed to the failure or limited success of HIV-1 vaccines evaluated The human immunodeficiency virus type 1 (HIV-1) affects 34 to date [5]. HIV-1’s extensive genetic diversity was first brought to light million adults and children worldwide, and the ongoing spread of the around 1983, when full-length sequences of the virus became available, epidemic resulted in about 2.5 million new infections and 1.7 million and has since then expanded [6]. -
A Novel Approach to Prevention for At-Risk HIV-Negative Menwhohavesexwithmen:Creatingateachablemoment to Promote Informed Sexual Decision-Making
RESEARCH AND PRACTICE A Novel Approach to Prevention for At-Risk HIV-Negative MenWhoHaveSexWithMen:CreatingaTeachableMoment to Promote Informed Sexual Decision-Making Lisa A. Eaton, PhD, Chauncey Cherry, MPH, Demetria Cain, MPH, and Howard Pope In the United States alone, 56000 new HIV Objectives. As a result of the impact of HIV among men who have sex with infections occur each year, the majority among men (MSM), multiple strategies for reducing HIV risks have emerged from within men who have sex with men (MSM).1 The stable the gay community. One common HIV risk reduction strategy limits unprotected number of MSM becoming infected with HIV sex partners to those who are of the same HIV status (serosorting). We tested testifies to the need for new and innovative a novel, brief, one-on-one intervention, based on informed decision-making and approachestoHIVpreventioninthishigh delivered by peer counselors, designed to address the limitations of serosorting priority population. Community-based pre- (e.g., risk for HIV transmission). vention programs targeting MSM have dwindled Methods. In 2009, we recruited a group of 149 at-risk men living in Atlanta, over the past decade, and only 3 evidence-based Georgia, and randomly assigned them to an intervention condition addressing interventions designed specifically for MSM are serosorting or a standard-of-care control condition. disseminated by the Centers for Disease Control Results. Men in the serosorting intervention reported fewer sexual partners 2 and Prevention, none of which are individual- (Wald c =8.79, P<.01) at the study follow-ups. Behavioral results were also consistent with changes in psychosocial variables, including condom use self- level or brief interventions (for details, see http:// efficacy and perceptions of risk for HIV transmission. -
Use of a Home-Use Test to Diagnose HIV Infection in a Sex Partner: a Case Report David a Katz1*, Matthew R Golden2,3 and Joanne D Stekler2,3
Katz et al. BMC Research Notes 2012, 5:440 http://www.biomedcentral.com/1756-0500/5/440 CASE REPORT Open Access Use of a home-use test to diagnose HIV infection in a sex partner: a case report David A Katz1*, Matthew R Golden2,3 and Joanne D Stekler2,3 Abstract Background: Home-use HIV tests have the potential to increase testing and may be used by sex partners to inform sexual decision-making. To our knowledge, this is the first report of an individual diagnosed with HIV using a home-use test with a sex partner. Case presentation: We are conducting a randomized controlled trial of home self-testing for HIV using the OraQuick ADVANCEW HIV-1/2 Antibody Test on oral fluids. In 2011, a 27-year-old, homeless, Latino man who has sex with men not enrolled in the trial (the case) reported receiving a reactive result from a diverted study kit. When interviewed by study staff, the case reported that, 11 months prior, he had unprotected anal sex with a trial subject without discussing HIV status. Afterwards, the subject asked the case if he would like to test, performed the test, and disclosed the reactive result. The case reported altering his behavior to decrease the risk of HIV transmission to subsequent partners and sought care two months later. Conclusions: This case demonstrates that home-use HIV tests will be used by sex partners to learn and disclose HIV status and inform sexual decision-making. It also highlights concerns regarding the absence of counseling and the potential for delayed entry into HIV care.