HEALTH TIP:   U = U Got Questions?

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Copy of Instagram Post – Untitled DesignU = U means undetectable equals untransmittable. This slogan refers to the fact that there is effectively no risk of sexually transmitting HIV when the virus is reduced to undetectable levels.

An undetectable viral load for people living with HIV means they will not transmit HIV to their partners. Active engagement in treatment as prevention is a key to maintaining an undetectable viral load and preventing HIV transmission. ‘Treatment as Prevention’ (TasP) is defined as any HIV prevention method that uses antiretroviral therapy (ART) to decrease the risk of HIV transmission to a sexual or needle-sharing partner. ART reduces HIV in blood, semen, vaginal fluid, and rectal fluid to very low levels, and as a result, lowers HIV transmission. ART can even lower viral load to undetectable levels.

Evidence from real-world studies including PARTNER and Opposites Attract shows the affect TasP and ART have on preventing HIV transmission in the PARTNER study that there were ZERO transmissions out of 58,000 condomless sex acts between people with undetectable HIV viral loads and their HIV-negative partners. In the Opposites Attract study, there were no transmissions out of 17,000 condomless sex acts between men. Since the advent of combination therapy, there have been no confirmed reports of anyone with an undetectable viral load sexually transmitting HIV.

An important aspect to TasP is regular viral load testing. Testing is recommended about 2-4 times a year for people who have a stable undetectable viral load. More frequent testing may be necessary and it is recommended that people speak with their doctors about appropriate care, treatment, and testing.

Evidence shows that with regular testing and continued treatment, people living with undetectable HIV viral loads may let go of fears about transmitting HIV to their partners. Instead, we can all focus on the fact undetectable does equal untransmitable.

References:

Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 Transmission. New England Journal of Medicine. 2016;0(July 18):1-10. http://www.nejm.org/doi/full/10.1056/NEJMoa1600693#t=article

Del Romero J, Castilla J, Hernando V, Rodríguez C, García S. Combined antiretroviral treatment and heterosexual transmission of HIV-1: cross sectional and prospective cohort study. British Medical Journal. 2010;340:c2205. http://www.bmj.com/content/bmj/340/bmj.c2205.full.pdf

Frieden TR, Foti KE, Mermin J. Applying Public Health Principles to the HIV Epidemic—How Are We Doing? New England Journal of Medicine. 2015;373(23):2281-2287. http://www.nejm.org/doi/full/10.1056/NEJMms1513641#t=article

i-Base. Q&A on the PARTNER study: how to interpret the zero transmission results. 2016; http://i-base.info/qa-on-the-partner-study/. Accessed 07/18/2016.

Loutfy M, Tyndall M, Baril J-G, Montaner JS, Kaul R, Hankins C. Canadian consensus statement on HIV and its transmission in the context of criminal law. Canadian Journal of Infectious Diseases and Medical Microbiology. 2014;25(3):135-140. http://www.hivlawandpolicy.org/resources/canadian-consensus-statement-hiv-and-its-transmission-context-criminal-law-mona-loutfy

Loutfy MR, Wu W, Letchumanan M, et al. Systematic review of HIV transmission between heterosexual serodiscordant couples where the HIV-positive partner is fully suppressed on antiretroviral therapy. PloS one. 2013;8(2):e55747. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055747

Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. Journal of the American Medical Association. 2016;316(2):171-181. http://jama.jamanetwork.com/article.aspx?articleid=2533066

Vernazza P. HIV-infizierte Menschen ohne andere STD sind unter wirksamer antiretroviraler Therapie sexuell nicht infektiös. 2008. http://www.aids.ch/de/downloads/pdfs/EKAF-Statment_2008-05-089.pdf

Vernazza PL, Bernard EJ. HIV is not transmitted under fully suppressive therapy: The Swiss Statement – eight years later Swiss Med Weekly 2016; http://bit.ly/SwissMedWeekly  Accessed Sept. 4, 2016, 146.

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Stay the Course, the Fight is Not Over! – – National Black HIV/AIDS Awareness Day

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Across the United States on Wednesday, February 7, 2018, there will be individuals and organizations participating in National Black HIV/Aids Awareness Day to promote HIV education, testing, community involvement and treatment in black communities. This year’s theme is “Stay the Course, the Fight is Not Over!”

Education

The statistics show there is a need for this day of awareness. In the United States, there were 972,813 individuals living with HIV, 42 percent of which are African American. Of the 40,040 newly diagnosed cases, 44 percent are African American. In 2016, there were 16,010 individuals living with HIV in San Francisco. Twelve percent of this population was African American. In the same year, there were 223 newly diagnosed HIV cases in San Francisco, 15 percent were African American individuals. Good news—there was a small percentage drop in newly diagnosed HIV cases between 2015 and 2016 in San Francisco.*

Testing

San Francisco Aids Foundation offers free, confidential HIV testing. You can find other testing sites in San Francisco here.  If you live outside of San Francisco, find a testing site near you.

 Community Involvement

National Black HIV/AIDS Awareness Day March & Vigil the Black Brothers Esteem, a prevention and support program of San Francisco AIDS Foundation has planned a march, which starts at 5:00 pm on the steps of San Francisco City Hall, and ends with the vigil at 6:00 pm at the African-American Arts and Cultural Center (726 Fulton Street).

Bayard Rustin LGBT Coalition is planning an event on Wednesday, February 7 at 9:00 am based on a Facebook Event.

In honor of National Black HIV/AIDS Awareness Day, San Francisco AIDS Foundation and Black Brothers Esteem (BBE) invite you to an open soirée celebrating black excellence and resilience in the gay community. The Royal Affair!  For a night of elegance, live entertainment, live music, food, and drinks. The event is entirely free and attendees are encouraged (but not required) to dress up and/ or wear a splash of purple. We will also be offering free on-site HIV testing. All attendees must be 21+

Friday, February 9, 2018, between 6:00 pm-9:00pm @ Mr. Smith’s, 34 Seventh Street, San Francisco

Treatment

HIV Treatment works! The CDC says more than 1.1 million people in the United States are living with HIV, and that staying in care and engaged in treatment helps people stay healthy, protect others, and live healthier lives.

*based on data HIV Epidemiology San Francisco 2106 Annual Report & 2015 Annual Report

HEALTH CARE TIP: Adult Dental Benefits

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Adult dental benefits were fully restored to Midi-Cal recipients effective January 1, 2018, as part of the 2017-2018 Budget Act. Now major services such as partial dentures, root canals on back teeth and gum treatment are covered. Along with an array of general maintenance services such as cleanings, x-rays and fillings and more, Western Center on Law & Poverty has a one-page fact sheet on the restored adult dental benefits.

Still, ongoing access to Denti-Cal services and providers is an issue in California. In 2015, the state appointed a State Dental Director to address Denti-Cal access. To access Denti-Cal and take advantage of these adult dental benefits enroll in Medi-Cal through Covered CA.

Reminder: Covered CA open enrollment ends Wednesday, January 31, 2018.

Take Three Actions to Fight the Flu

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The Center for Disease Control and Prevention (CDC) has stressed the need to have a defense against the influenza (the Flu) this season. With three more weeks of the regular flu season, here are three ways the CDC recommends to fight the flu.

infographic-fight flu

#1 Get a Flu Shot

This is the first and most important step in the defense of the flu. There are many different flu viruses, the vaccine protects against the most common ones research suggests.  It is important to keep in mind, the flu shot might not prevent every strain of the flu each season; however, it should aid in reducing the flu illnesses and doctors’ visits.

For those who have chronic health conditions and are at a high risk of serious flu complications and it is recommended to get the flu shot each year. If you or someone you know needs help with getting insurance to get a flu shot, open enrollment for Covered CA is open until January 31, 2018, reached out to PRC for more information.

#2 Everyday Prevention Goes Along Way

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose, and mouth. Germs spread this way.
  • Clean and disinfect surfaces and objects that may be contaminated; such as phones, keyboards, door knobs, etc.
  • Do your best to avoid close contact with sick people, if possible. If you need to help someone, wear protective gear such as rubber gloves, face masks, and wash hands often.

#3 If Your Doctor Prescribes an Antiviral Medication, Take It!

Antiviral medications are different from antibiotics. They are prescription medicines, which may come in pills, liquids or an inhaled powder. These are not available over-the-counter.

Antiviral medication can make illness milder and shorten the time you are sick. They can also prevent serious flu complications, like pneumonia. It is important they are used early to treat people who are very sick with the flu and who have a great risk of complications. Most otherwise-healthy people who get the flu, however, do not need to be treated with antiviral medications. Of course, always speak with your doctor before taking any medication.

Importance of the First Premium Payment for 2018 Health Coverage

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First, the deadline to enroll for 2018 health coverage is Wednesday, January 31, 2018, so enroll now.

Once signed up for a 2018 health plan through the marketplace, it is very important to pay the first month’s premium on time to activate coverage. If there are issues paying the first month’s premium payment in full, the Health Insurance Premium Payment Program may be able to provide financial assistance. Also, consider reaching out to the insurance company to understand payment options and/or grace periods. Once again, the first premium payment needs to be paid, or there is a chance of losing 2018 coverage.

If enrollment is not complete by January 31, 2018, there will not be another opportunity to enroll unless you qualify for a Special Enrollment Period. If you or someone you know is HIV+ and a San Francisco resident, PRC may be able to help with problems accessing health coverage.