The Indian Health Service (IHS) reported that cultural stigma against homosexuality and HIV prevents many Navajo tribe members from adhering to HIV treatment. HIV incidence among the Navajo is relatively low due to the seclusion of the reservation, but new cases surged by 20 percent from 2011 to 2012, according to IHS Chief Medical Officer Dr. Susan V. Karol. Men who have sex with men (MSM) comprised almost half of new HIV cases on the reservation.
Melvin Harrison, executive director of the Navajo AIDS Network (NAN), described how stigma against homosexuality and HIV affects health-seeking behavior among the Navajo. Approximately 75 percent of NAN clients are “closeted” MSM, according to Harrison. Most NAN clients have not told their family and friends about their diagnosis because they fear family rejection and shunning. One HIV-infected man reported that his mother would not hug him and fed him from disposable plates after learning of his diagnosis.
The need to remain silent is a major barrier to treatment compliance, since family and community awareness are instrumental in helping patients follow through with HIV treatment and checkups.
Although it is not clear why, American Indians with HIV or AIDS have a lower survival rate than other racial groups.
Canadians who contracted HIV and hepatitis C virus through tainted blood transfusions during the 1980s and the victims’ families are protesting the proposed licensing of three private plasma clinics in Toronto. The clinics’ opponents fear another “tainted blood tragedy” if the federal and Ontario governments allow the clinics to offer payment for plasma.
Activist Michael McCarthy, who received a contaminated transfusion in the 1980s, urged Health Canada to hold open meetings regarding the clinic licensing and asked the province to pass legislation prohibiting payments for blood. Ontario Health Minister Deb Matthews requested that Health Canada delay approval until she could consult with other provinces. Health Canada Spokesperson Steve Outhouse stated that Health Canada has consulted with tainted blood stakeholders and will open the consultations for public comment. Health Canada also has planned public hearings, but the provinces will make the final decision about payment for plasma, according to Outhouse.
Matthews affirmed that plasma contains proteins that hospitals and pharmaceutical companies buy for disease treatment. Cangene, a Winnipeg-based drug company, has been licensed for decades to buy plasma used in manufacturing products.
Justice Horace Krever’s four-year inquiry into the tainted blood tragedy, from1993 to 1997, resulted in 50 recommendations, including stricter rules and no-fault compensation for victims.
Although individuals with HIV are living longer due to antiretroviral drug therapy (ART), many of them also suffer from psychological disorders such as depression, neurocognitive disorders, and substance use disorders. An international team from the United States, Haiti, Uganda, and Tanzania recently released the first of a five-part policy report on improving HIV patient outcomes by integrating treatment for HIV and comorbid mental illness. According to the authors, some mechanisms link HIV with mental illness. These include social conditions under which patients live, fears about employment and housing, food security, and social stigma. Also, HIV can affect the central nervous system, causing long-term cognitive problems that ART may not help and place the patient at additional risk of contracting other infections.
According to the authors, scientific literature describes all of these problems but does not have much clinical data on programs to integrate the two types of diseases. The authors see potential in treating ailments such as depression and alcohol abuse disorder along with HIV, and beginning ART earlier to prevent some of the neurocognitive impairment. They also recommend integrating screenings and brief psychotherapeutic interventions with HIV care. They contend that the case for integrating mental health care into medical treatment is supported by good studies and that such integration may increase ART effectiveness for patients in developing countries who may not access mental health care separately, even if it is free.
The full report, “Grand Challenges: Improving HIV Treatment Outcomes by Integrating Interventions for Co-Morbid Mental Illness,” was published in the journal PLoS Med (2013; doi: 10(5): e1001447).
Students in the Cape Henlopen High School theater program in Lewes, Del., will host a fundraiser for Broadway Cares/Equity Fights AIDS (BC/EFA) at 8:00 p.m. on Saturday May 25, at the school’s theater. According to Martha E. Pfeiffer, the high school theater academy director and a longtime supporter of BC/EFA, the event will raise funds to help HIV-infected people as well as bring AIDS awareness to the community. She explained that the goal was to have the entire arts community of Rehoboth Beach and Lewes present for a one-night-only celebration of the arts. Tickets are $30 per person; BC/EFA will receive 100 percent of the proceeds. For more information, contact martha.pfeiffer@cape.k12.de.us; Facebook—Martha Pfeiffer; or call (240) 217–9777.
On May 21, Catskill Regional Medical Center (CRMC) in Harris, N.Y., issued a news release warning some patients of possible HIV and hepatitis exposure, because the center may have re-used insulin pens on more than one patient between 2007 and May 2013. CRMC Spokesperson Rob Lee said they discovered this issue during “routine nursing education on the use of insulin pens.” In the news release, the center stated, “While CRMC is not aware of any contamination between patients, as a precautionary measure CRMC is recommending that those patients be tested for hepatitis B, hepatitis C, and HIV.” Lee further noted that CRMC is ascertaining how many patients might have been exposed and will send letters to the affected patients.
According to a 2012 CDC alert, an insulin pen is designed to be used several times, but should never be used on more than one patient. Although a new needle is used on each injection, blood can find its way into the insulin cartridge, producing the risk of a pathogen being transmitted from one patient to another. In 2009, after a report that patients were exposed at a Texas hospital, the Food and Drug Administration issued a notice to healthcare professionals that the pens should be used on only one patient.
This past winter, two western New York hospitals reported health scares due to the shared use of insulin pens. The Buffalo News reported that 700 patients at Buffalo Veterans Hospital could have been exposed, and the Olean General Hospital announced that 1,915 persons might have been exposed since 2009. Three Oleans patients claimed they contracted hepatitis and have filed a lawsuit against the hospital. However, Oleans Hospital has denied that those patients contracted hepatitis through the pens, according to the Buffalo News. Officials described the risk of transmission as low.
CRMC patients should call 1–800–277–4221 to schedule a blood test or ask questions.
Beginning June 3, Jackson County, Mich., will begin charging county residents $10 and non-county residents $40 to receive services at its STD clinic. According to county officials, the program has been operating at a $100,000 loss; Jackson is one of the few counties in the state that does not charge for STD testing. As a result of this, the department has seen an increase in non-county and out-of-state individuals using the clinic.
A new report released on May 21 by the Joint United Nations Program on HIV/AIDS demonstrated that the number of individuals in Africa who receive antiretroviral drugs increased from less than 1 million in 2005 to more than 7 million in 2012. The report also stated that while Africa continued to be affected by HIV more than any other region in the world, AIDS-related deaths fell by a third from 2005 to 2012. According to the report, Africa accounted for 70 percent of all those infected with HIV globally. In 2011, the continent reported 1.8 million new HIV infections and 1.2 million deaths from AIDS-related illnesses.
Health Canada is lifting the lifetime ban on blood donations from men who have had sex with other men. Starting July 22, 2013, men who have abstained from sexual intercourse with other men for at least five years will be able to donate blood. Canadian Blood Services and Hema-Quebec explained that the five-year restriction is necessary because homosexual men’s HIV transmission frequency is higher than in the general population, and their HIV infection rate is 10 times higher than that of heterosexuals or lesbians. In the past, because of Hema-Quebec and Canadian Blood Services restrictions, men who had only one homosexual encounter since 1977 faced a lifetime ban on donating blood. Lobby groups have attempted to overturn that ban since it was established, and Health Canada has finally agreed to lift the ban, with tight restrictions.
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