HIV testing – Memphis Flyer

In order to help the city of Memphis to reduce HIV infections to 90 percent or more by 2030, doctors are urging HIV negative people to participate in clinical trials for prevention research.

The two major areas of research and development regarding the HIV virus deals with both those living with the virus, and those who test negative, said Doctor Aditya Gaur, director of clinical research in the department of infectious disease at St. Jude’s Children Research Hospital. However when it comes to prevention efforts, those who are usually approached are those who are not living with the virus.

Gaur works with St. Jude’s “Connect 2 Protect” program, which helps to promote outreach and awareness regarding the HIV epidemic in the Mid-South, while also “addressing youth barriers to preventing exposure, testing, obtaining medical care, and moving to adult care.”

“Research is always about taking information to an individual, and letting them make a decision based on the information you provided,” said Gaur, adding that there seems to be a sense of altruism when it comes to youth participation in clinical research trials.

Gaur used Memphis’ contributions to the HPTN 083 trials to emphasize the importance of youth participation. According to the HIV Prevention Trials Network, HPTN 083 “is the first study to compare the efficacy of CAB LA to daily oral TDF/FTC for HIV PrEP.” Gaur added that these trials are credited for an injectable option for HIV prevention. The injection can be taken once every two months, and is an alternative for daily oral medication.

“We had the opportunity to open HPTN 083 in Memphis, and take the study to HIV negative youth in our city and our county,” said Gaur. “The response we received was very, very heartening.”

The coalition enrolled 93 youth in the study, and over many years, combined with more than 4,000 individuals around the world, helped with the approval of the prevention agent.

“That’s a significant number of youth that are interested. That tells us that youth in our community were interested, and they took part in the study,” said Gaur said.

While youth may participate in hopes of benefiting themselves and others, there are other reasons such as incentives and compensation. “It may be that some individuals may join for compensation, but it doesn’t make them any good or bad for a trial. Someone can have altruism and also have a need for money. We have learned to not characterize individuals into just black and white boxes,” said Gaur.

While Gaur expressed the overwhelming response of participants for the HPTN 083 trials, he explained that participation for Purpose 2 Clinical trials have not been as successful.

He said that PURPOSE 2 “will test whether an investigational PrEP (pre-exposure prophylaxis) medicine, lenacapavir, helps reduce the chance of getting HIV through sex.” These trials seek cisgender men, transgender women, transgender men, and gender non-binary individuals who have sex with partners assigned male at birth for research.

Gaur said that one of the most exciting aspects of these trials is that it looks at an agent that is given “subcutaneously” once every six months. He said that the easier and less frequently that patients have to take medicine, the more beneficial it is to many.

“We are always trying to understand what it is. Is the trial too complicated? Are we getting it effectively to you? Always looking at how can we better get out the word so that people can get more information,” Gaur explained. He stressed the concerted efforts of not just community partners, but individuals as well, in order to end the HIV epidemic.

A study compiled by Innerbody.com shows Memphis has the highest reported STD rate of any city in the United States. Memphis’ rates have overtaken those of Jackson, Mississippi, which had previously been reported as number one.

The report also showed that cities located in the South have reported the highest numbers out of the 100 cities ranked.

The information was compiled from data by the Centers for Disease Control and Prevention (CDC). The report showed Memphis reported 1,460 STD cases per 100,000 people, with a total of five HIV cases, 4,772 gonorrhea cases, 9,681 chlamydia cases, and 605 syphilis cases.

While the data showed the numbers have worsened over the year, “the STD burden is not equal within our cities. … While we witness increases in STD infection across many groups, the STD burden continued to hit minority racial and ethnic groups the hardest,” the report said.

This report comes months after the state of Tennessee announced it would be cutting funding for programs “that are not affiliated with metro health departments as of May 31st.”

Krista Wright Thayer serves as the director of outreach and prevention for The Haven, a resource located at 622 Minor Road that “strives to promote the physical, mental and social well-being of everyone impacted by — or potentially impacted by — HIV, stigma or lack of support.”

Thayer said, speaking for an organization that will be affected by these funds being cut, the people Governor Bill Lee hopes to prioritize are “percentage-wise, not nearly at high risk for HIV infection” as marginalized communities.

Thayer said many believe the disease predominantly affects African-Americans because of behavior, but that it’s primarily due to poverty levels. “Those who are in high poverty areas don’t have access to care as much; they also can’t prioritize care as much as they would like to, because if you don’t know where your next meal is coming from, you’re not going to prioritize HIV prevention.”

Thayer said people who know about underserved communities know they have lack of access to care, meaning they are the people who need to be prioritized.

“Those are the ones where you have to bring the care to them, and that’s the work we do. That’s our outreach work,” Thayer said. “I can’t for the life of me understand why the governor would want to prioritize mother-to-baby HIV infections, when that’s not really a thing anymore with the advanced medicines that we have.”

According to HIVInfo, “the use of HIV medicines and other strategies have helped lower the rate of perinatal transmission of HIV to 1 percent or less in the United States and Europe.”

Thayer said the governor wants to prioritize first responders and EMT workers, despite HIV infections “being very very low” as a result of post exposure prophylaxis (PEP.)

While there are efforts being made that will affect the way people are able to access HIV prevention services and testing, Thayer explained there are also stigmas that stand in the way of this.

One of the best ways, according to the CDC, to prevent the spread of HIV is by being on PrEP (pre-exposure prophylaxis), Thayer said. “When I talk to some clients, some of them don’t want to be associated with taking a medicine every day. A lot of people think that people who are on PrEP are promiscuous, and they don’t want to be seen as just having a lot of casual sex, because that’s stigmatizing.”

Thayer said The Haven has money and grants they will be using sparingly, to not only host events, but to provide HIV testing and reduce stigma.

“We really have to work on how we see people living with HIV,” she said. “It’s easier to treat than diabetes, and the way our culture sees people living with HIV is not in a bright light.”