Legal highs 'may be linked' to rise in HIV in Glasgow area

 

Legal highs 'may be linked' to rise in HIV in Glasgow area

A drug misuse expert has warned that legal highs and lack of media attention may be contributing to an increase in HIV cases seen in the Glasgow area.

Health officials have warned people who take drugs about a near five-fold increase in HIV infections.
About 10 cases are linked to injecting in the Greater Glasgow and Clyde area each year - that rose to 47 last year.
Professor Neil McKeganey said legal highs could be a factor in more frequent high-risk injecting behaviour.
NHS Greater Glasgow and Clyde (NHSGGC) is now warning drug users of the dangers of sharing needles and advising anyone who injects to get tested.
For the first time in almost 30 years, new diagnoses of HIV related to drug injecting was at a comparable level among gay and heterosexual men.
Investigations into the outbreak highlighted that some drug users were sharing needles, syringes, spoons and water when preparing and injecting their drugs.
It has also highlighted that there is low awareness of the risks of HIV from doing so.

'Vitally important'

Dr Catriona Milosevic, consultant in public health medicine at NHSGGC, said it was "vitally important" that people who inject drugs do not share or reuse equipment.
She said: "This includes when injecting with close friends or partners - you can't guess whether someone has HIV, and they may have no symptoms and be unaware themselves.
"Everyone involved needs to use a new set of sterile injecting equipment every single time, including needles, syringes, water, filters, and spoons, to protect themselves and others. These are all available from injecting equipment services."
Dr Milosevic said the goal was to get people drug free, but until that is achieved the focus had to be on harm reduction.

Image copyright SPL

Prof McKeganey, of the Centre for Substance Use Research, said any increase in HIV cases was worrying.
He said: "Many people have lost the focus of attention on HIV - there hasn't been much in the media and people tend to think it's not there.
"Actually what we are seeing is an increase in injecting risk behaviour, more sharing of needles than in the past.
"That might be to do with new psychoactive substances, or legal highs, we know that people tend to inject much more frequently and there is evidence that it's a higher risk behaviour."

'Diagnosed early'

Although there is no cure for HIV, there are now treatments which reduce the virus to what doctors describe as "undetectable" levels.
Dr Milosevic added: "Recent discussions have highlighted that those at risk are not aware of the huge advancements made in HIV treatment - there is still a perception that a diagnosis of HIV is a 'death sentence'.
"If people are diagnosed and start treatment early, which requires a test, they can have a similar life expectancy as the rest of the population."

(News From BBC)

HIV update - 26th FEB 2017

Hepatitis C virus often found in semen

Researchers continue to investigate the biological mechanisms which could explain the ongoing epidemic of sexually transmitted hepatitis C in HIV-positive gay men.
Some studies have suggested that sexual transmission is mostly linked to sexual practices that involve some contact with blood (including tiny traces of blood you don’t notice). This makes sense as it is well known that hepatitis C is present in infectious quantities in blood. These sexual practices may include anal sex (especially when it goes on for a long time) as well as fisting and using sex toys.
Until now, it’s generally been thought that while hepatitis C may be present in semen, it’s usually at a low level that isn’t infectious.

Researchers took semen and blood samples from 33 gay men who had both HIV and hepatitis C. They found that one third of the men had detectable hepatitis C in their semen and that it was present in levels that were plausibly high enough to transmit the virus.
When individuals had high levels of hepatitis C in their blood (for example, soon after infection) they tended to have high levels in their semen. But this was not always the case – some men who had low levels of hepatitis C in their blood had high levels in their semen.
The results suggest that hepatitis C can be passed on during anal sex even when there has been no bleeding. They suggest that condoms can play an important role in preventing the transmission of hepatitis C.

Drug resistance in steep decline

The number of people with virus that is resistant to some anti-HIV drugs has fallen significantly in recent years,
A drug-resistant HIV strain is one which is less susceptible to the effects of one or more anti-HIV drugs. Having drug-resistant HIV limits the range of drugs you can use, but you will still usually be able to find an effective treatment.
Drug-resistant HIV can emerge if you regularly miss doses of your anti-HIV drugs or take them late.  Because HIV treatment is now easier to take, with fewer side-effects, resistance is less of a problem than it used to be.
Resistance can also develop when people take HIV treatment regimens which are not powerful enough to keep HIV under control – this was a problem in the 1990s, but is generally no longer an issue for people receiving care in the UK and similar countries.
Looking back at data on thousands of people living with HIV in Switzerland between 1999 and 2013, the researchers found that in 1999 there were 401 patients with a new case of drug resistance, including 69 people who had resistance to multiple drugs. Although many more people were living with HIV in 2013, there were only 23 new cases of drug resistance, including three people with resistance to multiple drugs.
These new cases of resistance in recent years are mostly due to resistant virus being sexually transmitted – individuals having resistant virus when first diagnosed with HIV.
Other people continue to have resistance to some drugs, as a legacy of problems with HIV treatment several years ago. Looking at those individuals who had resistant virus in 2013, most started to take HIV treatment before 2006. Only 15% of cases involved people who began HIV treatment after 2007.

People not taking treatment

Two recent studies shed light on the experiences of people who have chosen not to take HIV treatment or who have had difficulties taking treatment regularly. Researchers have called on clinicians and policy makers to pay more attention to the experiences of people who have fears or concerns about HIV treatment.
In an Australian study, some people were reluctant to start treatment for as long as they felt healthy and normal. They worried that starting treatment would make HIV feel more real rather than lessening its impact. The interviewees were aware of the evidence that HIV treatment reduces the infectiousness of people living with HIV and described feeling pressurised by friends and professionals to take treatment and ‘do the right thing’ for the sake of the wider community – a call that brought about ambivalence and resentment.
These people who had decided not to take treatment often said that they did not know anyone else who had HIV and was not taking treatment. They felt marginalised and silenced within groups of people living with HIV and by HIV support organisations.
In a separate study, researchers interviewed west African women living in London who had had difficulties adhering to their HIV treatment. Internalised stigma about HIV was an undercurrent in many of these women’s accounts, with some women feeling as negatively about the medications as about the illness they are used to treat. Several described HIV treatment as making them feel they were trapped in a monotonous life sentence. As one woman said, “They will tell you that you have to take it. It’s the words ‘for life’ I hate, I can’t stand it.”
But some interviewees talked about how their adherence and their health had improved, citing the support of family members and of doctors who treated them as equal partners. The researchers say that healthcare staff should educate patients about how HIV treatment works and fully involve them in decisions about treatment. They also say that, when possible, it’s helpful for people living with HIV to be open about their HIV status to friends and family, so that they are not isolated and can get support.

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Health Tips for Heart, Mind, and Body

Unhealthy lifestyle. It's a common contributor of our biggest health problems: stroke, heart disease, diabetes, cancer. What do the nation's top physicians recommend to keep your heart, mind, and body in optimally good health?

For the secrets to a long healthy life, WebMD turned to Richard A. Lange, MD, chief of cardiology at Johns Hopkins School of Medicine. His advice:

1. Daily exercise.

You brush your teeth every day; exercise is equally important for your daily routine. Turn off the TV or computer, and get at least 30 minutes of exercise every day.

To work your heart, it's got to be aerobic exercise. You've got lots of options: walking, jogging, biking, rowing machine, elliptical machine, swimming. But don't feel like you have to be an athlete. Walking is great exercise. Get 10 minutes here and there during the day. It all counts.

Start with something simple, like parking in the far corner of the parking lot -- so you get those extra steps to the door. Take the stairs one or two flights instead of the elevator. If you take public transportation, get off one stop early and walk the rest. Get out at lunch to walk. Or walk with your significant other or your spouse after work. You'll get a bonus -- relaxation and stress reduction.

2. Healthy diet.

Quit eating junk food and high-fat fast food. Your heart, brain, and overall health are harmed by foods high in saturated fats, salt, and cholesterol. There's no getting around it. You've got to replace them with healthy foods: lots of fruits, vegetables, fish, nuts, olive oil -- what we call the Mediterranean diet. Eat like an Italian, a Spaniard, a Greek! Enjoy!

3. Weight loss.

Too much body weight puts your health at great risk. When you take in more calories than you burn, you get fat -- it's that simple. You've got to eat less. You've got to exercise more. You've got to push yourself to make these lifestyle changes -- but you've got to do it to help avoid serious health problems like heart disease, diabetes, or stroke.

4. Regular physical exams.

Tell your doctor your family medical history. Learn your personal risk factors, and the screening tests you need. Women may have mammograms to screen for breast cancer and Pap tests for cervical cancer. Men may have prostate cancer PSA tests. Routine screening for colorectal cancer should start at age 50, perhaps earlier if colon cancer runs in your family. You also need regular diabetes, blood pressure, and cholesterol tests. Make sure your immunizations are up to date. You may need flu and pneumonia shots, depending on your age.

5. Less stress.

When a person says they're too busy to exercise, it tells me other things are crowding out what's important in life: They don't spend time with family and friends; don't exercise enough; don't eat right; don't sleep properly. All these things reduce stress in your life, and that is critical to your health and longevity.

To be healthy, we need to set boundaries -- and set limits on work hours. We should not be working so hard that we're neglecting the things that keep us healthy. This is important advice, too, for people who take care of elderly parents or young children. Make sure you're getting proper exercise and sleep -- and that you're not trying to do too much.