CARE AND TREATMENT
BY BENJAMIN RYAN
MAKING GAY A CRIME HARMS HIV FIGHT
Laws that criminalize homosexuality hamper access to both HIV prevention and care services for men who have sex with men (MSM) according to three reports presented at the International AIDS Conference in Melbourne, Australia. In one study that surveyed over 4,000 MSM around the world in 2012, nearly a quarter of sub-Saharan men reported having been arrested or convicted for homosexuality-related charges, along with 10 percent of Latin American men, 15 percent of Caribbean men, 13 percent of those in the Middle East and North Africa and 18 percent in Eastern Europe and Central Asia. When compared with the rest of the men in the survey, those who had been arrested or convicted for homosexuality-related charges had a respective 24 percent and 21 percent reduced likelihood of having access to condoms and HIV testing, and a respective 30 percent and 23 percent reduced likelihood of receiving medical care and mental health services. A conviction or arrest slashed in half the chance of accessing HIV treatment among those who were living with the virus. Michaela Clayton, director of the AIDS & Rights Alliance for Southern Africa, who operates out of Windhoek, Namibia, said such findings aren’t surprising to her, given the severity and widespread nature of Southern Africa’s homophobia. One of her organization’s most immediate goals is to try to change minds about homosexuality from the ground up. “I think we’re gaining more ground in changing public perception than we are at getting policy makers to change their minds,” she says.
36 POZ DECEMBER 2014 poz.com
A new study finds that having a superinfection—in other words, contracting a second strain of HIV—does not apparently accelerate HIV disease. To come to this conclusion, researchers studied 144 HIV-positive women in Mombasa, Kenya, between 1993 and 2008, during which 21 of them became superinfected. The women who contracted a second strain of HIV saw their viral loads rise more quickly than those who still only had one viral strain. The superinfected women also apparently lost CD4 cells more quickly, although this difference was only of borderline statistical significance, meaning there was not much statistical heft behind the notion that it did not happen by chance. Regardless of these two findings, the superinfected women’s HIV disease did not accelerate, meaning that it took them about the same amount of time as those with one strain of the virus to be diagnosed with certain conditions indicating HIV’s progress in harming the body. Keshet Ronen, PhD, a researcher at Fred Hutchinson Cancer Research Center in Seattle and the study’s lead author, notes that the superinfections all took place before the women were treated for HIV, as did the recorded changes in their viral load and CD4 levels. “Now that treatment is so widespread I think it’s important to remember that superinfection can change people’s clinical course if they become infected with a drug-resistant variant,” Ronen says. “And so that is a caution. But in terms of the biological effects of acquiring a second virus in itself, the effect seems to be quite modest.”
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Superinfection May Not Spur HIV