NYCSHP’s held their second August CE at NYY Steak in Midtown. NYY Steak is well known for their 21-day USDA Prime steaks, and they boast an extraordinary dining experience similar to being at the Yankee Stadium. Inside the restaurant, which was covered in Yankees memorabilia, our NYCSHP guests were escorted to the private dining room where they were warmly greeted with wine. The program was sponsored by Simply Speaking HIV.
NYCSHP President, Dr. Yi Guo, opened the evening by presenting the guest speaker, Dr. Princy N. Kumar, MD, who is the Chief in the Division of Infectious Diseases and Travel Medicine of Georgetown University School of Medicine. Dr. Kumar’s presentation was titled, “HIV Therapy as HIV Prevention: Reducing the Risk of HIV Infection among Uninfected Adults”.
Dr. Kumar’s presentation objectives are for her participants to be able to screen patients with HIV/AIDS using CDC recommendations, counsel HIV-infected patients on behavioral and biomedical interventions for the prevention of HIV transmission, counsel high risk patients on the use of antiretroviral agents for PrEP, and incorporate new clinical management approaches to lower community rates of HIV transmission. The main topics that she focused on were discussing the epidemiology of HIV/AIDS infection on a global scale, assessing prevention benefits of antiretroviral therapy, and PrEP prevention of HIV transmission in men who have sex with men (MSM).
According to the UNAIDS 2014 Global Summary, about 36.9 million people are living with HIV infection and need antiretroviral therapy (ART). It is estimated that only 41% of people living with HIV have ART coverage. In the US alone, adults older than 25 have an 88% diagnosis rate, but only have a 28% viral suppression. Moreover, the 12% who remain undiagnosed account for a staggering 54% of new infections. She discusses the importance of closing the gap on those who remain undiagnosed to reduce the number of new infections.
In assessing prevention benefits of ART, Dr. Kumar highlights a study (HPTN 052) on stable, healthy, sexually active, serodiscordant couples with the infected individual who has a CD4 count between 350-550 cells/mm3. These couples were randomized 1:1 to have delayed ART, when CD4 count is <250 cells/mm3, or early ART, when CD4 count is between 350-550 cells/mm3. The study showed that early ART led to a 96% reduction of sexual transmission of HIV in serodiscordant couples.
Dr. Kumar also discusses various studies on the use of PrEP in men who have sex with men (MSM) for the prevention of HIV transmission. One study in particular used emtricitabine/tenofovir in a novel way. The Ipergay trial was a double-blind, randomized, placebo-controlled trial that looked at HIV-negative, high-risk MSM with 2 or more partners within 6 months without the systematic use of condoms. The intervention was emtricitabine/tenofovir or placebo given 2 tablets 2-24 hours prior to sex, then 1 tablet at 24 and 48 hours after. Standard therapy with PrEP involves taking emtricitabine/tenofovir once daily. The study found an 86% reduction of HIV incidence using emtricitabine/tenofovir before and after sex compared with placebo.
In closing, Dr. Kumar welcomed questions from the audience. NYCSHP President Dr. Yi Guo ended the presentation with updates from NYCSHP.
Article by Peter Hoang
Photos by Peter Hoang and Gretchen Marcelino