PrEP/HIV

gizmo81

So, new diagnoses in the UK have decreased from 2,060 in 2014-15 to 1,700 in 2015-16, while in London there was an even steeper drop.

http://www.bbc.com/news/health-40370381

But Ireland's new diagnoses are rising, how can they keep burying their heads with the mounting evidence that PrEP drops the number of new diagnoses.

http://www.thejournal.ie/hiv-ireland-calling-for-prep-in-ireland-3445562-Jun2017/

Three years ago they were discussing it. How many new diagnoses could have been avoided in that time?

Ash885

Matt Cain, editor of Attitude, wrote a great piece on this recently on Prep and HIV stigma.

https://www.theguardian.com/society/2017/jun/22/sex-without-fear-my-experiment-with-hiv-preventative-drug-prep

gizmo81

Very good article I don't think people really grasp the sex and fear problems endemic in the community.

Ash885 wrote: »

Matt Cain, editor of Attitude, wrote a great piece on this recently on Prep and HIV stigma.

https://www.theguardian.com/society/2017/jun/22/sex-without-fear-my-experiment-with-hiv-preventative-drug-prep

wordofwarning

gizmo81 wrote: »

But Ireland's new diagnoses are rising, how can they keep burying their heads with the mounting evidence that PrEP drops the number of new diagnoses.

Three years ago they were discussing it. How many new diagnoses could have been avoided in that time?

The elephant in the room with HIV soaring in Ireland is the fact a certain nationality is responsible for the soaring rates.

The number of diagnoses in 2015 is the highest number ever reported among MSM in Ireland and is an increase of 34% compared to 2014. This is largely due to an increase in the number of diagnoses among MSM from Latin America

https://www.hpsc.ie/a-z/hivstis/hivandaids/hivdata/File,15862,en.pdf

PrEP will reduce HIV rates. But probably the most successful policy would requiring student visa applicants to undergo a HIV.

gizmo81

Yes immigration from Latin America has had a huge impact on our gay scene and beyond that too.

I don't know about testing for visa applications but the Government should have done more before allowing mass immigration from Latin America.

The Government had a lack of foresight for numerous societal issues that would arise.

wordofwarning wrote: »

The elephant in the room with HIV soaring in Ireland is the fact a certain nationality is responsible for the soaring rates.



https://www.hpsc.ie/a-z/hivstis/hivandaids/hivdata/File,15862,en.pdf

PrEP will reduce HIV rates. But probably the most successful policy would requiring student visa applicants to undergo a HIV.

Manion

gizmo81 wrote: »

Yes immigration from Latin America has had a huge impact on our gay scene and beyond that too.

I don't know about testing for visa applications but the Government should have done more before allowing mass immigration from Latin America.

The Government had a lack of foresight for numerous societal issues that would arise.

Forcing gay men to submit to HIV tests before being granted VISAs is fairly regressive. Also, there is no support for the idea that we have Mass immigration from Central and southern America. No need to be locking up your sons just yet :rolleyes:

http://www.cso.ie/en/releasesandpublications/er/pme/populationandmigrationestimatesapril2015/

gizmo81

I didn't say to force gay men to submit to HIV tests, read the thread.

There is support.

Eurostat figures out today said while Ukrainians were granted the highest number of permits across the EU, people from the major South American nation were granted easily the biggest share of residency places in Ireland.
Brazilians received over 22% of all first-time permits issued for the republic – some 7,263 out of the 32,780 issued to all nationalities.


http://www.thejournal.ie/brazilian-students-ireland-1739850-Oct2014/

Manion wrote: »

Forcing gay men to submit to HIV tests before being granted VISAs is fairly regressive. Also, there is no support for the idea that we have Mass immigration from Central and southern America. No need to be locking up your sons just yet :rolleyes:

http://www.cso.ie/en/releasesandpublications/er/pme/populationandmigrationestimatesapril2015/

Manion

Did you even click the link I provided to the CSO. There is no Mass immigration from Latin America, let alone Brazil. We're not getting flooded with a horde of Brazilians. Put a way the foreign panic. Before the Brazilians it was the sub-Saharan Africans. I wish we would stop blaming Irish problems on johnny foreigner.

wordofwarning

Manion wrote: »

I wish we would stop blaming Irish problems on johnny foreigner.

So are you going to write to the HSE or the HSPC to tell them to remove their observation that a large amount of HIV increase in Ireland is due to Latin American immigrants?

Stats on HIV infections are complied. They are clearly showing a large increase in HIV is due to Latin Americans. You are suggesting we should just ignore that ignore?

We should ignore the fact, that a single nationality which makes up a fraction of immigrants in Ireland is now accounting for about 20-25% of HIV infections. But it is 'regressive' for the state to protect its citizens from potential infections by requiring an extremely high risk group to tested for an infection?

Manion

It's a complex issue and I don't think hyperbole helps. Issues of stigmatising people and profiling are not trivial. You realise hiv is far more common among gay men in general? I wouldn't go recommending mandatory tests at the borders on that a particular grouping is statically more likely to have HIV unless you're OK with that also being extended to yourself.

Never the less, I stand by my point. There is no government failing here that has allowed mass unchecked immigration. This is not the ca use of the problem. Stigmatising people is counter productive.

LLMMLL

I haven't read the research so could be completely wrong but I thought PREP use is still relatively small. Is it not the fact that meds are making a lot of positive guys undetectable that is fuelling these drops?

Manion

No, the figures relate a drop in new cases. Or are you thinking people are still getting infected but prep is making it appear they are negative? That's unlikely as far as I'm aware.

LLMMLL

I meant that given that so many positive guys are undetectable they are in unlikely to infect new people. So how much of the drop is due to this and how much is due to prep.

wordofwarning

Manion wrote: »

I wouldn't go recommending mandatory tests at the borders on that a particular grouping is statically more likely to have HIV unless you're OK with that also being extended to yourself.

If I want to move to Australia in a few years, I have zero issue at all taking the required TB test, HIV test and all the other tests. The Australian Governments to protect its citizens from diseases and respect their decision. I accept that is a decision based on stats and protecting their citizens health.

Manion wrote: »

Stigmatising people is counter productive.

So we should just let the HIV rates in Ireland soar as despite research showing that a lot of the HIV increases among the MSM community is Latin Americans, as we don't want to offend them? I would love to know compulsory testing of a high risk group is "counterproductive"? I can't understand how preventing a high risk group from entering Ireland without knowing their status would not lead to a decline in HIV rates.

Manion

LLMMLL wrote: »

I meant that given that so many positive guys are undetectable they are in unlikely to infect new people. So how much of the drop is due to this and how much is due to prep.

True, other factors may also be at play. This is the problem with statistics. That said I don't believe there is any difference in the availability of HIV treatment between Ireland and the UK, so one could reasonably rule treatment out as a cause of the sudden drop. That said maybe better education programs or changes in drug use are also factors.

wordofwarning wrote: »

If I want to move to Australia in a few years, I have zero issue at all taking the required TB test, HIV test and all the other tests. The Australian Governments to protect its citizens from diseases and respect their decision. I accept that is a decision based on stats and protecting their citizens health.




So we should just let the HIV rates in Ireland soar as despite research showing that a lot of the HIV increases among the MSM community is Latin Americans, as we don't want to offend them? I would love to know compulsory testing of a high risk group is "counterproductive"? I can't understand how preventing a high risk group from entering Ireland without knowing their status would not lead to a decline in HIV rates.

And if they decided as a homosexual you stood a good chance, in their mind, of becoming positive and simply barred your entry? Frankly Australia is extremely regressive with regards immigration and minority rights. I'm glad we don't follow suit.

As explained, stigmatizing people with HIV drives them underground and ultimately exacerbates the problem. A mandatory test at the border will not positively impact someone's behaviour. The only impact it would have is if you banned entry on the basis of the result, for public health. This line of argument is bot far removed from the reason why homosexuality was illegal here.

wordofwarning

Manion wrote: »

Frankly Australia is extremely regressive with regards immigration and minority rights. I'm glad we don't follow suit.

What is regressive about preventing HIV/TB?

Manion wrote: »

As explained, stigmatizing people with HIV drives them underground and ultimately exacerbates the problem. A mandatory test at the border will not positively impact someone's behaviour.

The question OP is asking is how to reduce HIV rates in Ireland. In 2015, Latin Americans made up 34% of MSM HIV cases where as Irish MSM made up 33% of HIV cases. Whether you like to admit it or not, that stat is a quite scary and a cause for concern.

People who don't know their status as the most likely to spread it. When thousands of high risk individuals are coming to Ireland without knowing their status, that is a public health risk. If HIV testing was compulsory, these people would not be entering Ireland with an unknown status ie the risk of spreading HIV is pretty much eliminated

What would be your approach to dealing with the fact more Latin American MSM are testing positive for HIV in Ireland than Irish MSM?

Manion

What would be your approach to dealing with the fact more Latin American MSM are testing positive for HIV in Ireland than Irish MSM?

Did you even read the statistics you linked to. For someone who puts such faith in them you've willfully misrepresented what they say. The above is false. You can't just make shïte up. This is exactly the problem with opinion based public policy. You just manipulated the stats to say something they don't to push your own agenda.

gizmo81

Frankly I don't care if it is cause for offence.

Majority of male sex workers in Ireland are Latin American

Majority of transgender sex workers in Ireland are latin American.

Majority advertise 'party' something researchers are scrambling to identify as a new phenomena with this community!

I am waiting for a colleague to write a paper ON fake marriages/civil partnerships in the LGBTQ+ Community because it is endemic with our new migrant brothers and trans-sisters. As usual lesbian data is non-existent.

I'm sorry you're annoyed but latin Americans have dramatically changed the Irish Gay Scene because the Government was ill-prepared for the arrivals.

I'm as left as one can be in a modern society but there is a problem and we have to tackle the problem head on!

Manion

gizmo81 wrote: »

Frankly I don't care if it is cause for offence.

Majority of male sex workers in Ireland are Latin American

Majority of transgender sex workers in Ireland are latin American.

Majority advertise 'party' something researchers are scrambling to identify as a new phenomena with this community!

I am waiting for a colleague to write a paper ON fake marriages/civil partnerships in the LGBTQ+ Community because it is endemic with our new migrant brothers and trans-sisters. As usual lesbian data is non-existent.

I'm sorry you're annoyed but latin Americans have dramatically changed the Irish Gay Scene because the Government was ill-prepared for the arrivals.

I'm as left as one can be in a modern society but there is a problem and we have to tackle the problem head on!

In your opinion.

wordofwarning

Manion wrote: »

Did you even read the statistics you linked to. For someone who puts such faith in them you've willfully misrepresented what they say. The above is false. You can't just make shïte up. This is exactly the problem with opinion based public policy. You just manipulated the stats to say something they don't to push your own agenda.

What exactly have I misrepresented exactly? Please tell what is wrong with what I have said. What is wrong with the stats quoted?

Can I ask have you gone for an STI test in the last few years? When you go they ask you certain questions like do you do bareback? Or do you inject drugs? Now are now asking in some clinics, 'have you had sex with someone from Latin America'? Having sex with Latin American is now seen as a risk factor for contracting HIV to the extent it warrants a question in STI clinics.

BTW I see you did not suggest your approach to dealing with rising HIV rates within the Latin community in Dublin. Do you not have one?

Manion

Read your own link mate. Also why would I need a test, I'm not Brazilian.

wordofwarning

Manion wrote: »

Read your own link mate.

Just as I thought. You can't tell me what I "misrepresented"...

Also again no opinion on how to reduce HIV. You are really adding to this discussion

Manion

Sorry mate I actually said you're lying. It's your job to post supporting information. You haven't.

wordofwarning

Manion wrote: »

Sorry mate I actually said you're lying. It's your job to post supporting information. You haven't.

Just over a third (34%) of MSM were born in
Latin America, 33% in Ireland and 17% in Europe.

The rate among those who are born in Ireland has stayed very stable since 2003, ranging from 3.4 to 4.2 per 100,000 population. There has been much greater fluctuation in the rate among migrants and the rate has increased from 18.4 in 2011 to 34.8 per 100,000 in 2015.

From the link cited several times. Oh wow, it is supporting what I have said several times...

You have supplied zero supporting info to support your weak claims. You have completely ignored me asking how to reduce HIV in Ireland. Instead you just want to keep calling me a liar and that I am 'misrepresenting facts' without saying what I am wrong about.

Hopefully this time you will tell me what I am wrong about. I don't think you will, as A)you will not read the link supplied and you don't want to add/contribute anything to discussion, as I honestly don't think you have anything to add. Maybe you think that way too, since you are more concerned with saying my posts are 'lies' without supporting your point of view with facts

Aren't you that guy who was claiming there was little info supporting PrEP despite their being plenty? AFAIK you did not want to hear any other POVs on it. It kinda feels like this thread again. Despite how little info you have, others with tons of info are 'wrong'. Looking at your posts now and my posts now. It seems very familiar...

J_E

Manion wrote: »

Read your own link mate. Also why would I need a test, I'm not Brazilian.

Huh? You don't get tested regularly? Or are you trying to make some kind of point? I'm kind of confused as to why you are so hostile on this point.

wordofwarning wrote: »

So we should just let the HIV rates in Ireland soar as despite research showing that a lot of the HIV increases among the MSM community is Latin Americans, as we don't want to offend them? I would love to know compulsory testing of a high risk group is "counterproductive"? I can't understand how preventing a high risk group from entering Ireland without knowing their status would not lead to a decline in HIV rates.

I think the point was more that with a rule like that, even people with undetectable counts would still be banned from travelling, doesn't that seem unfair?

Annasopra

Manion wrote: »

Did you even read the statistics you linked to. For someone who puts such faith in them you've willfully misrepresented what they say. The above is false. You can't just make shïte up. This is exactly the problem with opinion based public policy. You just manipulated the stats to say something they don't to push your own agenda.

Manion wrote: »

Sorry mate I actually said you're lying. It's your job to post supporting information. You haven't.

Mod

Please actually discuss the point rather than a pointless back and forth argument of "you are wrong" - "where, why" - "I'm not telling you"
Endless back and forth like this adds nothing to the discussion. It's a fair request to be honest. If you make a claim that statistics are being misrepresented it is absolutely fair to ask you to back up your claim. Continuously refusing is just adding reams and reams of off topic pointless nonsense.

wordofwarning

J_E wrote: »

I think the point was more that with a rule like that, even people with undetectable counts would still be banned from travelling, doesn't that seem unfair?

It is seen on a case by case basis in Australia. If you can afford to support yourself in Australia, you will get a visa. IMO it seems fair. It prevents people going to Australia from a third world country looking to take advantage of their superior health care. We do it with healthcare in the EU. We don't allow a Pole or a Romanian with no connections to Ireland to seek cancer treatment here.

J_E

wordofwarning wrote: »

It is seen on a case by case basis in Australia. If you can afford to support yourself in Australia, you will get a visa. IMO it seems fair. It prevents people going to Australia from a third world country looking to take advantage of their superior health care. We do it with healthcare in the EU. We don't allow a Pole or a Romanian with no connections to Ireland to seek cancer treatment here.

Yet it's fine for us to pop over to Budapest for dental treatments...

wordofwarning

J_E wrote: »

Yet it's fine for us to pop over to Budapest for dental treatments...

That is not comparable. When we go to Budapest, we pay cash for the treatment and do not ask for the Hungarian Government to pick up the tab for us...

Breezer

Manion wrote:

And if they decided as a homosexual you stood a good chance, in their mind, of becoming positive and simply barred your entry? Frankly Australia is extremely regressive with regards immigration and minority rights. I'm glad we don't follow suit.

wordofwarning wrote: »

It is seen on a case by case basis in Australia. If you can afford to support yourself in Australia, you will get a visa. IMO it seems fair.

Canada, which prides itself on its pro-immigration policies, is the same. So is New Zealand. HIV positive people aren't banned from travelling there, but they won't get a work visa without very thorough proof that they can afford their own treatment. This isn't regressive. It makes sense, both as a public health and financial measure.

On PrEP itself, I think it's a fantastic medical breakthrough & needs to be more readily available. It's a high cost at present and a difficult sell politically when there's so much wrong with our health service, so it'll take time and lobbying. I'd liken it to the contraceptive pill in terms of moralising: that attracted all the same arguments initially. Plus most of what we treat in the health service is self-induced in some way, in that it's caused by smoking, bad diet, lack of exercise, etc., yet no one moralises about treating granny's 10th chest infection this year even though she smoked all her life.

Manion

@Joeytheparrot I think it's completely disingenuous for someone to compare the number of new Irish infections to the number of Latin American infection when that number both new and pre diagnosed. I read the report, not just the headline figures.

The number of diagnoses in 2015 is the highest number ever reported among MSM in Ireland
and is an increase of 34% compared to 2014. This is largely due to an increase in the number
of diagnoses among MSM from Latin America (see Figure 11). Forty percent of the diagnoses
among MSM born in Latin America previously tested HIV positive abroad.

I'll just leave this here.

Any person, regardless of nationality, who is accepted by the HSE as being ordinarily resident in Ireland is entitled to either full eligibility (Category 1, i.e. medical card holders) or limited eligibility (Category 2) for health services.

http://www.citizensinformation.ie/en/health/health_system/entitlement_to_public_health_services.html

jobbridge4life

https://twitter.com/sarahcareyIRL/status/883245453604728837

Not sure if this referring specifically to PrEP or someother treatment but will be worth a listen. Saturday at 8.00 am, Newstalk, but also available on their listen back feature on tehir website after airing.

gizmo81

SAVE THE GAYS!!

I didn't realise we had gone back to 1982!

jobbridge4life wrote: »

https://twitter.com/sarahcareyIRL/status/883245453604728837

Not sure if this referring specifically to PrEP or someother treatment but will be worth a listen. Saturday at 8.00 am, Newstalk, but also available on their listen back feature on tehir website after airing.

jobbridge4life

gizmo81 wrote: »

SAVE THE GAYS!!

I didn't realise we had gone back to 1982!

The tweet is a little less than stellar for sure. Carey normally does a good show, albeit with a firmly middle-class sensibility.

I'll be listening.

The HIV explosion in Ireland needs discussing. Frank, honest and uncomfortable discussing. I just hope we can have that discussion without having to indulge in homophobes expressing their 'concern' for 'their gay friends'.

wordofwarning

Manion wrote: »

@Joeytheparrot I think it's completely disingenuous for someone to compare the number of new Irish infections to the number of Latin American infection when that number both new and pre diagnosed. I read the report, not just the headline figures.




I'll just leave this here.

I read the entire report. I was struggling to understand your cryptic posts or your posts with zero context. Like in this post, quoting the HSE. "I'll just leave this here." What does that means? I don't know, as you have no made it clear

So the real reason why our HIV rates are so high is due to non-nationals coming to Ireland to take advantage the stellar range of drugs that the state buys? Why bother funding PrEP, when the state can fund the treatments of HIV+ English Language students...

Manion

wordofwarning wrote: »

I read the entire report. I was struggling to understand your cryptic posts or your posts with zero context. Like in this post, quoting the HSE. "I'll just leave this here." What does that means? I don't know, as you have no made it clear

So the real reason why our HIV rates are so high is due to non-nationals coming to Ireland to take advantage the stellar range of drugs that the state buys? Why bother funding PrEP, when the state can fund the treatments of HIV+ English Language students...

You compared a number which includes people registering per diagnosed infection to one that is just new infections in an effort to blame foreigners for our problems. Your Bias is so clear that when I point this out you conclude that the only reason we see this is because of people taking advantage of our healthcare system.

I don't see any point discussing this further with you.

wordofwarning

Manion wrote: »

Your Bias is so clear that when I point this out you conclude that the only reason we see this is because of people taking advantage of our healthcare system.

I have heard first hand from staff in STI clinics, that people come for our HIV care! You might have heard this too, but as you said you never step foot in a STI clinic. You can get the best HIV drugs in the world here for free. A lot of people would kill to have the HIV care we have here.

Manion wrote: »

I don't see any point discussing this further with you.

That is absolutely fine with me! I would not go so far as a discussion, but rather you merely trying to attack everything I say as it does not agree with your opinion...

wordofwarning

Gilead which is the maker of Truvada is going to the courts to attempt to block the expiration of their patient for Truvada. This is major since Mylan sells Truvada for less than €20 per month in countries like Thailand. Although it will be nowhere as cheap here, but if a third of the price of Truvada, the HSE might consider it. Well their HIV budget will be more manageable, as they can switch people to it instead of the branded one

https://www.irishtimes.com/business/health-pharma/gilead-in-row-with-generics-manufacturers-over-hiv-drug-in-ireland-1.3144610