Shock horror, superbug fears greatly exaggerated
“Strain of Superbug ‘may be new HIV’” was a headline in Metro newspaper that grabbed the attention of commuters across the UK yesterday.
A study finding a high prevalence in gay men in San Francisco of a strain of community-acquired MRSA with resistance to many types of antibiotics received widespread media attention. Many of the men with this strain of MRSA were HIV-positive.
It isn’t the first study to find that HIV-positive gay men have a high prevalence of community-acquired MRSA and there’s some evidence that transmission is occurring during the close physical contact that happens during sex.
People with HIV may be more vulnerable because of their high use of antibiotics and their risk of suppressed immunity.
But gay men and people with HIV aren’t the only groups affected by community-acquired MRSA. Heterosexual transmission has been reported. What’s more, there’s good evidence that the infection occurs more frequently in groups the media often likes to praise – such as athletes and military personnel.
And a lot of what was said about the new strain of MRSA was misleading or inaccurate.
It isn’t the “new HIV.”
MRSA (Methicillin-resistant Staphylococcus aureus) can cause very unpleasant symptoms, such as skin boils, and can in extreme cases cause a fatal form of pneumonia, but there are, in fact, antibiotics that can cure it.
Simple washing with soap and water after close physical contact (even after sex between men!) is enough to prevent infection in most cases.
And although the infection occurred more frequently in gay men in an area of San Francisco, it occurs in the general population.
It is important that people are told about potential health concerns. But the information provided needs to be accurate and measured. Much of the reporting in this case was alarmist and homophobic. And the wording of the press release that went out to the media wasn’t helpful, a reminder to investigators and publicity departments of the importance of sticking to the facts and avoiding sensation when presenting findings to the media and public.
Anti-HIV treatment
Superinfection
There is now good evidence that a person with HIV can be infected with another strain of HIV. This is called superinfection or reinfection. It seems to be quite rare and only about 30 cases have been reported from around the world so far. But new cases are reported every so often so the number will increase.
Some people have been superinfected with strains of HIV that are more aggressive or resistant to anti-HIV drugs.
Many people with HIV have unprotected sex with other HIV-positive people. There’s a concern that this could involve a risk of superinfection.
Viral load fell to undetectable levels in all these patients soon after anti-HIV treatment was started and then increased to detectable levels later. High rates of HIV-risk behaviour were reported by people in the study.
Tests showed that the genetic structure of HIV changed significantly in eight patients. But these changes were explained by the natural evolution of HIV and there was no evidence of superinfection.
Telling people you’re HIV-positive
Many people with HIV worry about the possible consequences of telling other people that they have HIV. (The act of telling somebody you have HIV is often called disclosure). The support that family members, friends and the wider community could offer to people with HIV could be undermined by the stigma that often surrounds HIV.
American researchers were concerned that this fear of stigma meant that HIV-positive women weren’t seeking support from their family members by disclosing their HIV status.
Their study showed that this was true to some extent, but that the women in the study had told 84% of their family members about their HIV infection.
A lot of this disclosure happened in the first six months after the women were first diagnosed with HIV. Women were more likely to tell their mothers and sisters that they had HIV than their fathers and brothers.
There’s some useful information about disclosure here. It’s been written with gay men in mind, but it should prove useful for people from all the communities affected by HIV.
If you’d like to speak to somebody about disclosure or any of the issues in this edition of HIV Weekly then ring THT Direct on 0845 1221 200. They have trained staff who can help with many questions, or they can refer you to an expert.