Dr. Blackwell's BLOG

 Great news and updates regarding two articles I recently wrote. One has gone on to publication while the other has moved to being classified as “in press.” The first article, “Pre-Exposure Prophylaxis: An Emerging Clinical Approach to Preventing HIV in High-Risk Adults” has been published in this month’s issue of The Nurse Practitioner: The American Journal of Primary Healthcare. The article explores advances in HIV prevention in those at high risk through the use of the antiretroviral medication Truvada. The abstract appears below.

Preexposure prophylaxis: An emerging clinical approach to preventing HIV in high-risk adults

Abstract: The HIV antiretroviral drug emtricitabine/tenofovir disoproxil fumarate (Truvada) was recently approved as preexposure prophylaxis (PrEP) therapy for adults at high risk for sexually acquired HIV infection. This article reviews the data supporting the efficacy of PrEP, and provides other relevant data regarding the implementation of PrEP.

 In other news, my article, “Assessment and Treatment of Depression in Gay and Bisexual Men in Emergency Settings” has been FULLY accepted for publication in the Advanced Emergency Nursing Journal and will most likely appear in-publication early next year. Browse my publications under the Research tab and download my CV for a full listing of my publication record.

I received some GREAT news yesterday! My proposal to present my research:Blackwell, C.W. & Eden, C. (2011, April). Human papillomavirus and anorectal knowledge in men who have sex with men.was accepted  for presentation at the 2011 Annual Conference of the American Public Health Association (APHA). APHA is the nation’s premier organization of public health professionals. Getting accepted to present at APHA is an incredible honor and it is by far my biggest accomplishment for a professional presentation in my career! I am very excited to be presenting in Washington, DC in November!

Great news! On Monday, April April 4th, 2011, I successfully passed the National League for Nursing’s Board Certification Examination in Nursing Education, earning the credential of Certified Nurse Educator. NLN’s Certification Program for Nurse Educators establishes nursing education as a specialty area of practice and creates a means for faculty to demonstrate their expertise in this role. It communicates to students, peers, and the academic and health care communities that the highest standards of excellence are being met. By becoming credentialed as a Certified Nurse Educator (CNE), the educator serves as a leader and role model. The credential is valid until April of 2016 and can be maintained by meeting NLN’s certification maintenance requirements.

 A study appearing today in the New England Journal of Medicine highlights research findings that the antiretroviral drug Truvada is highly effective at preventing HIV infection in men who have sex with men (MSM). Researchers studied the effect of Truvada in a sample of 2,500 MSM in San Francisco, CA and Lima, Peru. While infection rates declined an average of 44%; when participants took the drug precisely as prescribed, its efficacy rose to up to 90%! Adverse effects are low and included nausea, increased creatinine, and weight loss. The finding holds promise that perhaps pre-exposure prophylactic treatment could be the key to greatly reducing infection rates in the population at most risk. Of great concern, however is the cost. In the US, Truvada costs between $12,000-$14,000 annually. In addition, Gilead, the maker of the drug needs to pursue FDA approval for the pre-exposure indication, which could take months. 

 I am very happy to report that two of my articles were accepted for publication in the Journal of Social Service Research this week. The first, an article that was reworked from a data-driven to a clinical piece is titled, “Using the Internet to Meet Sexual Partners: Research and Practice Implications.” The article, focusing on drug use within sexual relationships initiated in the on-line environment, is co-written by Dr. Sophia Dziegielewski (Professor, School of Social Work, University of Cincinnati) and will appear in a special upcoming GLBT-focused issue of the journal. The second, “Reducing Alcohol Abuse in Gay Men: Clinical Recommendations from Conflicting Research” sheds light on the conflicting studies about alcohol use and abuse in gay men and provides the clinician with recommendations on how to effectively screen gay male clients for alcohol abuse. Both should appear in-print and on-line in late 2010 or early 2011.

 The Associated Press released a summary of a research article appearing in this week’s Nature Medicine by University of Michigan scientist Dr. Kathleen Collins indicating HIV can lie dormant and become reinfective. This is big news. A few years ago I attended a very informative HIV research conference where a top researcher from Johns Hopkins was studying the life cycle of the HIV retrovirus. At the time, there was hope that if HIV could be suppressed for a 3-month period, the virus could effectively die and theoretically, an infected person might be able to sercovert back to a negative serostatus. However, this new data essentially destroys that theory:

“The virus is dormant in the bone marrow cells,” she said, “but when those progenitor cells develop into blood cells, it can be reactivated and cause renewed infection. The virus kills the new blood cells and then moves on to infect other cells. If we’re ever going to be able to find a way to get rid of the cells, the first step is to understand where a latent infection can continue,” Collins said. This indicates that unless HIV can be killed where it lies dormant, and as these data show, that includes the bone marrow, antiretroviral medications will not be able to fully cure HIV infection.

 Great news! I just received a confirmation E-Mail from the editor of Social Work in Public Health informing me my research article “Requests for Bareback Sex and HIV Serostatus among Men who Have Sex with Men Using Internet Sexual Networking Sites to Initiate Sexual Relationships” has been ACCEPTED for publication! Social Work in Public Health is a crucial journal focusing on all aspects of policy and social and health care considerations in policy-related matters, including its development, formulation, implementation, evaluation, review, and revision. By blending conceptual and practical considerations, Social Work in Public Health enables authors from many disciplines to examine health and social policy issues, concerns, and questions. Dr. Mary Lou Sole partnered with me in the work, providing great assistance in the statistical analyses of my research. Below is the APA Citation and Abstract:

Blackwell, C.W. & Sole, M.L.S. (In Press). Requests for bareback sex and HIV serostatus among sen who have sex with men using Internet sexual networking sites to initiate sexual relationships. Social Work in Public Health.

Abstract: The use of Internet sexual networking sites is becoming a more prominent means for men who have sex with men (MSM) to initiate sexual relationships. The widespread use of such sites provides quick and often more anonymous access to the initiation of sexual relationships, which research suggests can make an impact on sexual decision making. This article presents findings from an original research study assessing the association between active requests for condomless (bareback) sex through personal Internet sexual profiles and HIV serostatus in a sample of MSM in Florida (n = 483). The findings indicated a statistically significant association between those men who actively requested bareback (BB) sex in their profile and HIV status. The association was significant for HIV-positive serostatus and unknown/non-disclosed HIV serostatus.  This suggests clinicians should consider the possible use of Internet sexual networking sites when discussing safer sex practices with their MSM clients, and specific public health strategies should be designed that promote safer sex practices among MSM using the Internet to initiate sexual relationships.

I am happy to report that 2 articles I authored based on a study I completed several months ago looking at high-risk sexual activity among men who have sex with men (MSM) have been accepted for publication. The first, “Requests for Safer Sex Among Men Who Have Sex with Men Using the Internet to Meet Sexual Partners: Implications for Healthcare Providers” has been accepted for publication in the Journal of Lesbian, Gay, Bisexual, and Transgender Health Research. The article focuses on safer-sex requests by MSM using a popular Internet sexual networking site to find sex partners and examines specific sex behavior requests which places them at lower risk for HIV and sexually-transmited infections (STIs). The second article, “The Relationship Between Population Size, Requests for Bareback Sex, and HIV Serostatus Among Men Who Have Sex With Men Using the Internet to Meet Sexual Partners” was accepted for publication in the Journal of Human Behavior in the Social Environment. The article uses data from the same sample and focuses on differences in the rates of unsafe sex requests in-relation to the population size of specific geographic regions. Both articles can be viewed under “Research.” The publication dates, volume, and issue numbers for each are pending.

After a multitude of studies have found circumcision can reduce HIV infection by almost half in heterosexual men, the Centers for Disease Control and Prevention (CDC) is strongly considering making a national health recommendation that all newborn boys be circumcised. Research, largely conducted in Africa where circumcision is rare, indicated the cells which makeup the foreskin of uncircumcised men are highly susceptible to the HIV retrovirus, which greatly enhances the likelihood of HIV transmission and infection from female body fluids during sexual intercourse. While the recommendation is important, the research has not been replicated in gay and bisexual men, who continue to comprise the largest group of Americans who are infected or who are becoming infected with HIV.