Medical journalist. Science editor @POZmagazine, @CancerHealth, Hep. Words for @aidsmap, @Slate, @eBARnews. Research beagle adopter. Same handle Threads/Bluesky
Feb 22 • 8 tweets • 6 min read
And now at #CROI2023, a special session on #monkeypox/#mpox.
John Brooks of @CDCgov: Mpox decline has not been even in all places -- we need to keep our eye on places where it hasn’t declined as much & need to stay vigilant for reemergence.
I'm not going to try to live-tweet this one & didn't request advance permission to share slides.
Feb 22 • 25 tweets • 20 min read
It's been a long day at #CROI2023, but I'll attempt to live-tweet @MichaelPelusoMD's presentation on #longCOVID. Though mainly an #HIV meeting, CROI also includes the hot infectious diseases of the day. (Thanks Dr Peluso for providing advance slides & permission to share.) 1/ @MichaelPelusoMD .@MichaelPelusoMD & colleagues' SCOPE cohort at @UCSF + international collaborators have now studied more than 700 people with #longCOVID 2/
Feb 21 • 6 tweets • 4 min read
.@MonicaGandhi9 presents promising results from @ZSFGCare@SF_DPH SPLASH program to treat disadvantaged safety-net population at Ward 86 with long-acting injectable antiretrovirals -- even if not virally suppression at outset. #CROI2023 1/
Among those without viral suppression (ie, outside FDA indication for Cabenuva), 55 out of 57 achieved undetectable VL after starting monthly injectables -- comparable to rates seen in pivotal clinical trials. 2/
Feb 21 • 4 tweets • 3 min read
Susan Buchbinder (@SF_DPH@BridgeHIV) & Larry Corey (@fredhutch) discuss where we are with #HIV vaccines after Mosaico trial failure. Buchbinder says it's "a very vibrant time" in HIV vaccine research. Corey adds that the science is "terrifically fascinating." #CROI2023 1/
I think his characterization of sophisticated novel HIV vaccine approaches as "a little bit more complicated" & going to "take a little more time" is an underestimate. It's certainly a lot more complicated to explain versus traditional vaccines! 2/ poz.com/article/hiv-va…
Feb 21 • 9 tweets • 7 min read
.@profchloeorkin presents disturbing data on #monkeypox/#mpox among HIV+ people w/low CD4 counts. High rate of complications & death. Concludes mpox is an opportunistic pathogen & severe necrotizing form is an AIDS-defining condition, @CDCgov & @WHO should include. #CROI2023 1/
Concern about IRIS for people who start antiretrovirals once severe symptoms are underway -- can make worse. But unclear whether ART would be beneficial if started at beginning of mpox symptoms. 2/
Feb 20 • 5 tweets • 4 min read
#DoxyPEP prevented STIs in gay men, but Jenell Stewart reports this was not the case for cisgender women. May be due to differing drug concentrations in vaginal/cervical vs rectal tissue or low adherence. We’ve seen something similar with TDF/FTC PrEP for women. #CROI2023
Here's my report for @eBARnews on the #doxyPEP study in gay & bi men & trans women presented last year. ebar.com/story.php?3193…
Dec 31, 2022 • 10 tweets • 10 min read
Since it's that time of year, here's a selection of some of my favorite articles I wrote in 2022.
My main focus is #HIV. Here, for @pozmagazine, a look at advances in antiretroviral treatment & prospects for a functional cure. 1/ poz.com/article/long-w…
For @aidsmap, a report from #AIDS2022 about a 5th person cured of #HIV after a stem cell transplant. (The 4th such case was reported earlier in the year at #CROI2022/#CROI22). 2/
This psychologizing of people with different risk tolerance is tedious. Mask proponents can't grasp that we've seen evidence over 3 years that masking doesn't appear to affect case trajectories much at the community level & decided marginal benefits aren't worth the drawbacks. 1/
.@ianmSC can be a gadfly, but he's posted many graphs like this showing that cities & countries with mask mandates or strong masking culture have case trajectories similar to those of places that don't. 2/
Promising news for #COVID treatment. But the fact that an antiviral works against both SARS-CoV-2 & #HIV does not mean COVID is similar to HIV disease. 1/ bit.ly/3AeSxoL
Azvudine (used for HIV in China but not the US) is a nucleoside analog, which works as a polymerase inhibitor; when used for HIV treatment it's called a reverse transcriptase inhibitor (RT is HIV's polymerase). 2/
Aug 30, 2022 • 6 tweets • 2 min read
I think this is a terrible idea. As we saw many times with #COVID & now #monkeypox the accepted consensus can change -- & it should change as we get more evidence. Who's smart enough & prescient enough to decide what's misinformation? 1/ nytimes.com/2022/08/29/tec…
Yes, sometimes misinformation is obvious -- those are the easy cases.
- Is SARS-CoV-2 airborne?
- Were school closures beneficial or harmful?
- How common is long COVID?
- Is monkeypox an STI?
Just a few questions where experts disagree & our understanding has evolved. 2/
Aug 30, 2022 • 4 tweets • 2 min read
There's a new round of dis/misinformation about the safety of #COVID vaccines during pregnancy. While pregnant women weren't included in clinical trials (as is typical), hundreds of thousands have safely gotten the vaccines in the real world.
It's true children historically got #monkeypox in African countries where the virus is endemic. But until recently, MPX was considered rare. It was not thought to spread easily between humans & outbreaks were small. That's still the case for everyone *except* gay/bi/MSM. 1/
That remained true until an outbreak in Nigeria in 2017, when cases shifted towards young urban men. Dr. Ogoina (profiled here) & other experts think it might be transmitted sexually there as well (& not necessarily limited to sex between men). 2/ n.pr/3PPiCR5
Aug 29, 2022 • 5 tweets • 2 min read
Just to be clear, @WHO reports 140 people under age 18 with #monkeypox. @CDCgov reports <20 in US. There has been no known transmission in schools. Official data lags, but cases in children have remained well under 1% for 3 months. 1/
If MPX were going to spread like wildfire among kids — & if it were easily transmitted through casual contact or the air — surely we’d have started to see some indication of that by now. 2/
Aug 11, 2022 • 4 tweets • 2 min read
Gay men don't need government directives or community shaming -- just be honest about how #monkeypox is spreading (ie, don't suggest sex, dancing together & touching clothing are equal risks) & they'll figure it out for themselves. It's already happening. wapo.st/3PbtLuk
Behavior change didn't *fail* to curb #HIV -- rather it was an incomplete success, so we needed new approaches like U=U & PrEP. Until #monkeypox vaccines are readily available, abstinence, fewer partners, different activities & condoms are all part of the harm reduction toolbox.
Things we do & do not know about this case. We know a daycare worker has #monkeypox. We're told some number of young children were exposed. None of the kids have MPX so far, but the incubation time is too short. 1/ nbcnews.to/3zD0CT9
The reported exposure ranges from touching the same objects to possibly varying degrees of skin-to-skin contact. Some of these exposure risks are considered very low risk, others are higher. 2/
Aug 6, 2022 • 5 tweets • 2 min read
People on both ends of the political spectrum came to distrust public health & the media during COVID because they think mitigation policies were either too strict or too lax & we warned the public either too much or not enough. The same thing is happening with #monkeypox. 1/
Through COVID social media, I've been exposed to a wider diversity of viewpoints than I was used to. And the way people on the two "sides" are reacting doesn't look all that different. 2/
Aug 5, 2022 • 6 tweets • 4 min read
I have no idea what condition this person might have, but #monkeypox shouldn’t still be producing new lesions at 6 weeks, right? Is this a known phenomenon?
Like many of the women on social media claiming to have monkeypox, a quick scan of her posts doesn’t show her saying she actually tested positive. The lesions she photographs could be many things.
Aug 1, 2022 • 11 tweets • 6 min read
If you read just one #monkeypox article, make it this one, illustrating both the folly of not listening to people on the ground in the most affected communities & the perils of shaming & stigmatizing sex so much that people won't talk about it. 1/ @NPR
#Monkeypox vaccine messaging is difficult & conflicting because there's not enough research. Data so far is based on immunogenicity (essentially, antibody production) not real-world effectiveness. Starting with 1 dose is a good strategy to get more people some protection ASAP. 1/
But saying a single dose provides adequate protection is premature. In particular, people with #HIV have a lower response rate & it seems like they should be prioritized for 2nd doses. @dr_demetre says @US_FDA stands by its recommended 2-dose regimen. #AIDS2022 2/