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AIDS Patient Care and STDs

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https://www.readbyqxmd.com/read/29148966/exploring-the-health-care-environment-and-associations-with-clinical-outcomes-of-people-living-with-hiv-aids
#1
Mary Hawk, Robert W S Coulter, James E Egan, Mackey Reuel Friedman, Steven Meanley, Stuart Fisk, Courtney Watson, Suzanne Kinsky
Despite three decades of dramatic treatment breakthroughs in antiretroviral regimens, clinical outcomes for people living with HIV vary greatly. The HIV treatment cascade models the stages of care that people living with HIV go through toward the goal of viral suppression and demonstrates that <30% of those living with HIV/AIDS in the United States have met this goal. Although some research has focused on the ways that patient characteristics and patient-provider relationships contribute to clinical adherence and treatment success, few studies to date have examined the ways that contextual factors of care and the healthcare environment contribute to patient outcomes...
November 17, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29087746/underutilization-of-statins-when-indicated-in-hiv-seropositive-and-seronegative-women
#2
Jonathan V Todd, Stephen R Cole, David A Wohl, Ross J Simpson, Michele Jonsson Funk, M Alan Brookhart, Jennifer Cocohoba, Daniel Merenstein, Anjali Sharma, Jason Lazar, Joel Milam, Mardge Cohen, Stephen Gange, Tené T Lewis, Greer Burkholder, Adaora A Adimora
Increased life expectancy of persons living with HIV infection receiving antiretroviral therapy heightens the importance of preventing and treating chronic comorbidities such as cardiovascular disease. While guidelines have increasingly advocated more aggressive use of statins for low-density lipoprotein (LDL) cholesterol reduction, it is unclear whether people with HIV, especially women, are receiving statins when indicated, and whether their HIV disease is a factor in access. We assessed the cumulative incidence of statin use after an indication in the Women's Interagency HIV Study (WIHS), from 2000 to 2014...
November 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29087745/substantially-higher-and-earlier-occurrence-of-anti-tuberculosis-drug-related-adverse-reactions-in-hiv-coinfected-tuberculosis-patients-a-matched-cohort-study
#3
Takashi Matono, Takeshi Nishijima, Katsuji Teruya, Eriko Morino, Jin Takasaki, Hiroyuki Gatanaga, Yoshimi Kikuchi, Mitsuo Kaku, Shinichi Oka
Little information exists on the frequency, severity, and timing of first-line anti-tuberculosis drug-related adverse events (TB-AEs) in HIV-tuberculosis coinfected (HIV-TB) patients in the antiretroviral therapy (ART) era. This matched-cohort study included HIV-TB patients as cases and HIV-uninfected tuberculosis (non-HIV-TB) patients as controls. Tuberculosis was culture-confirmed in both groups. Cases were matched to controls in a 1:4 ratio on age, sex, and year of diagnosis. TB-AEs were defined as Grade 2 or higher requiring drug discontinuation/regimen change...
November 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29087744/potential-healthcare-insurance-and-provider-barriers-to-pre-exposure-prophylaxis-utilization-among-young-men-who-have-sex-with-men
#4
Sarah J Marks, Roland C Merchant, Melissa A Clark, Tao Liu, Joshua G Rosenberger, Jose Bauermeister, Kenneth H Mayer
Young adult men-who-have-sex-with-men (YMSM) continue to have among the highest incidence of HIV infection in the United States. Pre-exposure prophylaxis (PrEP) is an effective and safe method of preventing HIV infection; however, despite US Food and Drug Administration approval, utilization remains low, in part, due to structural barriers, particularly access to healthcare. In this study, we used social media to recruit black, Hispanic, and white HIV-uninfected 18- to 24-year-old YMSM. Participants completed an online survey about their sexual behavior, healthcare access, and previous use of PrEP...
November 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29087743/experiences-of-young-parents-with-perinatally-acquired-hiv
#5
Cynthia Fair, Hannah Allen, Connie Trexler, Lawrence J D'Angelo
This research explores the perceptions of adolescents and young adults (AYA) living with perinatally acquired HIV (PHIV) as they transition into parenthood. We conducted hour-long, semistructured audio-recorded interviews with a purposive sample of 17 AYA parents with PHIV who were current or former patients at two US pediatric/adolescent infectious diseases clinics. Participants were asked about challenges/rewards of parenting and anticipated future fertility desires/intentions. Analysis of the transcribed interviews was guided by grounded theory...
November 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29039984/financial-barriers-and-lapses-in-treatment-and-care-of-hiv-infected-adults-in-a-southern-state-in-the-united-states
#6
David A Wohl, Rita K Kuwahara, Kamran Javadi, Christine Kirby, David L Rosen, Sonia Napravnik, Claire Farel
Antiretroviral (ARV) adherence has largely been considered from the perspective of an individual's behavior with less attention given to potential structural causes for lapses in treatment, such as the cost of medications and care. HIV medication expense is typically covered by third party payers. However, private insurance premiums and deductibles may rise, or policies terminated such as with a change in employment. Likewise, a patient's eligibility for publicly funded coverage like state AIDS Drug Assistance Programs (ADAP) or Medicaid can also be lost...
November 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28981337/comparing-outcomes-of-hiv-infected-chinese-adults-on-antiretroviral-therapy-by-cd4-count-at-treatment-initiation-a-nationwide-retrospective-observational-cohort-study-2012-2014
#7
Ran Hu, Fujie Zhang, Vania Wang, Zhihui Dou, Colin Shepard, Decai Zhao, Xia Liu, Weiwei Mu, Yasong Wu, Hongxin Zhao, Huiqin Li
The chief concerns for antiretroviral therapy (ART) programs considering removal of CD4(+) cell count thresholds for treatment are the increased incidence of ART-related adverse events. A nationwide observational cohort study was conducted among patients who initiated ART in 2012. We divided the eligible patients into three groups: an early ART group with a baseline CD4(+) cell count of 500 cells/μL or greater, a standard ART group with a baseline CD4(+) cell count between 350 and 499 cells/μL, and a late ART group with a baseline CD4(+) cell count between 200 and 349 cells/μL...
October 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28981336/fostering-a-feeling-of-worth-among-vulnerable-hiv-populations-the-role-of-linkage-to-care-specialists
#8
Michelle R Broaddus, Jill Owczarzak, Casey Schumann, Kimberly A Koester
To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care...
October 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28981335/strengthening-the-hiv-care-continuum-in-the-dominican-republic-application-of-a-triadic-implementation-framework-to-meet-the-unaids-90-90-90-treatment-goal
#9
Alex S Bowman, Mili Mehta, Leonel Lerebours Nadal, Mina Halpern, Stephen W Nicholas, Silvia Amesty
Innovative empirical frameworks to evaluate progress in efforts addressing HIV treatment and prevention barriers in resource-limited areas are sorely needed to achieve the UNAIDS 90-90-90 goal (90% diagnosed, 90% on treatment, and 90% virally suppressed). A triadic implementation framework (TIF) is a comprehensive conceptual tool for (1) monitoring attrition, (2) evaluating operational programs, and (3) measuring the impact of specific implementation goals within the care continuum. TIF will assess the effects of enhanced programs on adherence and virologic suppression within the HIV care continuum at a regional clinic in the Dominican Republic (Clínica de Familia La Romana [CFLR]) and its program serving high-risk, migratory batey (sugarcane cultivation) communities...
October 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28981334/adolescent-and-adult-hiv-providers-definitions-of-hiv-infected-youths-successful-transition-to-adult-care-in-the-united-states
#10
Morgan M Philbin, Amanda E Tanner, Alice Ma, Brittany D Chambers, Samuella Ware, Elizabeth N Kinnard, Sophia A Hussen, Sonia Lee, J Dennis Fortenberry
It is important for both individual- and population-level health that HIV-infected individuals progress through the Care Continuum. However, HIV-infected youth frequently disengage from care during transition from pediatric/adolescent to adult care; only 50% remain in adult care after 1 year. Understanding how providers define and approach a successful healthcare transition can improve the delivery of HIV-related services during critical years of HIV treatment. We conducted 58 staff interviews across 14 Adolescent Trials Network clinics (n = 30) and 20 adult clinics (n = 28)...
October 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28891717/longitudinal-viral-suppression-among-a-cohort-of-adolescents-and-young-adults-with-behaviorally-acquired-human-immunodeficiency-virus
#11
Sarah M Wood, Elizabeth Lowenthal, Susan Lee, Sarah J Ratcliffe, Nadia Dowshen
Youth living with HIV (YLWH) are less likely than older adults to achieve and sustain viral suppression. While treatment guidelines recommend decreased viral load (VL) monitoring in individuals with well-controlled HIV, the appropriateness of this strategy for adolescents is unknown. We conducted a retrospective cohort study to describe longitudinal viral suppression and identify incidence of, and risk factors for, virologic failure among YLWH at a US adolescent HIV clinic from 2002 to 2015. We utilized Cox proportional hazards modeling to compare hazard ratios (HRs) for virologic failure stratified by baseline characteristics...
September 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28891716/implementation-of-a-county-township-village-allied-hiv-prevention-and-control-intervention-in-rural-china
#12
Jun Yu, Yi Zhang, Junjun Jiang, Qinglin Lu, Bingyu Liang, Deping Liu, Keyong Fang, Jiegang Huang, Yang He, Chuanyi Ning, Yanyan Liao, Jingzhen Lai, Wudi Wei, Fengxiang Qin, Li Ye, Wenkui Geng, Hao Liang
In China, rural areas are a weak link of HIV/AIDS prevention and control. From September 2011, an innovative "county-township-village" allied intervention was implemented in Longzhou County, Guangxi, which assigned the tasks of HIV/AIDS prevention and control to the county Centers for Disease Control and Prevention (CDC), township hospitals, and village clinics, respectively, instead of traditional intervention in which the county CDC undertook the entire work. A 6-year consecutive cross-sectional survey, including 3-year traditional intervention (2009-2011) and 3-year innovative intervention (2012-2014), was conducted to evaluate the effects of the new intervention...
September 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28891715/-where-it-falls-apart-barriers-to-retention-in-hiv-care-in-latino-immigrants-and-migrants
#13
Julie H Levison, Laura M Bogart, Iman F Khan, Dianna Mejia, Hortensia Amaro, Margarita Alegría, Steven Safren
Latino immigrants in the United States are disproportionately affected by HIV. Barriers to consistent attendance (retention) in HIV primary care constrain opportunities for HIV treatment success, but have not been specifically assessed in this population. We conducted semistructured interviews with 37 HIV-infected Latinos (aged ≥18 years and born in Puerto Rico or a Latin American Spanish-speaking country) and 14 HIV providers in metropolitan Boston (total n = 51). The Andersen Model of Healthcare Utilization informed a semistructured interview guide, which bilingual research staff used to explore barriers to HIV care...
September 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28783374/hiv-and-cognitive-impairment-in-clinical-practice-the-evaluation-of-a-stepwise-screening-protocol-in-relation-to-clinical-outcomes-and-management
#14
Charlotte S Hakkers, Jordan M Kraaijenhof, Esther B van Oers-Hazelzet, Anne J M A Visser-Meily, Andy I M Hoepelman, Joop E Arends, Roos E Barth
Neurocognitive impairment (NCI) is an increasingly important comorbidity in an ageing HIV+ population. Despite the lack of available treatment modalities, screening for NCI is recommended. In the UMC Utrecht, yearly NCI screening is done using the Montreal Cognitive Assessment (MoCA) tool and the HIV Dementia Scale (HDS). The aim of this study was to evaluate this screening protocol in relation to clinical outcomes and management. A retrospective cohort study was performed in suppressed adult HIV+ patients...
September 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28771023/relationship-between-single-tablet-antiretroviral-regimen-and-adherence-to-antiretroviral-and-non-antiretroviral-medications-among-veterans-affairs-patients-with-human-immunodeficiency-virus
#15
Jenna Yager, John Faragon, Liam McGuey, Adam Hoye-Simek, Zachary Hecox, Steven Sullivan, Stefanie Neubert, Nimish Patel
Several antiretrovirals (ART) have been coformulated as single tablet regimens (STR). Study objectives were to compare ART and non-ART adherence between STR and multiple tablet regimens (MTR) recipients, determine whether STR independently predicts ART adherence, and determine whether ART adherence influences non-ART adherence. A retrospective cohort study was performed among Upstate New York Veterans' Healthcare Administration (VISN-2) patients from 2000 to 2013. Inclusion criteria were age ≥18 years, human immunodeficiency virus (HIV) infection, receipt of ≥3 ART medications for ≥3 months, and available pharmacy refill records...
September 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28753396/young-men-s-disclosure-of-same-sex-behaviors-to-healthcare-providers-and-the-impact-on-health-results-from-a-us-national-sample-of-young-men-who-have-sex-with-men
#16
Nathan W Stupiansky, Adrian Liau, Joshua Rosenberger, Susan L Rosenthal, Wanzhu Tu, Shan Xiao, Holly Fontenot, Gregory D Zimet
Many men who have sex with men (MSM) do not disclose their same sex behaviors to healthcare providers (HCPs). We used a series of logistic regression models to explore a conceptual framework that first identified predictors of disclosure to HCPs among young MSM (YMSM), and subsequently examined young men's disclosure of male-male sexual behaviors to HCPs as a mediator between sociodemographic and behavioral factors and three distinct health outcomes [HIV testing, sexually transmitted infection (STI) testing, and human papillomavirus (HPV) vaccination]...
August 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28753395/neurocognitive-impairment-in-a-chronically-well-suppressed-hiv-infected-population-the-dutch-trevi-cohort-study
#17
Lennert W J van den Dries, Marlies N Wagener, Lize C Jiskoot, Merel Visser, Kevin R Robertson, Kirsten S Adriani, Eric C M van Gorp
We assessed the value of screening for cognitive abnormalities in a chronically infected HIV population (N = 388) and investigated the association with clinical correlates. The mean age was 48 years (±11), the majority of the patients were male (89%), the median duration of infection was 6 years [interquartile range (IQR) = 2-12], the median CD count was 600 (IQR = 450-780), and 326 (84%) had a viral load below 200 copies/mL. Screening for cognitive complaints was applied using the three Simioni questions and the international HIV dementia scale (iHDS)...
August 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28719229/experiences-using-pre-exposure-prophylaxis-for-safer-conception-among-hiv-serodiscordant-heterosexual-couples-in-the-united-states
#18
Angela R Bazzi, Ashley A Leech, Dea L Biancarelli, Meg Sullivan, Mari-Lynn Drainoni
Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast...
August 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28719226/learned-helplessness-and-sexual-risk-taking-in-adolescent-and-young-adult-african-american-females
#19
Laura Pittiglio
Research involving adolescent and young African American (AA) females has demonstrated that they face uncontrollable obstacles which can interfere with the negotiation of safer sexual behaviors. If these obstacles are perceived as uncontrollable, then these females may be at risk for the development of Learned Helplessness (LH). As the LH model predicts, if these obstacles are believed not to be in their control, it may lead to deficits in motivational or cognitive decision-making, deficits that could certainly influence their sexual risk taking behaviors...
August 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28650703/program-implementation-of-option-b-at-a-president-s-emergency-plan-for-aids-relief-supported-hiv-clinic-improves-clinical-indicators-but-not-retention-in-care-in-mbarara-uganda
#20
Kathleen Miller, Winnie Muyindike, Lynn T Matthews, Michael Kanyesigye, Mark J Siedner
2013 WHO guidelines for prevention of mother to child transmission recommend combination antiretroviral therapy (ART) for all pregnant women, regardless of CD4 count (Option B/B+). We conducted a retrospective analysis of data from a government-operated HIV clinic in Mbarara, Uganda before and after implementation of Option B+ to assess the impact on retention in care. We limited our analysis to women not on ART at the time of their first reported pregnancy with CD4 count >350. We fit regression models to estimate relationships between calendar period (Option A vs...
August 2017: AIDS Patient Care and STDs
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