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AIDS Patient Care and STDs

Emma Sophia Kay, D Scott Batey, Michael J Mugavero
The Ryan White HIV/AIDS program (RWHAP) provides essential primary and supplementary health services to people living with HIV (PLWH). We examined the relationship between supplementary RWHAP services (Part B) and two outcomes: viral suppression (VS) and two separate measures of retention in care (RiC) based on kept- and missed-visits. We used purposive sampling to identify adult patients who received primary medical care at an academically-affiliated HIV/AIDS clinic in the southeastern United States (N = 1159) and who attended at least one scheduled HIV primary care appointment at the study site during 2015...
July 2018: AIDS Patient Care and STDs
Suzanne M McCluskey, Guinevere Q Lee, Kimia Kamelian, Annet Kembabazi, Nicholas Musinguzi, Mwebesa B Bwana, Conrad Muzoora, Jessica E Haberer, Peter W Hunt, Jeffrey N Martin, Yap Boum, David R Bangsberg, P Richard Harrigan, Mark J Siedner
The prevalence of HIV pretreatment drug resistance (PDR) is increasing in sub-Saharan Africa. We sought to describe correlates of PDR and evaluate effects of PDR on clinical outcomes in rural Uganda. We analyzed data from the Uganda AIDS Rural Treatment Outcomes study, a cohort of antiretroviral therapy (ART)-naive adults with HIV (2005-2015). We performed resistance testing on pre-ART specimens. We defined PDR as any World Health Organization (WHO) 2009 surveillance drug resistance mutation and classified PDR level using the Stanford algorithm...
July 2018: AIDS Patient Care and STDs
David J Brennan, Rusty Souleymanov, Nathan Lachowsky, Gerardo Betancourt, Daniel Pugh, Owen McEwen
The Internet is a common tool for gay, bisexual, and other men who have sex with men (MSM) to find sexual partners and sexual health information. Given persistently high human immunodeficiency virus (HIV) infection rates among MSM, it is important to examine the role of online outreach for MSM as part of HIV prevention and care. We provide an overview of the unique perspectives of online sexual health outreach, delivered through AIDS Service Organizations (ASOs) through sociosexual Internet sites and mobile applications...
July 2018: AIDS Patient Care and STDs
Maxine L Stitzer, Alexis S Hammond, Tim Matheson, James L Sorensen, Daniel J Feaster, Rui Duan, Lauren Gooden, Carlos Del Rio, Lisa R Metsch
This secondary analysis compares health behavior outcomes for two groups of HIV+ substance users randomized in a 3-arm trial [1] to receive Patient Navigation with (PN+CM) or without (PN) contingent financial incentives (CM). Mean age of participants was 45 years; the majority was male (67%), African American (78%), unemployed (35%), or disabled (50%). Behaviors incentivized for PN+CM were (1) attendance at HIV care visits and (2) verification of an active HIV medication prescription. Incentives were associated with shorter time to treatment initiation and higher rates of behaviors during the 6-month intervention with exception of month 6 HIV care visits...
July 2018: AIDS Patient Care and STDs
Joanne Simone, Mary Jo Hoyt, Deborah S Storm, Sarah Finocchario-Kessler
Preconception care can improve maternal and infant outcomes by identifying and modifying health risks before pregnancy and reducing unplanned pregnancies. However, information about how preconception care is provided to persons living with HIV (PLWH) is lacking. This study uses qualitative interviews with HIV care providers to describe current models of preconception care and explore factors influencing services. Single, anonymous, telephone interviews were conducted with 92 purposively selected HIV healthcare providers in Atlanta, Baltimore, Houston, Kansas City, Newark, Philadelphia, and San Francisco in 2013-2014...
July 2018: AIDS Patient Care and STDs
Ashley Murray, Sophia A Hussen, Lauren Toledo, LaTeshia Thomas-Seaton, Scott Gillespie, Chanda Graves, Rana Chakraborty, Madeline Y Sutton, Andres F Camacho-Gonzalez
HIV continuum of care analyses in Georgia during 2013 revealed that 82% of adolescents and adults living with HIV knew their diagnosis and that 75% were linked to care. However, of all persons in Georgia living with HIV in 2014, only 60% had at least one HIV care visit, and just 48% were retained in care. Understanding barriers for HIV testing, linkage, and retention in youth may strengthen HIV-related encounters and improve patient outcomes. We conducted 17 qualitative focus groups with HIV-positive and -negative youth, ages 18-24 years, from the Atlanta Metropolitan Statistical Area...
June 2018: AIDS Patient Care and STDs
Rebecca Dillingham, Karen Ingersoll, Tabor E Flickinger, Ava Lena Waldman, Marika Grabowski, Colleen Laurence, Erin Wispelwey, George Reynolds, Mark Conaway, Wendy F Cohn
Mobile health interventions may help People Living with HIV (PLWH) improve engagement in care. We designed and piloted PositiveLinks, a clinic-affiliated mobile intervention for PLWH, and assessed longitudinal impact on retention in care and viral suppression. The program was based at an academic Ryan White Clinic serving a nonurban population in Central Virginia. The PL intervention included a smartphone app that connected participants to clinic staff and provided educational resources, daily queries of stress, mood and medication adherence, weekly quizzes, appointment reminders, and a virtual support group...
June 2018: AIDS Patient Care and STDs
Alfred Osoti, Tecla M Temu, Nicholas Kirui, Edmond K Ngetich, Jemima H Kamano, Stephanie Page, Carey Farquhar, Gerald S Bloomfield
Metabolic syndrome (MetS), a cluster of cardiovascular disease risk factors, is increasingly common in people living with HIV; however, data on prevalence and the role of antiretroviral therapy (ART) as a risk factor for MetS in sub-Saharan Africa are lacking. We conducted a cross-sectional study to assess the prevalence and risk factors for MetS among ART-naive and ART-experienced HIV-infected adults without preexisting cardiometabolic disorders in Western Kenya using validated questionnaires and laboratory tests after overnight fasting...
June 2018: AIDS Patient Care and STDs
Julia E Hood, Susan E Buskin, Matthew R Golden, Sara N Glick, Caleb Banta-Green, Julia C Dombrowski
Methamphetamine use is a key driver of HIV transmission among men who have sex with men (MSM). We evaluated trends in incident HIV diagnosis rates among methamphetamine using and nonusing MSM and assessed the relationship between methamphetamine use and demographic, behavioral, and clinical characteristics among MSM newly diagnosed with HIV. We analyzed several sources of HIV and behavioral surveillance data to estimate incident rates of HIV diagnoses and the population attributable risk percent corresponding to methamphetamine use among MSM in King County, Washington...
June 2018: AIDS Patient Care and STDs
Cornelius Nattey, Nelly Jinga, Constance Mongwenyana, Idah Mokhele, Given Mohomi, Matthew P Fox, Dorina Onoya
Effective prevention of mother-to-child transmission benefits from early presentation to antenatal care (ANC). It is, however, unclear whether a previous HIV diagnosis results in earlier initiation of ANC. We estimated the probability of early ANC initiation among women with a previous HIV-positive diagnosis compared to those who first tested for HIV during ANC and explored determinants of early ANC among HIV-positive women. We conducted an analysis of a cross-sectional survey among 411 HIV-positive adult (>18 years) women who gave birth at midwife obstetrics units in Gauteng between October 2016 and May 2017...
June 2018: AIDS Patient Care and STDs
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May 2018: AIDS Patient Care and STDs
Chi-Chi N Udeagu, Sharmila Shah, Kavita Misra, Kent A Sepkowitz, Sarah L Braunstein
We examined care engagement and viral suppression (VS) over a 1- to 5-year period among persons re-engaged in HIV care using retrospective cohort study and longitudinal follow-up. The population comprised five cohorts of persons re-engaged in care from 2009 to 2013. We used surveillance data [CD4 T cell count or HIV viral load (VL) RNA] to measure four outcomes 1-5 years post-care engagement. Engagement-in-care indicated persons with laboratory reports in each follow-up year. Continuous engagement or sustained engagement, respectively, included persons with ≥1 or ≥2 (separated by 90 days) CD4 or VL reports in each follow-up year...
May 2018: AIDS Patient Care and STDs
Dima Dandachi, Bich N Dang, Rita Wilson Dib, Harvey Friedman, Thomas Giordano
Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adherence to universal HIV testing in an outpatient setting. A cross-sectional survey of internal medicine residents at four residency programs in Chicago was conducted from January to March 2016. Aggregate data on HIV screening were collected from 35 federally qualified community health centers in the Chicago area after inclusion of an HIV testing best practice alert in patients' electronic medical records...
May 2018: AIDS Patient Care and STDs
Suzanne M Grieb, Deanna Kerrigan, Vicki Tepper, Jonathan Ellen, Erica Sibinga
Adolescents and young adults living with HIV (YLHIV) face numerous stresses that affect their care and medication adherence. The clinic social environment may play an important supportive role for YLHIV, influencing health outcomes. The aim of this article is to explore how YLHIV in Baltimore, Maryland understand the various forms of social support provided within the social environment of their HIV clinic. We used qualitative research methods including iterative, semi-structured in-depth interviews with 20 YLHIV interviewed up to three times each to explore HIV stressors, support systems, and medication adherence...
May 2018: AIDS Patient Care and STDs
Jessica P Ridgway, Ellen A Almirol, Alvie Bender, Andrew Richardson, Jessica Schmitt, Eleanor Friedman, Nicola Lancki, Ivan Leroux, Nina Pieroni, Jessica Dehlin, John A Schneider
Emergency Departments (EDs) have the potential to play a crucial role in HIV prevention by identifying and linking high-risk HIV-negative clients to preexposure prophylaxis (PrEP) care, but it is difficult to perform HIV risk assessment for all ED patients. We aimed to develop and implement an electronic risk score to identify ED patients who are potential candidates for PrEP. Using electronic medical record (EMR) data, we used logistic regression to model the outcome of PrEP eligibility. We converted the model into an electronic risk score and incorporated it into the EMR...
May 2018: AIDS Patient Care and STDs
James W Carey, Neal Carnes, Alisú Schoua-Glusberg, Katherine Kenward, Deborah Gelaude, Damian Denson, Elizabeth Gall, Laura A Randall, Paula M Frew
Achieving optimal health among people living with HIV (PLWH) requires linkage to clinical care upon diagnosis, followed by ongoing engagement in HIV clinical care. A disproportionate number of black/African American and Hispanic/Latino men who have sex with men (MSM) living with HIV do not, however, achieve ongoing care. We conducted semistructured interviews in 2014 with 84 urban black/African American and Hispanic/Latino MSM living with HIV to understand their barriers and facilitators to engagement. We classified men as care-engaged or not at the time of the interview, and conducted content analysis of the interview transcripts to identify barriers and facilitators to engagement...
May 2018: AIDS Patient Care and STDs
Diana M Sheehan, Chelsea Cosner, Kristopher P Fennie, Merhawi T Gebrezgi, Elena Cyrus, Lorene M Maddox, Julie H Levison, Emma C Spencer, Theophile Niyonsenga, Mary Jo Trepka
The objective of this study was to estimate disparities in linkage to human immunodeficiency virus (HIV) care among Latinos by country/region of birth, HIV testing site, and neighborhood characteristics. A retrospective study was conducted using Florida HIV surveillance records of Latinos/Hispanics aged ≥13 diagnosed during 2014-2015. Linkage to HIV care was defined as a laboratory test (HIV viral load or CD4) within 3 months of HIV diagnosis. Multi-level Poisson regression models were used to estimate adjusted prevalence ratios (aPR) for nonlinkage to care...
April 2018: AIDS Patient Care and STDs
Julia C Dombrowski, Meena Ramchandani, Shireesha Dhanireddy, Robert D Harrington, Allison Moore, Matthew R Golden
The Max Clinic in Seattle, Washington is designed to engage patients who have extensive barriers to HIV care. In this article, we describe the clinic's evolution and outcomes of patients enrolled in the first 2 years. The clinic is a high-intensity, low-threshold, incentivized care model that includes walk-in access to primary care in a Sexually Transmitted Disease Clinic. Patients who have failed to engage in care and achieve viral suppression with lower intensity support are referred by clinicians, case managers, and the health department Data to Care program...
April 2018: AIDS Patient Care and STDs
Ndidiamaka Amutah-Onukagha, Meena Mahadevan, Ijeoma Opara, Monica Rodriguez, Megan Trusdell, Jessica Kelly
Project THANKS, (Turning HIV/AIDS into Knowledge for Sisters), is an evidence-based intervention that utilizes a community-based participatory and empowerment building approach for African American female substance abusers living with HIV and other chronic diseases. This qualitative study sought to gain insight from women living with HIV on how to improve Project THANKS. African American women living with substance abuse disorders, HIV, and other comorbidities were recruited from three community based health centers in New Jersey (N = 31)...
April 2018: AIDS Patient Care and STDs
Nadia O'Brien, Quan Nha Hong, Susan Law, Sarah Massoud, Allison Carter, Angela Kaida, Mona Loutfy, Joseph Cox, Neil Andersson, Alexandra de Pokomandy
Women living with HIV in high-income settings continue to experience modifiable barriers to care. We sought to determine the features of care that facilitate access to comprehensive primary care, inclusive of HIV, comorbidity, and sexual and reproductive healthcare. Using a systematic mixed studies review design, we reviewed qualitative, mixed methods, and quantitative studies identified in Ovid MEDLINE, EMBASE, and CINAHL databases (January 2000 to August 2017). Eligibility criteria included women living with HIV; high-income countries; primary care; and healthcare accessibility...
April 2018: AIDS Patient Care and STDs
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