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    3221 results match your criteria AIDS Patient Care and STDs[Journal]

    1 OF 65

    Providing Online-Based Sexual Health Outreach to Gay, Bisexual, and Queer Men in Ontario, Canada: Qualitative Interviews with Multisectoral Frontline Service Providers and Managers.
    AIDS Patient Care STDS 2018 Jun 13. Epub 2018 Jun 13.
    5 Gay Men's Health Activist , Toronto, Canada .
    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. Read More

    Enhancing Patient Navigation with Contingent Incentives to Improve Healthcare Behaviors and Viral Load Suppression of Persons with HIV and Substance Use.
    AIDS Patient Care STDS 2018 Jun 8. Epub 2018 Jun 8.
    5 Department of Sociomedical Sciences Mailman School of Public Health, Columbia University , New York, New York.
    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. Read More

    Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities.
    AIDS Patient Care STDS 2018 Jun 5. Epub 2018 Jun 5.
    2 Department of Family Medicine, University of Kansas Medical Center , Kansas City, Kansas.
    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. Read More

    Optimizing Community-Based HIV Testing and Linkage to Care for Young Persons in Metropolitan Atlanta.
    AIDS Patient Care STDS 2018 Jun;32(6):234-240
    6 Ponce Family and Youth Clinic , Grady Infectious Diseases Program, Grady Health Systems, Atlanta, Georgia .
    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. Read More

    PositiveLinks: A Mobile Health Intervention for Retention in HIV Care and Clinical Outcomes with 12-Month Follow-Up.
    AIDS Patient Care STDS 2018 Jun;32(6):241-250
    4 Department of Public Health Sciences, University of Virginia School of Medicine , Charlottesville, Virginia.
    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. Read More

    Metabolic Syndrome Among Antiretroviral Therapy-Naive Versus Experienced HIV-Infected Patients Without Preexisting Cardiometabolic Disorders in Western Kenya.
    AIDS Patient Care STDS 2018 Jun;32(6):215-222
    8 Department of Medicine, Duke Clinical Research Institute and Duke Global Health Institute, Duke University , Durham, North Carolina.
    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. We used logistic regression to identify associations between traditional risk factors, HIV disease characteristics, ART, and MetS. Read More

    The Changing Burden of HIV Attributable to Methamphetamine Among Men Who Have Sex with Men in King County, Washington.
    AIDS Patient Care STDS 2018 Jun;32(6):223-233
    1 HIV/STD Program, Public Health-Seattle & King County , Seattle, Washington.
    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. Read More

    Understanding Predictors of Early Antenatal Care Initiation in Relationship to Timing of HIV Diagnosis in South Africa.
    AIDS Patient Care STDS 2018 Jun;32(6):251-256
    1 Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg, South Africa .
    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. Read More

    Where Are They Now? Assessing if Persons Returned to HIV Care Following Loss to Follow-Up by Public Health Case Workers Were Engaged in Care in Follow-Up Years.
    AIDS Patient Care STDS 2018 May;32(5):181-190
    1 Epidemiology and Field Services Program , New York City Department of Health and Mental Hygiene, Long Island City, New York.
    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. Read More

    Knowledge of HIV Testing Guidelines Among US Internal Medicine Residents: A Decade After the Centers for Disease Control and Prevention's Routine HIV Testing Recommendations.
    AIDS Patient Care STDS 2018 May;32(5):175-180
    1 Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine , Houston, Texas.
    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. Read More

    The Clinic Environment as a Form of Social Support for Adolescents and Young Adults Living with HIV.
    AIDS Patient Care STDS 2018 May 24;32(5):208-213. Epub 2018 Apr 24.
    1 Department of Pediatrics, Johns Hopkins School of Medicine , Baltimore, Maryland.
    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. Read More

    Which Patients in the Emergency Department Should Receive Preexposure Prophylaxis? Implementation of a Predictive Analytics Approach.
    AIDS Patient Care STDS 2018 May 19;32(5):202-207. Epub 2018 Apr 19.
    1 Department of Medicine, University of Chicago , Chicago, Illinois.
    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. Read More

    Barriers and Facilitators for Clinical Care Engagement Among HIV-Positive African American and Latino Men Who Have Sex with Men.
    AIDS Patient Care STDS 2018 May 18;32(5):191-201. Epub 2018 Apr 18.
    4 Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine , Atlanta, Georgia .
    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. Read More

    Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos.
    AIDS Patient Care STDS 2018 Apr;32(4):165-173
    1 Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University , Miami, Florida.
    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. Read More

    The Max Clinic: Medical Care Designed to Engage the Hardest-to-Reach Persons Living with HIV in Seattle and King County, Washington.
    AIDS Patient Care STDS 2018 Apr;32(4):149-156
    1 Department of Medicine, University of Washington , Seattle, Washington.
    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. Read More

    Project THANKS: Examining HIV/AIDS-Related Barriers and Facilitators to Care in African American Women: A Community Perspective.
    AIDS Patient Care STDS 2018 Apr;32(4):119-128
    4 Department of Public Health, Montclair State University , Montclair, New Jersey.
    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). Read More

    Health System Features That Enhance Access to Comprehensive Primary Care for Women Living with HIV in High-Income Settings: A Systematic Mixed Studies Review.
    AIDS Patient Care STDS 2018 Apr;32(4):129-148
    1 Department of Family Medicine, McGill University , Montreal, Canada .
    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). Read More

    Gaps Up To 9 Months Between HIV Primary Care Visits Do Not Worsen Viral Load.
    AIDS Patient Care STDS 2018 Apr;32(4):157-164
    9 Department of Medicine, Baylor College of Medicine, Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Thomas Street Health Center and Harris Health System , Houston, Texas.
    Current guidelines specify that visit intervals with viral monitoring should not exceed 6 months for HIV patients. Yet, gaps in care exceeding 6 months are common. In an observational cohort using US patients, we examined the association between gap length and changes in viral load status and sought to determine the length of the gap at which significant increases in viral load occur. Read More

    Development and Piloting of a Home-Based Couples Intervention During Pregnancy and Postpartum in Southwestern Kenya.
    AIDS Patient Care STDS 2018 Mar;32(3):92-103
    3 Research, Care and Treatment Program, Centre for Microbiology Research, Kenya Medical Research Institute , Nairobi, Kenya .
    Engaging both partners of a pregnant couple can enhance prevention of mother-to-child transmission of HIV and promote family health. We developed and piloted an intervention to promote couple collaboration in health during pregnancy and postpartum in southwestern Kenya. We utilized formative data and stakeholder input to inform development of a home-based couples intervention. Read More

    Patient and Facility Correlates of Racial Differences in Viral Control for Black and White Veterans with HIV Infection in the Veterans Administration.
    AIDS Patient Care STDS 2018 Mar;32(3):84-91
    5 VA Center for Healthcare Organization and Implementation Research (CHOIR) at ENRM Veterans Affairs Medical Center , Bedford, Massachusetts.
    Black persons with HIV are less likely than white persons to experience viral control even while in treatment. We sought to understand whether patient characteristics and site of care explain these differences using a cross-sectional analysis of medical records. Our cohort included 8779 black and 7836 white patients in the Veterans Administration (VA) health system with HIV who received antiretroviral medication during 2013. Read More

    Sexualized Drug Use (Chemsex) Is Associated with High-Risk Sexual Behaviors and Sexually Transmitted Infections in HIV-Positive Men Who Have Sex with Men: Data from the U-SEX GESIDA 9416 Study.
    AIDS Patient Care STDS 2018 Mar;32(3):112-118
    7 Internal Medicine Service, Infanta Leonor University Hospital , Madrid, Spain .
    The magnitude of sexualized drug use (SDU), also known as chemsex, and its association with sexually transmitted infections (STI) has not been systematically explored in HIV-positive patients. This study aimed to calculate the prevalence of SDU and associated factors in a sample of HIV-positive men who have sex with men (MSM) in Spain. We calculated the frequency of SDU in a sample of HIV-positive MSM who responded to an anonymous online survey on sexual behavior and recreational drug use. Read More

    A Mobile Health Strategy to Support Adherence to Antiretroviral Preexposure Prophylaxis.
    AIDS Patient Care STDS 2018 Mar;32(3):104-111
    1 San Francisco Department of Public Health, San Francisco, California.
    Preexposure prophylaxis is a highly protective HIV prevention strategy, yet nonadherence can significantly reduce its effectiveness. We conducted a mixed methods evaluation of a mobile health intervention (iText) that utilized weekly bidirectional text or e-mail support messages to encourage preexposure prophylaxis (PrEP) adherence among participants in the multi-site iPrEx open-label extension study. A convenience sample of PrEP users from the San Francisco and Chicago sites participated in a 12-week pilot study. Read More

    Evaluation of Statin Eligibility, Prescribing Practices, and Therapeutic Responses Using ATP III, ACC/AHA, and NLA Dyslipidemia Treatment Guidelines in a Large Urban Cohort of HIV-Infected Outpatients.
    AIDS Patient Care STDS 2018 Feb;32(2):58-69
    Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University , Washington, District of Columbia.
    Statin coverage has been examined among HIV-infected patients using Adult Treatment Panel III (ATP III) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines, although not with newer National Lipid Association (NLA) guidelines. We investigated statin eligibility, prescribing practices, and therapeutic responses using these three guidelines. Sociodemographic, clinical, and laboratory data were collected between 2011 and 2016 for HIV-infected outpatients enrolled in the DC Cohort, a multi-center, prospective, observational study in Washington, DC. Read More

    Community-Acquired Meningitis in HIV-Infected Patients in the United States.
    AIDS Patient Care STDS 2018 Feb;32(2):42-47
    Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center , Houston, Texas.
    We conducted a retrospective study of 549 adults admitted with community-acquired meningitis (CAM) to several hospitals in New Orleans, LA and Houston, TX between 1999 and 2014 to characterize the current epidemiology, clinical manifestations, cerebrospinal fluid (CSF) characteristics, and outcomes of CAM between HIV-infected and uninfected patients and to identify risk factors for adverse outcomes in CAM. Bivariate analysis and logistic regression analysis were used to identify prognostic factors. A total of 1022 patients with CAM were screened. Read More

    A Conditional Economic Incentive Fails to Improve Linkage to Care and Antiretroviral Therapy Initiation Among HIV-Positive Adults in Cape Town, South Africa.
    AIDS Patient Care STDS 2018 Feb;32(2):70-78
    6 Department of Health Services, Policy and Practice (HSPP), Brown University School of Public Health , Providence, Rhode Island.
    Interventions to improve antiretroviral therapy (ART) access are urgently needed to maximize the multiple benefits from ART. This pilot study examined the effect of a conditional economic incentive on linkage to care and uptake of treatment following ART referral by a mobile health clinic. Between April 2015 and May 2016, 86 individuals (≥18 years old) referred for ART in a resource-limited setting were randomized (1:1) to a control group or to an incentive: R300 cash (∼$23, or 3. Read More

    Optimizing Delivery of HIV Preexposure Prophylaxis for Women in the United States.
    AIDS Patient Care STDS 2018 Jan;32(1):16-23
    6 Division of HIV/AIDS Prevention, National Center for HIV , Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia .
    Preexposure prophylaxis (PrEP) is a highly effective HIV prevention method; however, it is underutilized among women who are at risk for acquisition of HIV. Women comprise one in five HIV diagnoses in the United States, and significant racial disparities in new HIV diagnoses persist. The rate of new HIV diagnoses among black and African American women in 2015 was 16 times greater than that of white women. Read More

    Neuropsychological Assessment of 412 HIV-Infected Individuals in São Paulo, Brazil.
    AIDS Patient Care STDS 2018 Jan;32(1):1-8
    4 Department of Neurology, Institute of Infectology Emilio Ribas , São Paulo, Brazil .
    HIV-associated neurocognitive disorders (HAND) remain frequent even among individuals receiving combined antiretroviral therapy (cART). In addition, HAND may adversely affect the quality of life and adherence to cART. There is scarce epidemiological information about HAND in Latin America. Read More

    Modality of Primary HIV Disclosure and Association with Mental Health, Stigma, and Antiretroviral Therapy Adherence in Tanzanian Youth Living with HIV.
    AIDS Patient Care STDS 2018 Jan;32(1):31-37
    2 Kilimanjaro Christian Medical Center , KCMC-Duke Collaboration, Moshi, Tanzania .
    Disclosing HIV status to children before adolescence is a major challenge facing families and healthcare providers. This study used a mixed methods approach to explore the youth perspective of how youth living with HIV (YLHIV) found out their status and to quantify the association of disclosure modality with mental health, stigma, adherence, and HIV outcomes in adolescence. Youth 11-24 years of age attending adolescent HIV clinic in Moshi, Tanzania were included. Read More

    Correlates of Never Testing for HIV Among Sexually Active Internet-Recruited Gay, Bisexual, and Other Men Who Have Sex with Men in the United States.
    AIDS Patient Care STDS 2018 Jan 12;32(1):9-15. Epub 2017 Dec 12.
    8 Department of Psychology, University of Washington , Seattle, Washington.
    In the United States, gay, bisexual, and other men who have sex with men (GBMSM) are disproportionately affected by the HIV/AIDS epidemic. Despite great strides in HIV prevention, including biobehavioral HIV prevention strategies such as pre-exposure prophylaxis and treatment as prevention, there has been relatively low uptake of these strategies. The success of biobehavioral prevention strategies requires HIV testing but a subset of GBMSM have never been tested. Read More

    Factors Associated with Use of Short-Term Pre-Exposure Prophylaxis for HIV Among Female Partners of Migrant Miners in Mozambique.
    AIDS Patient Care STDS 2017 Dec;31(12):528-534
    1 Mailman School of Public Health, ICAP, Columbia University , New York, New York.
    Effective interventions tailored to specific types of behaviors and contexts are needed for women at risk for HIV acquisition. Oral pre-exposure prophylaxis (PrEP) is an efficacious HIV prevention intervention that uses antiretroviral drugs to reduce the risk of acquiring HIV infection. In Mozambique, HIV remains a major public health concern, with a national prevalence of 13%. Read More

    HIV Care Providers' Intentions to Prescribe and Actual Prescription of Pre-Exposure Prophylaxis to At-Risk Adolescents and Adults.
    AIDS Patient Care STDS 2017 Dec;31(12):504-516
    1 Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.
    Pre-exposure prophylaxis (PrEP) is indicated for use in US adults, and little is known about clinician intentions to prescribe and actual prescription of PrEP to adolescents younger than 18. Fifty-six clinicians who care for HIV-infected and at-risk youth completed an anonymous online survey in 2014. Primary outcomes were (1) intentions to prescribe PrEP to adolescents and adults in four risk categories [men who have sex with men (MSM), transgender women, heterosexuals with multiple partners of unknown HIV status, heterosexuals with HIV-infected partners]; and (2) actual prescription of PrEP to adolescents and adults in these risk groups. Read More

    Facilitators and Barriers to Pre-Exposure Prophylaxis Willingness Among Young Men Who Have Sex with Men Who Use Geosocial Networking Applications in California.
    AIDS Patient Care STDS 2017 Dec;31(12):517-527
    1 University of California , Los Angeles, Los Angeles, California.
    While correlates of pre-exposure prophylaxis (PrEP) uptake have been explored among older men who have sex with men (MSM), less is known about the facilitators and barriers that encourage uptake among younger MSM (YMSM). This study explores the association between willingness to take PrEP and demographic characteristics, sexual risk, and substance use, and attitudinal factors among YMSM in California who use geosocial networking applications (GSN apps). Based on survey data from YMSM recruited through GSN apps (n = 687), PrEP willingness was positively associated with Hispanic ethnicity [adjusted odds ratio (aOR): 1. Read More

    Durability of Second Antiretroviral Regimens in the Italian Cohort Naive Antiretrovirals Foundation Study and Factors Associated with Discontinuation.
    AIDS Patient Care STDS 2017 Dec;31(12):487-494
    8 Division of Infectious Diseases, San Paolo Hospital, University of Milan , Milan, Italy .
    The study was designed to investigate the median duration of second antiretroviral regimens and factors associated with early discontinuation in HIV patients who switched with an undetectable viral load. We conducted a retrospective analysis of the Italian Cohort Naive Antiretrovirals Foundation Study (ICONA), which collects data throughout the country. Patients who started first antiretroviral therapy (ART) after January 1, 2008 in any center involved in this cohort and then switched to a second regimen were included in the study. Read More

    The Pre-Exposure Prophylaxis-Stigma Paradox: Learning from Canada's First Wave of PrEP Users.
    AIDS Patient Care STDS 2018 Jan 29;32(1):24-30. Epub 2017 Nov 29.
    5 St. Michael's Hospital , Toronto, Ontario, Canada .
    With the emergence of daily oral tenofovir disoproxil fumarate and emtricitabine-based pre-exposure prophylaxis (PrEP) use in Canada, questions have emerged concerning the impacts of this HIV prevention tool on gay men's social and sexual lives. We conducted small focus groups and individual qualitative interviews with 16 gay men in Toronto who were part of the 'first wave' of Canadian PrEP users. Participants were on PrEP for at least one year as part of a demonstration project (November 2014-June 2016). Read More

    Exploring the Healthcare Environment and Associations with Clinical Outcomes of People Living with HIV/AIDS.
    AIDS Patient Care STDS 2017 Dec 17;31(12):495-503. Epub 2017 Nov 17.
    5 UPMC Center for High-Value Health Care , Pittsburgh, Pennsylvania.
    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. Read More

    Underutilization of Statins When Indicated in HIV-Seropositive and Seronegative Women.
    AIDS Patient Care STDS 2017 Nov;31(11):447-454
    1 Institute for Global Health and Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina.
    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. Read More

    Substantially Higher and Earlier Occurrence of Anti-Tuberculosis Drug-Related Adverse Reactions in HIV Coinfected Tuberculosis Patients: A Matched-Cohort Study.
    AIDS Patient Care STDS 2017 Nov;31(11):455-462
    1 AIDS Clinical Center, National Center for Global Health and Medicine , Tokyo, Japan .
    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. Read More

    Potential Healthcare Insurance and Provider Barriers to Pre-Exposure Prophylaxis Utilization Among Young Men Who Have Sex with Men.
    AIDS Patient Care STDS 2017 Nov;31(11):470-478
    7 Fenway Health, Beth Israel Deaconess Medical Center/Harvard Medical School , Boston, Massachusetts.
    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. Read More

    Experiences of Young Parents with Perinatally Acquired HIV.
    AIDS Patient Care STDS 2017 Nov;31(11):479-485
    4 Youth Pride and Burgess Clinics , Division of Adolescent and Young Adult Medicine.
    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. Read More

    Financial Barriers and Lapses in Treatment and Care of HIV-Infected Adults in a Southern State in the United States.
    AIDS Patient Care STDS 2017 Nov 17;31(11):463-469. Epub 2017 Oct 17.
    1 University of North Carolina at Chapel Hill School of Medicine , Division of Infectious Diseases, Chapel Hill, North Carolina.
    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. Read More

    Comparing Outcomes of HIV-Infected Chinese Adults on Antiretroviral Therapy by CD4 Count at Treatment Initiation: A Nationwide Retrospective Observational Cohort Study, 2012-2014.
    AIDS Patient Care STDS 2017 10;31(10):413-420
    5 Yunnan AIDS Care Center , Kunming, China .
    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. Read More

    Fostering a "Feeling of Worth" Among Vulnerable HIV Populations: The Role of Linkage to Care Specialists.
    AIDS Patient Care STDS 2017 10;31(10):438-446
    4 Center for AIDS Prevention Studies, University of California , Department of Medicine, San Francisco, San Francisco, California.
    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. Read More

    Strengthening the HIV Care Continuum in the Dominican Republic: Application of a Triadic Implementation Framework to Meet the UNAIDS 90-90-90 Treatment Goal.
    AIDS Patient Care STDS 2017 10;31(10):407-412
    1 College of Physicians and Surgeons, Columbia University , New York, New York.
    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. Read More

    Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States.
    AIDS Patient Care STDS 2017 10;31(10):421-427
    7 Department of Pediatrics, Indiana University School of Medicine , Indianapolis, Indiana.
    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. Read More

    Longitudinal Viral Suppression Among a Cohort of Adolescents and Young Adults with Behaviorally Acquired Human Immunodeficiency Virus.
    AIDS Patient Care STDS 2017 09;31(9):377-383
    1 Craig-Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.
    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. Read More

    Implementation of a "County-Township-Village" Allied HIV Prevention and Control Intervention in Rural China.
    AIDS Patient Care STDS 2017 09;31(9):384-393
    1 Guangxi Key Laboratory of AIDS Prevention and Treatment and Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University , Nanning, China .
    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. Read More

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