AIDS patient care and STDs最新文献_第9页

A Qualitative Study of Barriers to Anal Cancer Screenings in US Veterans Living with HIV. 美国艾滋病患者肛门癌症筛查障碍的定性研究。

IF 4.9 2区医学

AIDS patient care and STDs Pub Date : 2023-09-01 DOI: 10.1089/apc.2023.0144

Cristina B Sanger, Elle Kalbfell, Linda Cherney-Stafford, Rob Striker, Esra Alagoz

{"title":"A Qualitative Study of Barriers to Anal Cancer Screenings in US Veterans Living with HIV.","authors":"Cristina B Sanger, Elle Kalbfell, Linda Cherney-Stafford, Rob Striker, Esra Alagoz","doi":"10.1089/apc.2023.0144","DOIUrl":"10.1089/apc.2023.0144","url":null,"abstract":"People living with human immunodeficiency virus (HIV) are at high risk for anal cancer. Anal cancer screenings are recommended annually for US veterans with HIV. Screenings can identify treatable precursor lesions and prevent cancer development. In a previous study, we found screening rate to be only 15%. Semistructured interviews were conducted with Veterans Affairs (VA) providers who treat veterans living with HIV. Participants described their experiences with anal cancer screenings. Researchers developed a codebook based on Theoretical Domains Framework (TDF) and coded data using thematic analysis to identify barriers to anal cancer screenings. Twenty-three interviews were conducted with VA providers representing 10 regions. Barriers identified corresponded with five targetable TDF domains: Knowledge, Skills, Environmental Context/Resources, Professional Roles/Identities, and Social Influence. Many providers lacked knowledge of screening protocols. Knowledgeable providers often lacked needed resources, including swabs, clinic space, reliable pathology, access to high-resolution anoscopy, or leadership support to implement a screening program. Providers mentioned competing priorities in the care of veterans with HIV infection and lack of skilled/trained personnel to perform the tests. It was often unclear which provider specialty should \"own\" screening responsibilities. Additional factors included patient discomfort with screening exams. Anal cancer screening protocols are recommended but not widely adopted in VA. There is a critical need to address barriers to anal cancer screenings in veterans. The TDF domains identified align with five intervention domains to target, including education, training, resource/environment, delineation of provider roles, and improved counseling efforts. Targeting these barriers may help improve the uptake of anal cancer screenings within VA.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":"37 9","pages":"436-446"},"PeriodicalIF":4.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10337454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Receipt of Injectable HIV Treatment in Clinic Versus at Home: Perspectives of Persons Living with HIV Infection. 在诊所接受艾滋病毒注射治疗与在家接受治疗：艾滋病毒感染者的观点。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2023-09-01 DOI: 10.1089/apc.2023.0154

Ruth O Adekunle, Stephanie Kirk, Jamila Williams, Rochelle Hanson, Angela Moreland-Johnson, Virginia Fonner, Mulugeta Gebregziabher, Eric G Meissner

引用次数: 0

Rosalind Franklin Society Proudly Announces the 2022 Award Recipient for AIDS Patient Care and STDs. 罗莎琳德·富兰克林协会自豪地宣布了2022年艾滋病患者护理和性病奖获得者。

IF 4.9 2区医学

AIDS patient care and STDs Pub Date : 2023-08-01 DOI: 10.1089/apc.2023.29019.rfs2022

Sannisha K Dale

引用次数: 0

Pandemic-Era Policies That Can Help End the HIV Epidemic for Latinas/os/xs. 流行病时代有助于结束拉丁裔艾滋病毒流行的政策。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2023-08-01 Epub Date: 2023-07-25 DOI: 10.1089/apc.2023.0072

Thespina Yamanis, Cristian Mendoza Gomez, Miriam Landis, Corey Donnelly, Taryn Morrissey, Jody Gan, Joseph Gregory Rosen, Owen Woodfield Smith, Kathleen Page, Maria Cecilia Zea

引用次数: 0

Racial Disparities in Access to the Kidney Transplant Waitlist Among People with Human Immunodeficiency Virus. 人类免疫缺陷病毒感染者获得肾移植等待名单的种族差异。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2023-08-01 DOI: 10.1089/apc.2023.0037

Brittany A Shelton, David J Becker, Paul A MacLennan, Bisakha Sen, Henna Budhwani, Jayme E Locke

{"title":"Racial Disparities in Access to the Kidney Transplant Waitlist Among People with Human Immunodeficiency Virus.","authors":"Brittany A Shelton, David J Becker, Paul A MacLennan, Bisakha Sen, Henna Budhwani, Jayme E Locke","doi":"10.1089/apc.2023.0037","DOIUrl":"10.1089/apc.2023.0037","url":null,"abstract":"The epidemiology of human immunodeficiency virus (HIV) has shifted such that Black individuals disproportionately represent incident HIV diagnoses. While risk of end-stage kidney disease (ESKD) among people with HIV (PWH) has declined with effective antiretroviral therapies, a substantial racial disparity in ESKD burden exists with the greatest prevalence among Black PWH. Disparities in waitlisting for kidney transplantation, the optimal treatment for ESKD, exist for both PWH and Black individuals without HIV, but it is unknown whether these characteristics together exacerbate such disparities. Six hundred two thousand six ESKD patients were identified from the United States Renal Data System (January 1, 2007 to December 31, 2017), and HIV-status was determined through Medicare claims. Cox proportional hazards regression was used to determine waitlisting rates. Multiplicative interaction terms between HIV-status and race were examined. The 6250 PWH were significantly younger, more commonly Black, and less commonly female than those without HIV. HIV-status and race were independently associated with 50% and 12% lower likelihood of waitlisting, respectively [adjusted hazard ratio (aHR): 0.50, 95% confidence interval (CI): 0.36-0.69, p < 0.001; aHR: 0.88, 95% CI: 0.87-0.90, p < 0.001]. There was also a significant interaction present between HIV-status and Black race (aHR: 0.80, 95% CI: 0.66-0.98, p < 0.001) such that, while HIV-status and Black race were independently associated with decreased waitlisting, the interaction of Black race and HIV-status exacerbated those disparities. While limited by lack of HIV-specific data that may impact inferences with respect to race, additional studies are urgently needed to understand the interplay between HIV risk factors, HIV-stigma, and racism, and how intersectionality may exacerbate disparities in transplantation among PWH.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":"37 8","pages":"394-402"},"PeriodicalIF":3.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10093582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations Between Sexual History Documentation in Electronic Health Records and Referral to Pre-Exposure Prophylaxis Navigator on Prescription of Pre-Exposure Prophylaxis at a Multi-Site Federally Qualified Health Center. 电子健康记录中的性史文件与多地点联邦合格健康中心暴露前预防处方的暴露前预防导航器之间的关联。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2023-08-01 DOI: 10.1089/apc.2023.0068

Kelly W Gagnon, Robert W S Coulter, James E Egan, Ken Ho, Mary Hawk

{"title":"Associations Between Sexual History Documentation in Electronic Health Records and Referral to Pre-Exposure Prophylaxis Navigator on Prescription of Pre-Exposure Prophylaxis at a Multi-Site Federally Qualified Health Center.","authors":"Kelly W Gagnon, Robert W S Coulter, James E Egan, Ken Ho, Mary Hawk","doi":"10.1089/apc.2023.0068","DOIUrl":"10.1089/apc.2023.0068","url":null,"abstract":"This cross-sectional study examined the relationships between sexual history screening (SHS) and referrals to a pre-exposure prophylaxis (PrEP) navigator (non-clinical staff member who assists patients in overcoming structural barriers to PrEP) on the proportion of days covered by PrEP for adult patients at a federally qualified health center. Patients' sociodemographics, PrEP prescriptions, referral to a PrEP navigator, and SHS data were extracted from the electronic health record (EHR). The analytic sample was 214 adult patients who were human immunodeficiency virus (HIV) negative and taking PrEP to prevent infection from January 2016 to December 2019. Mixed-effects negative binomial models were conducted accounting for clustering by patients' primary care providers. Documentation of SHS was associated with a higher proportion of days covered by PrEP (incidence rate ratio = 1.44, 95% confidence interval: 1.17-1.77). There was no significant effect of having a referral to the PrEP navigator on the proportion of days covered by PrEP, nor did having a referral to the PrEP navigator moderate the relationship between having SHS documented in the EHR and the proportion of days covered by PrEP. This study is the first to investigate the relationship between having sexual history documented in the EHR, referrals to a PrEP navigator, and their combined effect on the proportion of days covered by PrEP. Results of this study provide foundational evidence for future studies examining SHS as an opportunity to improve PrEP access and adherence and indicate the need for additional research exploring the value of PrEP navigators as an implementation strategy to overcome social and structural barriers to care.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":"37 8","pages":"403-415"},"PeriodicalIF":3.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10093581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementation Facilitators and Barriers for Primary Care Providers Prescribing Daily Oral PrEP to Adolescents in the United States. 美国初级医疗服务提供者为青少年开具每日口服 PrEP 处方的促进因素和障碍。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2023-08-01 DOI: 10.1089/apc.2023.0090

Christopher Owens, Samuel J Gray, Kaileigh Carter, Matt Hoffman, Cody Mullen, Randolph D Hubach

{"title":"Implementation Facilitators and Barriers for Primary Care Providers Prescribing Daily Oral PrEP to Adolescents in the United States.","authors":"Christopher Owens, Samuel J Gray, Kaileigh Carter, Matt Hoffman, Cody Mullen, Randolph D Hubach","doi":"10.1089/apc.2023.0090","DOIUrl":"10.1089/apc.2023.0090","url":null,"abstract":"Primary care providers (PCPs) are critical in prescribing human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) to adolescents at risk of HIV. More research is needed to identify facilitators and barriers PCPs encounter in prescribing PrEP to eligible adolescents post-Food and Drug Administration (FDA) approval. This online cross-sectional survey examined the PrEP implementation facilitators and barriers among a national sample of PCPs in the United States. PCPs (n = 502) specializing in family medicine or pediatrics were recruited from a Qualtrics panel from July 15 to August 9, 2022. We analyzed the collected data using content analysis and applied the Expert Recommendations for Implementing Change (ERIC) to codebook creation and data analysis. We conducted a Fisher's exact chi-square test of independence to compare facilitator and barrier prevalence differences between participants who had and had not prescribed PrEP to an adolescent patient. Results demonstrate that (1) distributing prescriber-focused educational materials, (2) involving parents, (3) changing liability laws, (4) enhancing adolescent PrEP uptake and adherence, (5) changing clinical resources, and (6) using mass/social media to change community norms might be strategies that influence PCPs prescribing PrEP to eligible adolescent patients. Results from this study could facilitate the planning of hybrid implementation-effectiveness trials designed to determine the acceptability, feasibility, and effectiveness of implementation strategies in improving the practices of PCPs prescribing PrEP to at-risk adolescents.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":"37 8","pages":"379-393"},"PeriodicalIF":3.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The CARES Program: Improving Viral Suppression and Retention in Care Through a Comprehensive Team-Based Approach to Care for People with HIV and Complex Psychosocial Needs. CARES计划：通过一种基于团队的综合方法来护理艾滋病毒感染者和复杂的心理社会需求，提高病毒在护理中的抑制和保留。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2023-08-01 DOI: 10.1089/apc.2023.0061

Stephanie Sweitzer, Maddie Giegold, Yunyun Chen, Eugene W Farber, Jeri Sumitani, Arkeelaua Henderson, Kirk Easley, Wendy S Armstrong, Jonathan A Colasanti, Rachel J Ammirati, Vincent C Marconi

{"title":"The CARES Program: Improving Viral Suppression and Retention in Care Through a Comprehensive Team-Based Approach to Care for People with HIV and Complex Psychosocial Needs.","authors":"Stephanie Sweitzer, Maddie Giegold, Yunyun Chen, Eugene W Farber, Jeri Sumitani, Arkeelaua Henderson, Kirk Easley, Wendy S Armstrong, Jonathan A Colasanti, Rachel J Ammirati, Vincent C Marconi","doi":"10.1089/apc.2023.0061","DOIUrl":"10.1089/apc.2023.0061","url":null,"abstract":"Retention in HIV care and viral suppression rates remain suboptimal, especially among people with HIV (PWH) facing complex barriers to care such as mental health conditions, substance use disorders, and housing insecurity. The Center for Adherence, Retention, and Engagement Support (CARES) program utilizes an interdisciplinary team that delivers integrated services in a drop-in setting to provide individualized care to PWH with complex psychosocial needs. We describe the CARES program and evaluate its effectiveness in retaining patients in care to achieve virological suppression. We characterized 119 referrals of PWH experiencing homelessness, mental health conditions, and substance use disorders to CARES between 2011 and 2017, and collected data for a 24-month observation period through 2019. Outcomes of patients who participated in CARES were compared with those who were referred but did not participate. The primary outcome was viral suppression (<200 copies/mL) at least once during 2-year follow-up. Retention in care (≥2 completed medical visits ≥90 days apart in each year post-referral) was a secondary outcome. Of 119 PWH referred to CARES, 59 participated with ≥2 visits. Those who participated in CARES were more likely to achieve viral suppression [adjusted odds ratio (aOR) 3.50, 95% confidence interval (CI) 1.19-10.32] and to be retained in care (aOR 3.73, 95% CI 1.52-9.14) compared with those who were referred but did not participate. This analysis found that the CARES program improved retention in care and viral suppression among PWH with complex psychosocial needs and suggests that it may represent a useful model for future programming.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":"37 8","pages":"416-424"},"PeriodicalIF":3.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10339664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence and Correlates of HIV Disclosure Without Consent Among Women Living With HIV in Metro Vancouver, Canada. 加拿大温哥华大都会HIV感染者中未经同意披露HIV的患病率和相关性。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2023-07-01 DOI: 10.1089/apc.2023.0018

Mika S Ohtsuka, Kate Shannon, Andrea Krüsi, Melanie Lee, Desire King, Melissa Braschel, Kathleen Deering

{"title":"Prevalence and Correlates of HIV Disclosure Without Consent Among Women Living With HIV in Metro Vancouver, Canada.","authors":"Mika S Ohtsuka, Kate Shannon, Andrea Krüsi, Melanie Lee, Desire King, Melissa Braschel, Kathleen Deering","doi":"10.1089/apc.2023.0018","DOIUrl":"10.1089/apc.2023.0018","url":null,"abstract":"This study identified the prevalence and perpetrators of HIV disclosure without consent, and social-structural correlates, among women living with HIV (WLWH). Data were drawn from 7 years (September 14 to August 21) of a longitudinal community-based open cohort of cis and trans WLWH living and/or accessing care in Metro Vancouver, Canada. The study sample included 1871 observations among 299 participants. Overall, 160 (53.3%) women reported lifetime HIV disclosure without consent at baseline, and 115 (38.5%) reported HIV disclosure without consent in the previous 6 months during 7 years of follow-up. In a subanalysis (n = 98), the most common perpetrators of HIV disclosure without consent were friends, people in the community, family, health professionals, and neighbors. In multivariable logistic regression analysis with generalized estimating equations, recent (last 6 months) housing insecurity [adjusted odds ratio (AOR): 1.43, 95% confidence interval: (1.10-1.86)], minoritized sexual identities (LGBQ2S) [AOR: 1.84 (1.22-2.78)], recently being treated, monitored, or diagnosed with depression, anxiety, or post-traumatic stress disorder [AOR: 1.37 (0.98-1.92)], and experiencing physical symptoms related to HIV [AOR: 1.75 (1.25-2.44)] was positively associated with recent disclosure without consent. In a context where HIV nondisclosure before sex is criminalized unless viral load is low and a condom is used, it is concerning that a large proportion of women have experienced HIV disclosure without consent. Laws should focus on protecting rights of WLWH, promoting equity, guaranteeing sexual and reproductive rights, and ensuring access to essential services and privacy. Findings highlight the need for trauma-informed approaches among health and housing services that are responsive to intersections of violence and stigma, and include a focus on confidentiality, autonomy, and safe disclosure practices.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":"37 7","pages":"351-360"},"PeriodicalIF":3.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10354302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient-Provider Relationships and Antiretroviral Therapy Adherence and Durable Viral Suppression Among Women with HIV, Miami-Dade County, Florida, 2021-2022. 2021-2022 年佛罗里达州迈阿密戴德县感染 HIV 的女性患者与提供者的关系以及抗逆转录病毒疗法的依从性和持久病毒抑制。

IF 3.4 2区医学

AIDS patient care and STDs Pub Date : 2023-07-01 DOI: 10.1089/apc.2023.0029

Mary Jo Trepka, Melissa K Ward, Kristopher Fennie, Diana M Sheehan, Sofia Beatriz Fernandez, Tan Li, Michele Jean-Gilles, Jessy G Dévieux, Gladys E Ibañez, Tendai Gwanzura, Ekpereka Nawfal, Aaliyah Gray, Mary Catherine Beach, Robert Ladner

{"title":"Patient-Provider Relationships and Antiretroviral Therapy Adherence and Durable Viral Suppression Among Women with HIV, Miami-Dade County, Florida, 2021-2022.","authors":"Mary Jo Trepka, Melissa K Ward, Kristopher Fennie, Diana M Sheehan, Sofia Beatriz Fernandez, Tan Li, Michele Jean-Gilles, Jessy G Dévieux, Gladys E Ibañez, Tendai Gwanzura, Ekpereka Nawfal, Aaliyah Gray, Mary Catherine Beach, Robert Ladner","doi":"10.1089/apc.2023.0029","DOIUrl":"10.1089/apc.2023.0029","url":null,"abstract":"Women with HIV in the United States are more negatively affected by adverse social determinants such as low education and poverty than men, and thus, especially need a supportive health care system. This cross-sectional study assessed the role of the patient-provider relationship on antiretroviral therapy (ART) adherence and durable viral suppression among women with HIV (WHIV) in Miami-Dade County, Florida. Patient-provider relationship was measured, in part, using the Health Care Relationship Trust Scale and Consumer Assessment of Health Care Providers and Systems. The survey was administered by telephone to women in the Ryan White Program June 2021-March 2022. Adherence was defined as 90% adherent on the average of three self-reported items. Lack of durable viral suppression was defined by at least one viral load ≥200 copies/mL among all tests conducted in a year. Logistic regression models were generated using backward stepwise modeling. Of 560 cis-gender women, 401 (71.6%) were adherent, and 450 (80.4%) had durable viral suppression. In the regression model, adherence was associated with higher patient-provider trust and provider communication as well as excellent perceived health, lack of significant depressive symptoms, no alcohol use within the last 30 days, and lack of transportation problems. In the regression model using provider as a random effect, durable viral suppression was associated with older age, Hispanic ethnicity, and lack of illegal drug use. While the results show that a strong patient-provider relationship facilitates ART adherence in WHIV, there was no association with durable viral suppression.","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":"37 7","pages":"361-372"},"PeriodicalIF":3.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10354312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9923838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0