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Census Bureau Updates Interactive HIV/AIDS Database; New Prevalence Estimates from More Than 100 Countries

July 22, 2014 Comments off

Census Bureau Updates Interactive HIV/AIDS Database; New Prevalence Estimates from More Than 100 Countries
Source: U.S. Census Bureau

The U.S. Census Bureau today released its annually updated interactive global resource on the prevalence of HIV infection and AIDS cases and deaths. First developed in 1987, the database now holds more than 164,000 statistics, an increase of approximately 5,900 new estimates in the last year, and is the most comprehensive resource of its kind in the world.

The Census Bureau database is maintained with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID).

The tool consists of a library of statistics from more than 14,900 sources in international scientific and medical journals, individual countries’ annual HIV/AIDS surveillance reports, and papers and posters presented at international conferences. China represents 28 percent of the new records in the database, the largest increase by a single country.

The menu-driven access tool enables users to search for statistical information in countries and territories across the world, as well as by subpopulation, geographic subarea (such as urban and rural), age, sex and year from the 1960s to 2013.

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UNAIDS report shows that 19 million of the 35 million people living with HIV today do not know that they have the virus

July 17, 2014 Comments off

UNAIDS report shows that 19 million of the 35 million people living with HIV today do not know that they have the virus
Source: Joint United Nations Programme on HIV/AIDS (UNAIDS)

A new report by UNAIDS shows that 19 million of the 35 million people living with HIV globally do not know their HIV-positive status.

The UNAIDS Gap report shows that as people find out their HIV-positive status they will seek life-saving treatment. In sub-Saharan Africa, almost 90% of people who tested positive for HIV went on to access antiretroviral therapy (ART). Research shows that in sub-Saharan Africa, 76% of people on ART have achieved viral suppression, whereby they are unlikely to transmit the virus to their sexual partners. New data analysis demonstrates that for every 10% increase in treatment coverage there is a 1% decline in the percentage of new infections among people living with HIV.

The report highlights that efforts to increase access to ART are working. In 2013, an additional 2.3 million people gained access to the life-saving medicines. This brings the global number of people accessing ART to nearly 13 million by the end of 2013. Based on past scale-up, UNAIDS projects that as of July 2014 as many as 13 950 296 people were accessing ART.

Behavioral and Clinical Characteristics of Persons Receiving Medical Care for HIV Infection — Medical Monitoring Project, United States, 2009

June 21, 2014 Comments off

Behavioral and Clinical Characteristics of Persons Receiving Medical Care for HIV Infection — Medical Monitoring Project, United States, 2009
Source: Morbidity and Mortality Weekly Report (CDC)

Problem:
As of December 31, 2009, an estimated 864,748 persons were living with human immunodeficiency virus (HIV) infection in the 50 U.S. states, the District of Columbia, and six U.S.-dependent areas. Whereas HIV surveillance programs in the United States collect information about persons with a diagnosis of HIV infection, supplemental surveillance systems collect in-depth information about the behavioral and clinical characteristics of persons receiving outpatient medical care for HIV infection. These data are needed to reduce HIV-related morbidity and mortality and HIV transmission.

Reporting Period Covered:
Data were collected during June 2009–May 2010 for patients receiving medical care at least once during January–April 2009.

Description of the System:
The Medical Monitoring Project (MMP) is an ongoing surveillance system that assesses behaviors and clinical characteristics of HIV-infected persons who have received outpatient medical care. For the 2009 data collection cycle, participants must have been aged ≥18 years and have received medical care during January–April 2009 at sampled facilities that provide HIV medical care within participating MMP project areas. Behavioral and selected clinical data were collected using an in-person interview, and most clinical data were collected using medical record abstraction. A total of 23 project areas in 16 states and Puerto Rico were funded to collect data during the 2009 data collection cycle. The data were weighted for probability of selection and nonresponse to be representative of adults receiving outpatient medical care for HIV infection in the United States and Puerto Rico. Prevalence estimates are presented as weighted percentages. The period of reference is the 12 months before the patient interview unless otherwise noted.

Results:
The patients in MMP represent 421,186 adults who received outpatient medical care for HIV infection in the United States and Puerto Rico during January–April 2009. Of adults who received medical care for HIV infection, an estimated 71.2% were male, 27.2% were female, and 1.6% were transgender. An estimated 41.4% were black or African American, 34.6% were white, and 19.1% were Hispanic or Latino. The largest proportion (23.1%) were aged 45–49 years. Most patients (81.1%) had medical coverage; 40.3% had Medicaid, 30.6% had private health insurance, and 25.7% had Medicare.

An estimated 69.6% of patients had three or more documented CD4+ T-lymphocyte cell (CD4+) or HIV viral load tests. Most patients (88.7%) were prescribed antiretroviral therapy (ART), and 71.6% had a documented viral load that was undetectable or ≤200 copies/mL at their most recent test. Among sexually active patients, 55.0% had documentation in the medical record of being tested for syphilis, 23.2% for gonorrhea, and 23.9% for chlamydia.

Noninjection drugs were used for nonmedical purposes by an estimated 27.1% of patients, whereas injection drugs were used for nonmedical purposes by 2.1% of patients. Overall, 12.9% of patients engaged in unprotected sex with a partner of negative or unknown HIV status.

Unmet supportive service needs were prevalent, with an estimated 22.8% in need of dental care and 12.0% in need of public benefits, including Social Security Income or Social Security Disability Insurance. Fewer than half of patients (44.8%) reported receiving HIV and sexually transmitted disease prevention counseling from a health-care provider.

Interpretation:
The findings in this report indicate that most adults living with HIV who received medical care in 2009 were taking ART, had CD4+ and HIV viral load testing at regular intervals, and had health insurance or other coverage. However, some patients did not receive clinical services and treatment in accordance with guidelines. Some patients engaged in behaviors, such as unprotected sex, that increase the risk for transmitting HIV to sex partners, and some used noninjection or injection drugs or both.

Public Health Actions:
Local and state health departments and federal agencies can use MMP data for program planning to determine allocation of services and resources, guide prevention planning, assess unmet medical and supportive service needs, inform health-care providers, and help focus intervention programs and health policies at the local, state, and national levels.

The Role of Substance Use and Mental Health Problems in Medication Adherence Among HIV-Infected MSM

June 19, 2014 Comments off

The Role of Substance Use and Mental Health Problems in Medication Adherence Among HIV-Infected MSM
Source: LGBT Health

Mental health and substance abuse problems are highly prevalent among HIV-infected men who have sex with men (MSM) and frequently interfere with antiretroviral therapy (ART) adherence. Novel interventions that address underlying psychosocial health problems are necessary for improving ART adherence to enhance HIV-related health outcomes and suppress HIV viral load in an effort to prevent transmission to uninfected partners. This brief review describes the mental health problems and specific substances that pose the greatest threat to medication adherence among MSM and summarizes findings from recent intervention trials that simultaneously address ART adherence and comorbid psychosocial factors among HIV-infected MSM.

New Report Recommends Federal Action to Address Pervasive Profiling, Punishment, and Imprisonment of LGBT People and People Living with HIV

May 23, 2014 Comments off

New Report Recommends Federal Action to Address Pervasive Profiling, Punishment, and Imprisonment of LGBT People and People Living with HIV
Source: Center for American Progress

Lesbian, gay, bisexual, and transgender, or LGBT, people and people living with HIV, or PLWH, face sweeping discrimination at all stages of the criminal legal system—including policing, adjudication, and incarceration—according to a new report published by the Center for Gender & Sexuality Law at Columbia Law School and co-authored by the Center for American Progress, The Center for HIV Law and Policy, and Streetwise & Safe, or SAS.

The report, “A Roadmap for Change: Federal Policy Recommendations for Addressing the Criminalization of LGBT People and People with HIV,” is one of the first reports of its kind to offer comprehensive federal policy recommendations to address the cycles of criminalization and discriminatory treatment faced by LGBT people and PLWH. Co-authored by Catherine Hanssens, Aisha C. Moodie-Mills, Andrea J. Ritchie, Dean Spade, and Urvashi Vaid with input from more than 50 legal, advocacy, and grassroots organizations working on LGBT and criminal justice policy, the report provides an extensive outline of policy measures that federal agencies can adopt to address discriminatory and abusive policing practices, improve conditions for LGBT prisoners and immigrants in detention, decriminalize HIV, and prevent LGBT youth and adults from coming in contact with the system in the first place.

Prophylaxis for the Prevention of HIV Infection — 2014 Available Online

May 16, 2014 Comments off

Prophylaxis for the Prevention of HIV Infection — 2014 Available Online
Source: Morbidity and Mortality Weekly Report (CDC)

The documents Preexposure Prophylaxis for the Prevention of HIV Infection — 2014: a PHS Clinical Practice Guideline* and a Clinical Providers’ Supplement† are now available online.

The guideline and supplement are intended for use by clinicians in the United States providing medical care for persons without human immunodeficiency virus (HIV) infection who are at substantial risk for acquiring it by their sexual or injection drug use behaviors. The guideline is the first federal resource that provides comprehensive, evidence-based information about the provision of daily oral antiretroviral preexposure prophylaxis (PrEP), including how to identify patients with indications for PrEP, guidance for safe prescribing practices, monitoring clinical safety for patients taking PrEP medications, and supporting medication adherence and the reduction of HIV risk behaviors. The supplement provides additional tools and information that might be useful to clinicians prescribing PrEP.

Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up

May 8, 2014 Comments off

Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up
Source: PLoS Collections

With new HIV infections in Sub-Saharan Africa occurring at a rate of 2.3 million each year, this new Collection, featuring research published in PLOS Medicine and PLOS ONE, presents interim results from a large public health intervention of voluntary medical male circumcision (VMMC) performed by health care practitioners in low-resource settings to prevent new infections.

The Collection examines lessons learned from the scaled-up VMMC program since 2008. Research papers focus on programs in Kenya, South Africa, Tanzania, Zimbabwe and Lesotho, identifying strengths and challenges in key program areas, including demand creation, the quality of surgical services, operational efficiencies, data collection and cost controls.

The VMMC program faces challenges at multiple levels, such as maintaining quality of services while rapidly scaling up, generating demand, and resource and capacity constraints. In order to accelerate scale-up and impact, the Collection authors recommendations include increasing program efficiency by identifying and prioritizing those most at risk of acquiring HIV, matching supply with demand, and exploring the role of technology.

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