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Archive for the ‘HIV/AIDS’ Category

Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System

April 14, 2014 Comments off

Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System
Source: PLoS ONE

Background
With increased life expectancy for HIV-infected persons, there is concern regarding comorbid depression because of its common occurrence and association with behaviors that may facilitate HIV transmission. Our objectives were to estimate the prevalence of current depression among HIV-infected persons receiving care and assess the burden of major depression, relative to that in the general population.

Methods and Findings
We used data from the Medical Monitoring Project (MMP) and the Behavioral Risk Factors Surveillance System (BRFSS). The eight-item Patient Health Questionnaire was used to identify depression. To assess the burden of major depression among HIV-infected persons receiving care, we compared the prevalence of current major depression between the MMP and BRFSS populations using stratified analyses that simultaneously controlled for gender and, in turn, each of the potentially confounding demographic factors of age, race/ethnicity, education, and income. Each unadjusted comparison was summarized as a prevalence ratio (PR), and each of the adjusted comparisons was summarized as a standardized prevalence ratio (SPR). Among HIV-infected persons receiving care, the prevalence of a current episode of major depression and other depression, respectively, was 12.4% (95% CI: 11.2, 13.7) and 13.2% (95% CI: 12.0%, 14.4%). Overall, the PR comparing the prevalence of current major depression between HIV-infected persons receiving care and the general population was 3.1. When controlling for gender and each of the factors age, race/ethnicity, and education, the SPR (3.3, 3.0, and 2.9, respectively) was similar to the PR. However, when controlling for gender and annual household income, the SPR decreased to 1.5.

Conclusions
Depression remains a common comorbidity among HIV-infected persons. The overall excess burden among HIV-infected persons receiving care is about three-times that among the general population and is associated with differences in annual household income between the two populations. Relevant efforts are needed to reduce this burden.

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Guideline on the Use of Devices for Adult Male Circumcision for HIV Prevention

March 14, 2014 Comments off

Guideline on the Use of Devices for Adult Male Circumcision for HIV Prevention
Source: World Health Organization (via National Center for Biotechnology Information)

This guideline provides an evidence-based recommendation on the use of adult male circumcision devices for HIV prevention in public health programmes in high HIV prevalence, resource-limited settings. It also presents key programmatic considerations for the introduction and use of these devices in public health HIV prevention programmes. The primary audiences are policy- and decision-makers, programme managers, health-care providers, donors and implementing agencies.

The guideline was developed according to the WHO standards and requirements for guideline development. The process involved internal and external consultations with technical experts, national programme managers, consumer advocates and an evidence review methodologist. Two complementary annexes are also available.

In Harm’s Way: State Response to Sex Workers, Drug Users and HIV in New Orleans

January 1, 2014 Comments off

In Harm’s Way: State Response to Sex Workers, Drug Users and HIV in New Orleans
Source: Human Rights Watch

This 57-page report documents government violations of the right to health and other abuses of at-risk populations in New Orleans. It calls for changes in state and local laws and policies that stigmatize, discriminate against, and facilitate police abuse of sex workers and drug users, and interfere with health services for people at high risk for HIV. The report was released in advance of the third annual Southern Harm Reduction and Drug Policy Conference, which opens in New Orleans on December 12, 2013.

New From the GAO

November 22, 2013 Comments off

New GAO Report
Source: Government Accountability Office

Minority AIDS Initiative: Consolidation of Fragmented HIV/AIDS Funding Could Reduce Administrative Challenges. GAO-14-84, November 22.
http://www.gao.gov/products/GAO-14-84
Highlights - http://www.gao.gov/assets/660/659217.pdf

Estimated Percentages and Characteristics of Men Who Have Sex with Men and Use Injection Drugs — United States, 1999–2011

October 7, 2013 Comments off

Estimated Percentages and Characteristics of Men Who Have Sex with Men and Use Injection Drugs — United States, 1999–2011
Source: Morbidity and Mortality Weekly Report (CDC)

Male-to-male sex and illicit injection drug use are important transmission routes for human immunodeficiency virus (HIV) infection. Of all new HIV infections in 2010, 80% were among men, of which 78% were among men who have sex with men (MSM), 6% among male injection drug users (IDU), and 4% among men who have sex with men and inject drugs (MSM/IDU) (1). MSM/IDU might have different prevention needs from men who are either MSM or IDU, but not both. A combination of effective, scalable, and evidence-based approaches that address male-to-male sex and injection drug use behaviors might reduce HIV infections among MSM/IDU. To refine calculations of disease rates attributed to MSM and IDU (2,3) by accounting for MSM/IDU, CDC used data from 1999–2008 National Health and Nutrition Examination Survey (NHANES) to estimate the percentage and number of MSM/IDU in the general population. To further describe demographic similarities and differences of MSM/IDU identified by different surveillance systems, CDC also compared data from four HIV surveillance systems: the 2008 and 2009 National HIV Behavioral Surveillance System (NHBS), the 2011 National HIV Surveillance System (NHSS), and the 2007–2009 Medical Monitoring Project (MMP). Of males aged ≥18 years, MSM/IDU comprised an estimated 0.35% in NHANES, 7%–20% in NHBS, an estimated 4%–8% in NHSS, and 9% in MMP. Across surveillance systems, MSM/IDU accounted for 4%–12% of MSM and 11%–39% of male IDU. Risk reduction programs and interventions targeted toward male IDU populations might be more effective if they also incorporate messages about male-to-male sex.
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CRS — The President’s Emergency Plan for AIDS Relief (PEPFAR), U.S. Global HIV/AIDS, Tuberculosis, and Malaria Programs: A Description of Permanent and Expiring Authorities

October 1, 2013 Comments off

The President’s Emergency Plan for AIDS Relief (PEPFAR), U.S. Global HIV/AIDS, Tuberculosis, and Malaria Programs: A Description of Permanent and Expiring Authorities (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

Fighting HIV/AIDS, tuberculosis (TB), and malaria globally is a priority for Congress. The 108th and 110th Congresses enacted two pieces of legislation that have shaped U.S. responses to these diseases: P.L. 108-25, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Leadership Act), and P.L. 110-293, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (Lantos-Hyde Act). The Leadership Act authorized $15 billion to be spent from FY2004 through FY2008 on fighting HIV/AIDS, TB, and malaria. The Lantos-Hyde Act amended the Leadership Act to authorize $48 billion for fighting the three diseases from FY2009 through FY2013.

The Leadership Act (and the legislation that it amends) is the primary vehicle through which U.S. global assistance for fighting these diseases is authorized. The Lantos-Hyde Act mostly amends the Leadership Act, though it amends some other acts, such as the Foreign Assistance Act of 1961, and includes some stand-alone authorities. The Leadership Act and the Lantos-Hyde Act (primarily through amendments to the Leadership Act) created frameworks for how the funds should be spent, established program goals and targets, and established coordinating offices for managing government-wide responses.

The Leadership Act required the President to establish the Coordinator of the United States Government Activities to Combat HIV/AIDS Globally (known as the Global AIDS Coordinator) at the Department of State. Congress appropriates the bulk of global HIV/AIDS funds to the Office of the Global AIDS Coordinator, which leads the President’s Emergency Plan for AIDS Relief (PEPFAR). The Global AIDS Coordinator distributes the majority of these funds to U.S. federal agencies and departments and multilateral groups like the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Lantos-Hyde Act amended the Leadership Act to establish the Coordinator of the United States Government Activities to Combat Malaria Globally (known as the Malaria Coordinator) at the U.S. Agency for International Development (USAID) to oversee implementation of related efforts by USAID and the Centers for Disease Control and Prevention. Some authorities within these Acts are enduring, such as those that created the Global AIDS and Malaria Coordinator positions (Leadership Act, as amended) and permitted U.S. participation in advance market commitments for vaccine development (Lantos-Hyde Act). Other authorities, however, are set to expire, such as language authorizing funding for global HIV/AIDS, TB, and malaria programs.

This report explains which authorities within the Leadership and Lantos-Hyde Acts are set to expire and which are permanent. Table A-1 in the Appendix A offers a side-by-side comparison of the Leadership Act in its original form and the Lantos-Hyde Act, which amends the Leadership Act and other legislation. A third column explains which sections are set to expire and summarizes language in S. 1545 and H.R. 3177 that amend the Leadership Act, as amended. The Leadership Act, as amended and Lantos-Hyde Act include comprehensive reporting requirements. Table A-2 in the Appendix A lists the reporting requirements and describes the extent to which the Administration has complied with the requirements.

Rather than revisit some of the contentious issues that dominated debate when crafting the Lantos-Hyde Act, House and Senate Members introduced legislation (H.R. 3177 and S. 1545) that is narrowly aimed at key priorities: enhancing oversight of U.S. global HIV/AIDS, TB, and malaria programs; authorizing appropriations for the Global Fund through FY2018; and allocating a portion of HIV/AIDS funds for orphans and vulnerable children (OVC) and for HIV/AIDS treatment and care. Table B-1 in Appendix B summarizes key amendments in the bills, entitled the PEPFAR Stewardship and Oversight Act.

UNAIDS reports a 52% reduction in new HIV infections among children and a combined 33% reduction among adults and children since 2001

September 30, 2013 Comments off

UNAIDS reports a 52% reduction in new HIV infections among children and a combined 33% reduction among adults and children since 2001
Source: UNAIDS

As world leaders prepare to meet at the United Nations General Assembly to review progress towards the Millennium Development Goals—a new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) shows dramatic acceleration towards reaching 2015 global targets on HIV.

New HIV infections among adults and children were estimated at 2.3 million in 2012, a 33% reduction since 2001. New HIV infections among children have been reduced to 260 000 in 2012, a reduction of 52% since 2001. AIDS-related deaths have also dropped by 30% since the peak in 2005 as access to antiretroviral treatment expands.

By the end of 2012, some 9.7 million people in low- and middle-income countries were accessing antiretroviral therapy, an increase of nearly 20% in just one year. In 2011, UN Member States agreed to a 2015 target of reaching 15 million people with HIV treatment. However, as countries scaled up their treatment coverage and as new evidence emerged showing the HIV prevention benefits of antiretroviral therapy, the World Health Organization set new HIV treatment guidelines, expanding the total number of people estimated to be in need of treatment by more than 10 million.

CA — HIV/AIDS – Past, Present and Future

August 6, 2013 Comments off

HIV/AIDS – Past, Present and Future
Source: Library of Parliament (Canada)

The first case of AIDS (acquired immune deficiency syndrome) in Canada was reported in February 1982, and the virus responsible, the human immunodeficiency virus (HIV), was discovered in 1983. For over 25 years, governments around the world have spent billions of dollars and scientists have worked tirelessly to develop treatments, preventative vaccines and a cure for this fatal disease. This paper will briefly describe the origins and present state of HIV/AIDS, as well as recent scientific advances in treatment and disease control.

New From the GAO

July 8, 2013 Comments off

New GAO Reports

Source: Government Accountability Office

1. Internet Pharmacies: Federal Agencies and States Face Challenges Combating Rogue Sites, Particularly Those Abroad. GAO-13-560, July 8.
http://www.gao.gov/products/GAO-13-560
Highlights – http://www.gao.gov/assets/660/655752.pdf

2. Investment Advisers: Requirements and Costs Associated with the Custody Rule. GAO-13-569, July 8.
http://www.gao.gov/products/GAO-13-569
Highlights – http://www.gao.gov/assets/660/655755.pdf

3. Electronic Drug Labeling: No Consensus on the Advantages and Disadvantages of Its Exclusive Use. GAO-13-592, July 8.
http://www.gao.gov/products/GAO-13-592
Highlights – http://www.gao.gov/assets/660/655761.pdf

4. Troubled Asset Relief Program: Treasury’s Use of Auctions to Exit the Capital Purchase Program. GAO-13-630, July 8.
http://www.gao.gov/products/GAO-13-630
Highlights – http://www.gao.gov/assets/660/655759.pdf

5. Defense Acquisition Workforce: The Air Force Needs to Evaluate Changes in Funding for Civilians Engaged in Space Acquisition. GAO-13-638, July 8.
http://www.gao.gov/products/GAO-13-638
Highlights – http://www.gao.gov/assets/660/655769.pdf

6. President’s Emergency Plan for AIDS Relief: Millions Being Treated, but Better Information Management Needed to Further Improve and Expand Treatment. GAO-13-688, July 8.
http://www.gao.gov/products/GAO-13-688
Highlights – http://www.gao.gov/assets/660/655765.pdf

CRS — U.S. Global Health Assistance: Background and Issues for the 113th Congress

July 5, 2013 Comments off

U.S. Global Health Assistance: Background and Issues for the 113th Congress (PDF)
Source: Congressional Research Service (via U.S. Department of State Foreign Press Center)

Congressional support for global health programs has been increasing, particularly during the George W. Bush Administration. Combined global health funding from State-Foreign Operations, Labor-HHS and Defense appropriations rose from $1.7 billion in FY2001 to $8.9 billion in FY2012. The FY2013 Consolidated Appropriations Ac t (P.L. 113-6) includes approximately $8.4 billion for global health programs funded through State-Foreign Operations appropriations, up from $8.2 billion in FY2012. (FY2013 funding levels will likely change, however, due to sequestration.) These funds support global health programs implemented and managed by the U.S. Agency for International Development (USA ID), State Department and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund)—a multilateral organization aimed at fighting HIV/AIDS, TB, and malaria worldwide. The act does not specify how much should be spent on global health programs through other appropriations.

Concern about infectious diseases, especially HIV/AIDS, has driven much of the budgetary increases. Excluding funding for the Global Fund, roughly 34% of the FY2001 U.S. global health budget was aimed at programs that address HIV/ AIDS. By 2012, about 57% of U.S. global health spending was aimed at fighting HIV/AIDS worldwide, and the FY2014 budget request calls for nearly 54% of global health spending to be aimed at the disease.

In the 112 th Congress, concerns about the strength of the U.S. economy and federal spending precipitated discussions about the role and effica cy of U.S. foreign aid, including global health programs. Critics began to push for U.S. global health programs to demonstrate impact and improve cost-efficiency. At the same time, supporters underscored the advances U.S. global health programs had made, the millions of lives saved in part with U.S. resources, and the promise of innovative health solutions. It is likely that this debate will continue in the 113 th Congress. Other issues the 113 th Congress may face include

  • deliberating funding levels for U.S. global health programs;
  • examining U.S. leadership of U.S. global health programs;
  • maintaining global HIV/AIDS commitments;
  • deliberating the reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR) in FY2013; and
  • determining the appropriate mix of multilateral and bilateral spending for global HIV/AIDS, TB, and malaria programs.

Evaluation of PEPFAR

July 2, 2013 Comments off

Evaluation of PEPFAR
Source: Institute of Medicine

The U.S. government supports programs to combat global HIV/AIDS through an initiative that is known as the President’s Emergency Plan for AIDS Relief (PEPFAR). This initiative was originally authorized in the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 and focused on an emergency response to the HIV/AIDS pandemic to deliver lifesaving care and treatment in low- and middle-income countries (LMICs) with the highest burdens of disease. It was subsequently reauthorized in the Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (the Lantos-Hyde Act).

Evaluation of PEPFAR makes recommendations for improving the U.S. government’s bilateral programs as part of the U.S. response to global HIV/AIDS. The overall aim of this evaluation is a forward-looking approach to track and anticipate the evolution of the U.S. response to global HIV to be positioned to inform the ability of the U.S. government to address key issues under consideration at the time of the report release.

HIV in the European Region: Using Evidence to Strengthen Policy and Programmes

June 7, 2013 Comments off

HIV in the European Region: Using Evidence to Strengthen Policy and Programmes

Source: World Bank

Social and structural factors – like poverty, marginalization and stigma – and not just individual behaviors are shaping the HIV epidemic in Europe and Central Asia. This is the main conclusion of a new report released today by the World Bank Group, the World Health Organization Regional Office for Europe and the London School of Hygiene & Tropical Medicine.

The study systematically reviews evidence on HIV vulnerability and response in all 53 countries of the WHO European Region, stretching from Iceland to the borders of China.

The report focuses on key populations most at risk of HIV infection: people who inject drugs, sex workers and men who have sex with men. It confirms that they are disproportionately affected by the growing HIV epidemic in Europe, where the number of reported HIV cases reached more than 1.5 million in 2011.

HIV cases in these three groups account for approximately 50% of total diagnoses. Economic volatility and recession risks are increasing vulnerability to HIV and infections.

New From the GAO

May 28, 2013 Comments off

New GAO Reports

Source: Government Accountability Office

1. Coast Guard: Clarifying the Application of Guidance for Common Operational Picture Development Would Strengthen Program. GAO-13-321, April 25.
http://www.gao.gov/products/GAO-13-321
Highlights – http://www.gao.gov/assets/660/654204.pdf

2. Defense Health Care: Department of Defense Needs a Strategic Approach to Contracting for Health Care Professionals. GAO-13-322, May 28.
http://www.gao.gov/products/GAO-13-322
Highlights – http://www.gao.gov/assets/660/654848.pdf

3. President’s Emergency Plan For AIDS Relief: Drug Supply Chains Are Stronger, but More Steps Are Needed to Reduce Risks. GAO-13-483, April 26.
http://www.gao.gov/products/GAO-13-483
Highlights – http://www.gao.gov/assets/660/654248.pdf

New From the GAO

May 13, 2013 Comments off

New GAO Reports

Source: Government Accountability Office

1. Agricultural Research: Two USDA Agencies Can Enhance Safeguards against Project Duplication and Strengthen Collaborative Planning. GAO-13-255, April 12.
http://www.gao.gov/products/GAO-13-255
Highlights – http://www.gao.gov/assets/660/653753.pdf

2. Management Report: Improvements Are Needed to Enhance the Internal Revenue Service’s Internal Controls. GAO-13-420R, May 13.
http://www.gao.gov/products/GAO-13-420R

3. President’s Emergency Plan for AIDS Relief: Shift toward Partner-Country Treatment Programs Will Require Better Information on Results. GAO-13-460, April 12.
http://www.gao.gov/products/GAO-13-460
Highlights – http://www.gao.gov/assets/660/653767.pdf

4. Defense Logistics: The Department of Defense’s Report on Strategic Seaports Addressed All Congressionally Directed Elements. GAO-13-511R, May 13.
http://www.gao.gov/products/GAO-13-511R

New From the GAO

April 15, 2013 Comments off

New GAO Reports
Source: Government Accountability Office
1. President’s Emergency Plan for AIDS Relief: Per-Patient Costs Have Declined Substantially, but Better Cost Data Would Help Efforts to Expand Treatment. GAO-13-345, March 15.
http://www.gao.gov/products/GAO-13-345
Highlights – http://www.gao.gov/assets/660/653067.pdf

2. Corporate Tax Expenditures: Information on Estimated Revenue Losses and Related Federal Spending Programs. GAO-13-339, March 18.
http://www.gao.gov/products/GAO-13-339
Highlights – http://www.gao.gov/assets/660/653121.pdf

HIV Infection Among Heterosexuals at Increased Risk — United States, 2010

March 18, 2013 Comments off

HIV Infection Among Heterosexuals at Increased Risk — United States, 2010

Source: Morbidity and Mortality Weekly Report (CDC)

In 2009, an estimated 27% of human immunodeficiency virus (HIV) infections in the United States were attributed to heterosexual contact (1). During 2006–2007, as part of the data collection for the National HIV Behavioral Surveillance System (NHBS), CDC surveyed heterosexuals who lived in urban areas with a high prevalence of acquired immunodeficiency syndrome (AIDS) and found an overall HIV prevalence of 2.0% and a prevalence of 2.3% among persons with annual household incomes at or below the poverty level and 2.8% among persons with less than a high school education (2). This report summarizes HIV testing results from the second cycle of NHBS, conducted in 2010, which focused on heterosexual persons with low socioeconomic status (SES) living in areas with high AIDS case rates. The results indicated that HIV prevalence was 2.3% overall and 1.1% among participants who did not report a previous positive HIV test result. Overall, 25.8% of participants had never been tested for HIV until the NHBS survey. Given the high HIV prevalence in this sample, additional research should be conducted to identify culturally appropriate interventions that overcome barriers to HIV testing and increase linkage to care for heterosexuals with low SES in urban areas with high prevalence of AIDS.

IOM — Evaluation of PEPFAR

February 26, 2013 Comments off

Evaluation of PEPFAR

Source: Institute of Medicine

Through the President’s Emergency Plan for AIDS Relief (PEPFAR), the United States has provided an unprecedented level of health and development assistance and health diplomacy around the world. PEPFAR has saved and improved the lives of millions of people; supported HIV prevention, care, and treatment; strengthened systems; and engaged with partner countries to facilitate HIV policy and planning for sustainable responses to their epidemic.

The IOM evaluation drew upon a variety of data sources, including quantitative data, extensive document review, and primary qualitative data collection through more than 400 interviews, including some site visits, with diverse stakeholders in 13 PEPFAR partner countries, at PEPFAR’s headquarters, and at other institutions and agencies involved in the global HIV response.

PEPFAR has been globally transformative. Across partner countries, PEPFAR was described as a lifeline, and people credit PEPFAR for restoring hope. The initiative’s future contributions will be informed by its past achievements and lessons learned from challenges it has faced. PEPFAR will continue a new direction as it supports partner countries in taking on more central roles in accountability and setting strategic priorities for investment in their HIV response.

Belief in AIDS-Related Conspiracy Theories and Mistrust in the Government: Relationship with HIV Testing Among At-Risk Older Adults

January 30, 2013 Comments off

Belief in AIDS-Related Conspiracy Theories and Mistrust in the Government: Relationship with HIV Testing Among At-Risk Older Adults
Source: Gerontologist

Purpose:
One in 4 persons living with HIV/AIDS is an older adult (age 50 or older); unfortunately, older adults are disproportionately diagnosed in late stages of HIV disease. Psychological barriers, including belief in AIDS-related conspiracy theories (e.g., HIV was created to eliminate certain groups) and mistrust in the government, may influence whether adults undergo HIV testing. We examined relationships between these factors and recent HIV testing among at-risk, older adults.

Design and Methods:
This was a cross-sectional study among older adults enrolled in a large venue–based study. None had a previous diagnosis of HIV/AIDS; all were seeking care at venues with high HIV prevalence. We used multiple logistic regression to estimate the associations between self-reported belief in AIDS-related conspiracy theories, mistrust in the government, and HIV testing performed within the past 12 months.

Results:
Among the 226 participants, 30% reported belief in AIDS conspiracy theories, 72% reported government mistrust, and 45% reported not undergoing HIV testing within the past 12 months. Belief in conspiracy theories was positively associated with recent HIV testing (adjusted odds ratio [OR] = 1.94, 95% confidence interval [CI] = 1.05–3.60), whereas mistrust in the government was negatively associated with testing (OR = 0.43, 95% CI = 0.26–0.73).

Implications:
Psychological barriers are prevalent among at-risk older adults seeking services at venues with high HIV prevalences and may influence HIV testing. Identifying particular sources of misinformation and mistrust would appear useful for appropriate targeting of HIV testing strategies.

Overview of substance use disorders and incarceration of African American males

December 1, 2012 Comments off

Overview of substance use disorders and incarceration of African American males

Source: Frontiers in Forensic Psychiatry

Incarceration affects the lives of many African American men and often leads to poverty, ill health, violence, and a decreased quality of life. There has been an unprecedented increase in incarceration among African American males since 1970. In 2009, the incarceration rate among black males was 6.7 times that of white males and 2.6 times of Hispanic males. Substance abuse in African American males leads to higher mortality rates, high rates of alcohol-related problems, more likely to be victims of crimes, and HIV/AIDS. African Americans comprised only 14% of the U.S. population but comprised 38% of the jail population. The cost of incarcerating persons involved in substance related crimes has increased considerably over the past two decades in the U.S. A reduction in the incarceration rate for non-violent offences would save an estimated $17 billion per year. Substance use disorder makes the individual more prone to polysubstance use and leads to impulse control problems, selling drugs, and other crimes. The high rate of incarceration in U.S. may adversely affect health care, the economy of the country, and will become a burden on society. Implementation of good mental health care, treatment of addiction during and after incarceration will help to decrease the chances of reoffending. Therapeutic community programs with prison-based and specialized treatment facilities, cognitive behavioral therapy treatment for 91–180 days, and 12-step orientation with staff specialized in substance abuse can be helpful. It is essential for health care professionals to increase public awareness of substance abuse and find ways to decrease the high rates of incarceration.

See: Systematic Incarceration of African American Males Is a Wrong, Costly Path (Science Daily)

HIV Infections Attributed to Male-to-Male Sexual Contact — Metropolitan Statistical Areas, United States and P uerto Rico, 2010

November 30, 2012 Comments off

HIV Infections Attributed to Male-to-Male Sexual Contact — Metropolitan Statistical Areas, United States and Puerto Rico, 2010

Source: Morbidity and Mortality Weekly Report (CDC)

Human immunodeficiency virus (HIV) infections attributed to male-to-male sexual contact comprised 64% of the estimated new HIV infections in the United States in 2009 (1). Assessing the geographic distribution of HIV infection by transmission category can help public health programs target prevention resources to men who have sex with men (MSM) in areas where HIV infection from male-to-male sexual contact is most frequent. In 2004, CDC published data on acquired immunodeficiency syndrome diagnoses among MSM and others by metropolitan statistical area (MSA) (2). To examine geographic differences in the prevalence of HIV infection from male-to-male sexual contact among persons aged ≥13 years in the United States and Puerto Rico, CDC estimated the number of HIV infections in persons newly diagnosed in 2010 and analyzed them by transmission category and location. Results indicated that HIV infections attributed to male-to-male sexual contact made up the largest percentage of HIV infections in MSAs (62.1%), smaller metropolitan areas (56.1%), and nonmetropolitan areas (53.7%). Of the 28,851 infections attributed to male-to-male sexual contact, 23,559 (81.7%) were in MSAs, and 11,410 (48.4%) of those infections were in seven MSAs that represented 31.7% (53,169,004 of 167,919,694) of the overall population aged ≥13 years in the MSAs that were assessed. These data support planning for targeted interventions to prevent HIV acquisition and transmission by male-to-male sexual contact among MSM, particularly in those areas most affected.

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