scholarly journals Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis

PEDIATRICS ◽  
2021 ◽  
Author(s):  
Katherine K Hsu ◽  
Natella Yurievna Rakhmanina
Keyword(s):  
United States ◽  
Hiv Testing ◽  
Injection Drug Users ◽  
Drug Users ◽  
The United States ◽  
Clinical Report ◽  
Hiv Screening ◽  
Sexually Active ◽  
Routine Hiv Screening ◽  
Routine Hiv Testing

Most sexually active youth in the United States do not believe that they are at risk for contracting HIV and have never been tested. Creating safe environments that promote confidentiality and respect, obtaining an accurate sexual and reproductive health assessment, and providing nonstigmatizing risk counseling are key components of any youth encounters. Pediatricians can play a key role in preventing and controlling HIV infection by promoting risk-reduction counseling and offering routine HIV testing and prophylaxis to adolescent and young adult (youth) patients. In light of persistently high numbers of people living with HIV in the United States and documented missed opportunities for HIV testing, the Centers for Disease Control and Prevention and the US Preventive Services Task Force recommend universal and routine HIV screening among US populations, including youth. Recent advances in HIV diagnostics, treatment, and prevention help support this recommendation. This clinical report reviews epidemiological data and recommends that routine HIV screening be offered to all youth 15 years or older, at least once, in health care settings. After initial screening, youth at increased risk, including those who are sexually active, should be rescreened at least annually, and potentially as frequently as every 3 to 6 months if at high risk (male youth reporting male sexual contact, active injection drug users, transgender youth; youth having sexual partners who are HIV-infected, of both genders, or injection drug users; youth exchanging sex for drugs or money; or youth who have had a diagnosis of or have requested testing for other sexually transmitted infections). Youth at substantial risk for HIV acquisition should be routinely offered HIV preexposure prophylaxis, and HIV postexposure prophylaxis is also indicated after high-risk exposures. This clinical report also addresses consent, confidentiality, and coverage issues that pediatricians face in promoting routine HIV testing and HIV prophylaxis for their patients.

scholarly journals HIV Testing: Support for Routine Screening

1970 ◽  
Vol 10 (1) ◽  
Author(s):  
Brett Edwards, BSc. Pharm ◽  
Stephen Vaughan MD DTMH
Keyword(s):  
Hiv Testing ◽  
Task Force ◽  
Preventive Services ◽  
The United States ◽  
Routine Screening ◽  
Hiv Screening ◽  
Screening Cost ◽  
National Body ◽  
Routine Hiv Screening ◽  
Routine Hiv Testing

This article discusses the recent evolution of human immunodeficiency virus (HIV) screening recommendations with significantly expanded role for routine HIV testing. After the Centre for Disease Control (CDC) released recommendations for routine screening in 2006, it was anticipated that the United States Preventive Services Task Force (USPSTF), a national body charged with providing evidence-based recommendations for preventive services, would follow shortly. However, they refrained, citing a lack of evidence at the time to make such a recommendation, and maintained a recommendation for risk-based screening. Following an analysis of recent literature, in 2013 the USPSTF finally made a recommendation for routine HIV screening on the grounds of new evidence. The recommendations are based on the clinical benefit, the failures of risk-based screening, cost-effectiveness data with reduction in HIV related morbidity/mortality, and lower rates of transmission. This article highlights some of the literature that accounted for the change in recommendations and provides a basic review of HIV testing techniques available to the internists and the recommendations for routine screening of patients.

scholarly journals Pre-Exposure Prophylaxis Training among Medical Schools in the United States

2021 ◽  
Vol 12 ◽  
pp. 215013272110287
Author(s):  
Robert L. Cooper ◽  
Mohammad Tabatabai ◽  
Paul D. Juarez ◽  
Aramandla Ramesh ◽  
Matthew C. Morris ◽  
...  
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Injection Drug Users ◽  
Drug Users ◽  
Healthcare Providers ◽  
Medical Schools ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

Viral Hepatitis A

2021 ◽  
Author(s):  
Kenrad E Nelson ◽  
Brittany L Kmush
Keyword(s):  
United States ◽  
Acute Hepatitis ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Severe Disease ◽  
The United States ◽  
Childhood Immunization ◽  
Effective Prevention

Epidemics of infectious jaundice have been reported throughout recorded history. However, the proof that many of these outbreaks and individual cases of acute hepatitis were caused by a viral infection, the hepatitis A virus (HAV), did not appear until the 1960s. After the transmission of infection to marmosets and humans, the epidemiologic and virologic characteristics that differed between hepatitis A and hepatitis B virus infections were defined more clearly. After the development and licensure of hepatitis A vaccines in the 1990s, it became possible to implement an effective prevention program involving routine immunization of young children in the United States and several other Western countries. However, despite the dramatic efficacy of the childhood immunization program in reducing the incidence of acute hepatitis from HAV in the population, older children and adults remained susceptible. Significant morbidity continues to occur in the United States among international travelers, injection drug users, persons with underlying liver disease, and other high-risk populations. Since HAV is a global pathogen, the prevention of increasing morbidity from hepatitis A attributable to the incidence of clinically more severe disease increases in countries transitioning from high to intermediate or low endemic status is a major public health challenge. In this review, we discuss the epidemiology, virology, clinical characteristics, and prevention of hepatitis A infections. This review contains 8 figures, 3 tables and 89 references Key words: epidemiology, global impact, hepatitis A vaccine, hepatitis A virus, prevention, reservoirs, risk factors, treatment

The Incidence of Kaposi Sarcoma Among Injection Drug Users With AIDS in the United States

2004 ◽  
Vol 37 (2) ◽  
pp. 1282-1287 ◽  
Author(s):  
Jonnae O Atkinson ◽  
Robert J Biggar ◽  
James J Goedert ◽  
Eric A Engels
Keyword(s):  
United States ◽  
Injection Drug Users ◽  
Drug Users ◽  
Kaposi Sarcoma ◽  
The United States ◽  
Injection Drug

scholarly journals Update and Overview of Practical Epidemiologic Aspects of HIV/AIDS among Injection Drug Users in the United States

2006 ◽  
Vol 83 (1) ◽  
pp. 86-100 ◽  
Author(s):  
Scott S. Santibanez ◽  
Richard S. Garfein ◽  
Andrea Swartzendruber ◽  
David W. Purcell ◽  
Lynn A. Paxton ◽  
...  
Keyword(s):  
United States ◽  
Injection Drug Users ◽  
Drug Users ◽  
The United States ◽  
Injection Drug ◽  
Hiv Aids

Young adult injection drug users in the United States continue to practice HIV risk behaviors

2009 ◽  
Vol 104 (1-2) ◽  
pp. 167-174 ◽  
Author(s):  
Amanda J. Rondinelli ◽  
Lawrence J. Ouellet ◽  
Steffanie A. Strathdee ◽  
Mary H. Latka ◽  
Sharon M. Hudson ◽  
...  
Keyword(s):  
United States ◽  
Young Adult ◽  
Risk Behaviors ◽  
Hiv Risk ◽  
Injection Drug Users ◽  
Drug Users ◽  
The United States ◽  
Hiv Risk Behaviors ◽  
Injection Drug
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