Sociocultural Factors Influencing The Transmission of HIV/AIDS in The United States

2017 ◽  
Author(s):  
Robert E Fullilove
Keyword(s):  
United States ◽  
Criminal Justice ◽  
Correctional Facility ◽  
The United States ◽  
Hiv Care ◽  
Sociocultural Factors ◽  
Effective Interventions ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

This chapter discusses the unique impact that social disadvantage in general and the criminal justice systems in the United States in particular have on the conditions that drive the HIV/AIDS epidemic in this country. HIV/AIDS is classified as an important racial/ethnic health disparity because residents of marginalized black and Hispanic communities are overrepresented among persons living with HIV/AIDS in the United States. Members of black and Hispanic communities are also overrepresented in the criminal justice; in terms of the epidemic, approximately one out of seven persons living with HIV/AIDS will pass through a U.S. correctional facility in any given year. A history of incarceration is associated with poor treatment outcomes for HIV illness. Improving the quality of HIV care in correctional facilities and in the communities to which incarcerated persons will return is imperative, as is effective interventions in incarcerated populations and communities. Having AIDS activists, scientists, and healthcare workers join in efforts to reform incarceration policies and practices will improve efforts to prevent and treat HIV/AIDS, particularly in communities that confront high rates of HIV/AIDS and incarceration.

scholarly journals 1309. Effects of a Pharmacist-Driven Antiretroviral Stewardship and Transitions of Care Service in Persons Living with HIV/AIDS

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S471-S472
Author(s):  
Marisa B Brizzi ◽  
Rodrigo M Burgos ◽  
Thomas D Chiampas ◽  
Sarah M Michienzi ◽  
Renata Smith ◽  
...  
Keyword(s):  
Care Service ◽  
Transitions Of Care ◽  
Hiv Care ◽  
Outpatient Clinics ◽  
Readmission Rates ◽  
Implementation Phase ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background Historical data demonstrate that PLWHA experience higher rates of medication-related errors when admitted to the inpatient setting. Prior to initiation of this program, rapid-start initiation of antiretroviral therapy (ART) was not implemented prior to discharge. The purpose of this study was to evaluate the impact of a pharmacist-driven antiretroviral stewardship and transitions of care service in persons living with HIV/AIDS (PLWHA). Methods This was a retrospective pre- and post-analysis of PLWHA hospitalized at University of Illinois Hospital (UIH). Patients included were adults following at UIH outpatient clinics for HIV care admitted to UIH for acute care. Data were collected between April 19, 2017 and October 19, 2017 for the pre-implementation phase, and between July 1, 2018 and December 31, 2018 for the post-implementation phase. The post-implementation phase included an HIV-trained clinical pharmacist (Figure 1). Primary and secondary endpoints included follow-up rates at UIH outpatient HIV clinics, 30-day readmission rates, and access to medications at hospital discharge. Statistical analysis included descriptive statistics and Fisher’s Exact test. Results A total of 119 patients were included in the analysis, 66 in the pre-implementation phase and 53 in the post-implementation phase. Patients included were mostly black males with median age of 48. In the pre-implementation phase 50 out of 65 (77%) patients attended follow-up visits for HIV care at UIH outpatient clinics, vs. 42 out of 47 (89%) patients in the post-implementation phase (P = 0.1329). Thirty-day readmission occurred in 17 of 62 (27%) patients in the pre-implementation phase vs. 5 of 52 (10%) of patients in the post-implementation phase (P = 0.0183). During the post-implementation phase, the HIV pharmacist secured access of ART and opportunistic infection medications prior to discharge for 22 patients (42%), 2 of which were new diagnoses. Conclusion A pharmacist-led antiretroviral stewardship and TOC program led to a decrease in 30-day readmission rates in PLWHA. Although not significant, the HIV-pharmacist led to higher rates of clinic follow-up. Finally, the HIV-pharmacist helped secure access to ART and initiate rapid-start therapy in newly diagnosed patients prior to leaving the hospital. Disclosures All authors: No reported disclosures.

scholarly journals Socioeconomic, Behavioral, and Clinical Characteristics of Persons Living with HIV Who Experience Homelessness in the United States, 2015–2016

2019 ◽  
Vol 24 (6) ◽  
pp. 1701-1708 ◽  
Author(s):  
Jacob J. Wainwright ◽  
◽  
Linda Beer ◽  
Yunfeng Tie ◽  
Jennifer L. Fagan ◽  
...  
Keyword(s):  
United States ◽  
Clinical Characteristics ◽  
The United States ◽  
Persons Living With Hiv ◽  
Living With Hiv

scholarly journals Heterogeneity in the costs of medical care among people living with HIV/AIDS in the United States

AIDS ◽  
2019 ◽  
Vol 33 (9) ◽  
pp. 1491-1500 ◽  
Author(s):  
Benjamin Enns ◽  
Emanuel Krebs ◽  
William C. Mathews ◽  
Richard D. Moore ◽  
Kelly A. Gebo ◽  
...  
Keyword(s):  
United States ◽  
Medical Care ◽  
The United States ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

HIV/AIDS in Later Life

2018 ◽  
Author(s):  
Philip Sayegh ◽  
David J. Moore ◽  
Pariya Fazeli Wheeler
Keyword(s):  
Successful Aging ◽  
Neuropsychiatric Symptoms ◽  
Later Life ◽  
Well Being ◽  
The United States ◽  
Neurocognitive Deficits ◽  
Everyday Functioning ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

Since the first cluster of people with HIV was identified in 1981, significant biomedical advances, most notably the development of antiretroviral therapy (ART), have led to considerably increased life expectancy as well as a reduction in the morbidity and mortality associated with HIV/AIDS. As a result, HIV/AIDS is no longer considered a terminal illness, but rather a chronic illness, and many persons living with HIV/AIDS are beginning to enter or have already reached later life. In fact, Americans ages 50 years and older comprise approximately half of all individuals with HIV/AIDS and represent the most rapidly growing subpopulation of persons living with HIV/AIDS in the United States. Despite significant advances in HIV/AIDS treatment and prognosis, older adults living with HIV (OALH) face a number of unique challenges and circumstances that can lead to exacerbated symptoms and poorer outcomes, despite demonstrating generally better ART adherence than their younger counterparts. These detrimental outcomes are due to both chronological aging and cohort effects as well as social and behavioral factors and long-term ART use. For instance, neurocognitive deficits and neuropsychiatric symptoms, including depression, anxiety, apathy, and fatigue, are often observed among OALH, which can result in feelings of loneliness, social isolation, and reduced social support. Taken together, these factors can lead to elevated levels of problems with everyday functioning (e.g., activities of daily living) among OALH. In addition, sociocultural factors such as race/ethnicity, ageism, sexism, homophobia, transphobia, geographic region, socioeconomic status and financial well-being, systemic barriers and disparities, and cultural values and beliefs play an influential role in determining outcomes. Notwithstanding the challenges associated with living with HIV/AIDS in later life, many persons living with HIV/AIDS are aging successfully. HIV/AIDS survivor and community mobilization efforts, as well as integrated care models, have resulted in some significant improvements in overall HIV/AIDS patient care. In addition, interventions aimed at improving successful aging outcomes among OALH are being developed in an attempt to effectively reduce the psychological and physical morbidity associated with HIV disease.

scholarly journals HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project

2019 ◽  
Vol 17 (1) ◽  
pp. 171
Author(s):  
Hanna B. Demeke ◽  
Qingwei Luo ◽  
Ruth E. Luna-Gierke ◽  
Mabel Padilla ◽  
Gladys Girona-Lozada ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
Medical Monitoring ◽  
Place Of Birth ◽  
Sustained Viral Suppression ◽  
Medical Monitoring Project ◽  
Hiv Aids

Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes between mainland US-born (referent group), Puerto Rican (PR-born), and those born outside the United States (non-US-born). We reported weighted percentages of characteristics and used logistic regression with predicted marginal means to examine differences between groups (p < 0.05). PR-born Hispanics/Latinos were more likely to be prescribed antiretroviral therapy (ART) (94%) and retained in care (94%) than mainland-US-born (79% and 77%, respectively) and non-US-born (91% and 87%, respectively) Hispanics/Latinos. PR-born Hispanics/Latinos were more likely to have sustained viral suppression (75%) than mainland-US-born Hispanics/Latinos (57%). Non-US-born Hispanics/Latinos were more likely to be prescribed ART (91% vs. 79%), retained in care (87% vs. 77%), and have sustained viral suppression (74% vs. 57%) than mainland-US-born Hispanics/Latinos. Greater Ryan White HIV/AIDS-funded facility usage among PR-born, better mental health among non-US-born, and less drug use among PR-born and non-US-born Hispanics/Latinos may have contributed to better HIV outcomes. Expanding programs with comprehensive HIV/AIDS services, including for mental health and substance use, may reduce HIV outcome disparities among Hispanics/Latinos.

scholarly journals Poverty stigma is associated with suboptimal HIV care and treatment outcomes among women living with HIV in the United States

AIDS ◽  
2019 ◽  
Vol 33 (8) ◽  
pp. 1379-1384 ◽  
Author(s):  
Anna M. Leddy ◽  
Janet M. Turan ◽  
Mallory O. Johnson ◽  
Torsten B. Neilands ◽  
Mirjam-Colette Kempf ◽  
...  
Keyword(s):  
United States ◽  
Treatment Outcomes ◽  
The United States ◽  
Hiv Care ◽  
Women Living With Hiv ◽  
Care And Treatment ◽  
Living With Hiv

scholarly journals Burden of Suicidal Ideation and Attempt among Persons Living with HIV and AIDS in Semiurban Uganda

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Godfrey Zari Rukundo ◽  
Brian Leslie Mishara ◽  
Eugene Kinyanda
Keyword(s):  
Suicidal Ideation ◽  
Hiv And Aids ◽  
Hiv Care ◽  
State Anger ◽  
Increased Risk ◽  
Persons Living With Hiv ◽  
Considerable Morbidity ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv Aids

Although the impact of HIV/AIDS has changed globally, it still causes considerable morbidity and mortality, including suicidality, in countries like Uganda. This paper describes the burden and risk factors for suicidal ideation and attempt among 543 HIV-positive attending two HIV specialized clinics in Mbarara municipality, Uganda. The rate of suicidal ideation was 8.8% (n=48; 95% CI: 6.70–11.50) and suicidal attempt was 3.1% (17, 95% CI 2.00–5.00). The factors associated with increased risk for suicidal ideation and attempts were state anger (OR = 1.06, 95% CI: 1.03–1.09;p=0.001); trait anger (OR 1.10, 95% CI 1.04–1.16,p=0.002); depression (OR 1.13, 95% CI 1.07–1.20,p=0.001); hopelessness (OR 1.12, 95% CI 1.02–1.23,p=0.024); anxiety (OR 1.06, 95% CI 1.03–1.09); low social support (OR 0.19, 95% CI 0.07–0.47,p=0.001); inability to provide for others (OR 0.19, 95% CI 0.07–0.47,p=0.001); and stigma (OR 2.48, 95% CI 1.11–5.54,p=0.027). At multivariate analysis, only state anger remained statistically significant. HIV/AIDS is associated with several clinical, psychological, and social factors which increase vulnerability to suicidal ideation and attempts. Making suicide risk assessment and management an integral part of HIV care is warranted.

Persons Living With HIV in the United States

2016 ◽  
Vol 72 (5) ◽  
pp. 552-557 ◽  
Author(s):  
Qiang Xia ◽  
Sarah L. Braunstein ◽  
Ellen W. Wiewel ◽  
Joanna J. Eavey ◽  
Colin W. Shepard ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Persons Living With Hiv ◽  
Living With Hiv
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