Settings and Models of AIDS Psychiatric Care

2010 ◽  
Author(s):  
Harold W. Goforth ◽  
Sami Khalife
Keyword(s):  
Hiv Infection ◽  
Mental Health Professionals ◽  
Hiv Transmission ◽  
The United States ◽  
Hiv And Aids ◽  
Easy Access ◽  
Full Description ◽  
Psychiatric Illnesses ◽  
Adolescents And Adults ◽  
Primary Physicians

From primary prevention to end-of-life care, AIDS psychiatry can make significant contributions to preventing risk behaviors and HIV transmission, mitigating suffering, and improving adherence to risk reduction and medical care. Early in the epidemic, stigma and discrimination magnified suffering and excluded persons known to have HIV and AIDS from many settings in the United States and throughout the world. Such treatment of persons with AIDS was described (Cohen, 1989) as a new form of discrimination called “AIDSism.” As we approach the end of the third decade of the HIV pandemic, in most countries education, training, and experience have mitigated AIDSism, and persons with HIV and AIDS are now seen in varieties of medical and nonmedical settings. The multimorbid medical and psychiatric illnesses associated with HIV infection have complicated the care of persons with HIV and AIDS. A primary care guideline for the care of persons with HIV is available in print (Aberg et al., 2009) and online and is updated regularly at: http://www.journals.uchicago.edu/page/cid/IDSAguidelines.html. AIDS psychiatrists, psychosomatic medicine psychiatrists, as well as child, adult, and geriatric psychiatrists and other mental health professionals are in a unique position to intervene and provide both preventive and treatment interventions for children, adolescents, and adults who are vulnerable to, infected with, or affected by HIV infection. Psychiatrists generally make long-term and trusting relationships with their patients and take complete histories including sexual histories and substance use histories. Primary physicians, pediatricians, obstetricians, and HIV specialists as well as parents and teachers may also have unique opportunities to intervene throughout the life cycle. In this chapter, we provide a list of settings where educational opportunities abound and can lead to an improved understanding of how to prevent HIV transmission. These settings are summarized in Table 1.1. Since a full description of every setting with potential for intervention is beyond the scope of this chapter, we provide more specific descriptions of settings where providing education and easy access to testing, condoms, and drug and alcohol treatment can be therapeutic and lifesaving.

The Under-Enrollment of HIV-infected Foster Children in Clinical Trials and Protocols and the Need for Corrective State Action

1994 ◽  
Vol 20 (3) ◽  
pp. 231-249
Author(s):  
Briar McNutt
Keyword(s):  
United States ◽  
New York ◽  
Hiv Infection ◽  
The United States ◽  
Hiv And Aids ◽  
Medical Community ◽  
State Action ◽  
Pediatric Aids ◽  
Control And Prevention ◽  
Year 2000

The incidence of HIV infection and AIDS in children has grown at an alarming rate. Approximately one million children worldwide have HIV infection. By the year 2000, an estimated ten million children will suffer from the disease. Currently, the United States has a population of an estimated 10,000 to 20,000 HIV-infected children. As of June 30, 1993, the Centers for Disease Control and Prevention (CDC) reported 4,710 known AIDS cases in children twelve years-old and younger. At that point, New York City reported 1,124 pediatric AIDS cases which represented twenty-four percent of all cases in the United States.With the rising number of HIV-infected children, the medical community in the United States has begun to search for HIV-and AIDS-related treatments particularized for children. In addition to establishing guidelines for HIV-infected children's frequent check-ups and timely immunizations, the medical community has initiated research studies involving HIV-infected children.

scholarly journals Epidemiology of Human Immunodeficiency Virus in the United States

2007 ◽  
Vol 20 (3) ◽  
pp. 478-488 ◽  
Author(s):  
Susan Hariri ◽  
Matthew T. McKenna
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
The United States ◽  
Population Based ◽  
True Incidence ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Fundamental Shift

SUMMARY The human immunodeficiency virus (HIV) epidemic emerged in the early 1980s with HIV infection as a highly lethal disease among men who have sex with men and among frequent recipients of blood product transfusions. Advances in the treatment of HIV infection have resulted in a fundamental shift in its epidemiology, to a potentially chronic and manageable condition. However, challenges in the prevention of this infection remain. In particular, increasing evidence suggests that transmission of drug-resistant virus is becoming more common and that the epidemic is having a profound impact on morbidity and mortality in ethnic and racial minority subgroups in the United States. New population-based data collection systems designed to describe trends in behaviors associated with HIV transmission and better methods for measuring the true incidence of transmission will better elucidate the characteristics of HIV infection in the United States and inform future public health policies.

scholarly journals Trends in Women With an HIV Diagnosis at Delivery Hospitalization in the United States, 2006-2014

2020 ◽  
Vol 135 (4) ◽  
pp. 524-533
Author(s):  
Maria Vyshnya Aslam ◽  
Kwame Owusu-Edusei ◽  
Steven R. Nesheim ◽  
Kristen Mahle Gray ◽  
Margaret A. Lampe ◽  
...  
Keyword(s):  
Black Women ◽  
Hiv Infection ◽  
White Women ◽  
Hiv Transmission ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Adjusted Relative Risk ◽  
Hiv Diagnosis ◽  
Mother To Child ◽  
Privately Insured

Objectives The risk of mother-to-child HIV transmission can be reduced to ≤0.5% if the mother’s HIV status is known before delivery. This study describes 2006-2014 trends in diagnosed HIV infection documented on delivery discharge records and associated sociodemographic characteristics among women who gave birth in US hospitals. Methods We analyzed data from the 2006-2014 National Inpatient Sample and identified delivery discharges and women with diagnosed HIV infection by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We used a generalized linear model with log link and binomial distribution to assess trends and the association of sociodemographic characteristics with an HIV diagnosis on delivery discharge records. Results During 2006-2014, an HIV diagnosis was documented on approximately 3900-4400 delivery discharge records annually. The probability of having an HIV diagnosis on delivery discharge records decreased 3% per year (adjusted relative risk [aRR] = 0.97; 95% CI, 0.94-0.99), with significant declines identified among white women aged 25-34 (aRR = 0.93; 95% CI, 0.88-0.97) or those using Medicaid (aRR = 0.93; 95% CI, 0.90-0.97); among black women aged 25-34 (aRR = 0.95; 95% CI, 0.92-0.99); and among privately insured women who were black (aRR = 0.96; 95% CI, 0.92-0.99), Hispanic (aRR = 0.92; 95% CI, 0.86-0.98), or aged 25-34 (aRR = 0.96; 95% CI, 0.92-0.99). The probability of having an HIV diagnosis on delivery discharge records was greater for women who were black (aRR = 8.45; 95% CI, 7.56-9.44) or Hispanic (aRR = 1.56; 95% CI, 1.33-1.83) than white; for women aged 25-34 (aRR = 2.33; 95% CI, 2.12-2.55) or aged ≥35 (aRR = 3.04; 95% CI, 2.79-3.31) than for women aged 13-24; and for Medicaid recipients (aRR = 2.70; 95% CI, 2.45-2.98) or the uninsured (aRR = 1.87; 95% CI, 1.60-2.19) than for privately insured patients. Conclusion During 2006-2014, the probability of having an HIV diagnosis declined among select sociodemographic groups of women delivering neonates. High-impact prevention efforts tailored to women remaining at higher risk for HIV infection can reduce the risk of mother-to-child HIV transmission.

scholarly journals Management of HIV Infection during Pregnancy in the United States: Updated Evidence-Based Recommendations and Future Potential Practices

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Bassam H. Rimawi ◽  
Lisa Haddad ◽  
Martina L. Badell ◽  
Rana Chakraborty
Keyword(s):  
United States ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
The United States ◽  
Maternal Serum ◽  
World Health ◽  
Screening Tests ◽  
Virologic Suppression ◽  
Perinatal Hiv ◽  
Health Organization

All HIV-infected women contemplating pregnancy should initiate combination antiretroviral therapy (cART), with a goal to achieve a maternal serum HIV RNA viral load beneath the laboratory level of detection prior to conceiving, as well as throughout their pregnancy. Successfully identifying HIV infection during pregnancy through screening tests is essential in order to preventin uteroand intrapartum transmission of HIV. Perinatal HIV transmission can be less than 1% when effective cART, associated with virologic suppression of HIV, is given during the ante-, intra-, and postpartum periods. Perinatal HIV guidelines, developed by organizations such as the World Health Organization, American College of Obstetricians and Gynecologists, and the US Department of Health and Human Services, are constantly evolving, and hence the aim of our review is to provide a useful concise review for medical providers caring for HIV-infected pregnant women, summarizing the latest and current recommendations in the United States.

scholarly journals Association between Knowledge of Sexually Transmitted Infections and Sources of the Previous Point of Care among Nigerians: Findings from Three National HIV and AIDS Reproductive Health Surveys

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Imran O. Morhason-Bello ◽  
Adeniyi F. Fagbamigbe
Keyword(s):  
Reproductive Health ◽  
Hiv Infection ◽  
Sexually Transmitted Infections ◽  
Hiv Transmission ◽  
Point Of Care ◽  
Health Facilities ◽  
Hiv And Aids ◽  
Good Knowledge ◽  
Effective Control ◽  
Sexually Transmitted

Background. Adequate knowledge of sexually transmitted infections (STIs) is critical for effective control of disease. Health education/counselling at the point of care provides ample opportunities to improve knowledge of patient seeking treatment. There is no study from Nigeria that investigates association between sources of previous point of care of STI and quality of knowledge of people on STI. We hypothesised that previous treatment of STI will be associated with better knowledge of STI and HIV infection. Methods. Three consecutives nationally representative cross-sectional surveys on HIV and AIDS Reproductive Health in Nigeria, conducted in 2005, 2007, and 2012 were analysed. Outcome measures were knowledge of STI only, and a combined knowledge of STI and HIV transmission and prevention. We designed a knowledge scale of 14-item questions for STI and 41-item questions for STI and HIV. Logistic regression was used to identify risk factors at 5% significance level. Results. Knowledge of STI increased from 13.4% in 2005 to 15.0% in 2007 to 26.5% in 2012. Respondents that received treatment from pharmacy and patient medicine vendors had higher odds of good knowledge of STI than those who did not receive any treatment (aOR = 2.55) in 2005. In 2012, respondents treated at health facilities were over two times likely to have good knowledge of STI and HIV transmission and prevention (aOR = 2.35). STI positive individuals in the highest economic class were two times likely to have good knowledge of STI and HIV transmission and prevention than those in the lowest class. Conclusion. Participants that previously sought care from health facilities, pharmacy, and patient medicine vendors had better knowledge of STIs and HIV infection prevention and transmission than those who sought care from unorthodox sources. We recommend a national awareness creation on STI prevention including provision of information on safe point of care for STIs in Nigeria.

scholarly journals Modelling for HIV Spread in Homosexual Population

2005 ◽  
Vol 4 (1) ◽  
pp. 68-77
Author(s):  
T. Srivenkataramana ◽  
C. Nagaraja Rao
Keyword(s):  
Health Care ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Hiv And Aids ◽  
Health Care Needs ◽  
Care Needs ◽  
Stochastic Mode

Statical modeling of HIV infection is useful to understand HIV spread mechanism, for predicting HIV and AIDS counts and for forecasting health care needs. This article: i. stresses the need for modeling of HIV and AIDS . ii. discusses the appropriateness of a stochastic mode for HIV transmission and iii. examines the applicability of diffusion of news and rumors model of Taga & Isli(1959), reported in Bartholomew(1967) and presents the adapted version of this model to suit HIV spread in homosexual populations. Three different cases are considered under this model.

scholarly journals Reconsidering the Number of Women With HIV Infection Who Give Birth Annually in the United States

2018 ◽  
Vol 133 (6) ◽  
pp. 637-643 ◽  
Author(s):  
Steven R. Nesheim ◽  
Lauren F. FitzHarris ◽  
Margaret A. Lampe ◽  
Kristen Mahle Gray
Keyword(s):  
United States ◽  
Hiv Infection ◽  
Birth Rate ◽  
Hiv Transmission ◽  
The United States ◽  
Annual Number ◽  
Childbearing Age ◽  
Perinatal Hiv ◽  
Women With Hiv ◽  
Living With Hiv

Objectives: The annual number of women with HIV infection who delivered infants in the United States was estimated to be 8700 in 2006. An accurate, current estimate is important for guiding perinatal HIV prevention efforts. Our objective was to analyze whether the 2006 estimate was consistent with the number of infants with HIV infection observed in the United States and with other data on perinatal HIV transmission. Methods: We compared the number of infants born with HIV in 2015 (n = 53) with data on interventions to prevent perinatal HIV transmission (eg, maternal HIV diagnosis before and during pregnancy and prenatal antiretroviral use). We also estimated the annual number of deliveries to women living with HIV by using the number of women of childbearing age living with HIV during 2008-2014 and the estimated birth rate among these women. Finally, we determined any changes in the annual number of infants born to women with HIV from 2007-2015, among 19 states that reported these data. Results: The low number of infants born in the United States with HIV infection and the uptake of interventions to prevent perinatal HIV transmission were not consistent with the 2006 estimate (n = 8700), even with the best uptake of interventions to prevent perinatal HIV transmission. Given the birth rate among women with HIV (estimated at 7%) and the number of women aged 13-44 living with HIV during 2008-2014 (n = 111 273 in 2008, n = 96 363 in 2014), no more than about 5000 women with HIV would be giving birth. Among states consistently reporting the annual number of births to women with HIV, the number declined about 14% from 2008 to 2014. Conclusion: The current annual number of women with HIV infection delivering infants in the United States is about 5000, which is substantially lower than the 2006 estimate. More accurate estimates would require comprehensive reporting of perinatal HIV exposure.

HIV and AIDS

2018 ◽  
Author(s):  
Daniel R. Kuritzkes
Keyword(s):  
Black Women ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
The United States ◽  
Hiv And Aids ◽  
Hiv Care ◽  
Hiv Replication ◽  
Quarter Century ◽  
Treatment And Prevention

In the quarter-century since the first report of AIDS in the United States, HIV infection has spread throughout the population, disproportionately affecting black women, Hispanic women, and men who have sex with men. The prognosis for persons infected with HIV has improved dramatically with the introduction and evolution of highly active antiretroviral therapy (HAART). The underlying principle of HAART is that a combination of potent antiretrovirals, each of which requires different mutations in the HIV genome for resistance to develop, can suppress replication sufficiently to prevent mutation and the emergence of resistance. The prospect that currently available antiretroviral therapy (ART) regimens may suppress HIV replication indefinitely provides the hope that infected patients will have life expectancies similar to those of age-matched uninfected individuals. For these patients, HIV care has shifted from an emphasis on treatment and prevention of the complications of HIV disease itself to a focus on suppression of HIV replication and management of short- and long-term complications of HIV, ART toxicities, and aging. This chapter describes the epidemiology, pathophysiology and pathogenesis, prevention, diagnosis, and management of acute and chronic HIV infection and AIDS, with figures and tables illustrating each chapter section. This review contains 9 highly rendered figures, 22 tables, and 248 references.

HIV and AIDS

2017 ◽  
Author(s):  
Daniel R. Kuritzkes
Keyword(s):  
Black Women ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
The United States ◽  
Hiv And Aids ◽  
Hiv Care ◽  
Hiv Replication ◽  
Quarter Century ◽  
Treatment And Prevention

In the quarter-century since the first report of AIDS in the United States, HIV infection has spread throughout the population, disproportionately affecting black women, Hispanic women, and men who have sex with men. The prognosis for persons infected with HIV has improved dramatically with the introduction and evolution of highly active antiretroviral therapy (HAART). The underlying principle of HAART is that a combination of potent antiretrovirals, each of which requires different mutations in the HIV genome for resistance to develop, can suppress replication sufficiently to prevent mutation and the emergence of resistance. The prospect that currently available antiretroviral therapy (ART) regimens may suppress HIV replication indefinitely provides the hope that infected patients will have life expectancies similar to those of age-matched uninfected individuals. For these patients, HIV care has shifted from an emphasis on treatment and prevention of the complications of HIV disease itself to a focus on suppression of HIV replication and management of short- and long-term complications of HIV, ART toxicities, and aging. This chapter describes the epidemiology, pathophysiology and pathogenesis, prevention, diagnosis, and management of acute and chronic HIV infection and AIDS, with figures and tables illustrating each chapter section. This review contains 9 highly rendered figures, 22 tables, and 248 references.

Epidemiology of Psychiatric Disorders Associated with HIV and AIDS

2017 ◽  
Author(s):  
Francine Cournos ◽  
Karen McKinnon ◽  
Milton Wainberg
Keyword(s):  
Mental Illness ◽  
General Population ◽  
Hiv Infection ◽  
Severe Mental Illness ◽  
The United States ◽  
Population Based ◽  
Hiv And Aids ◽  
Mental Illnesses ◽  
Strong Focus ◽  
Specific Disorders

This chapter presents the prevalence of common and severe mental illnesses among people with HIV infection, as well as the prevalence of HIV infection among people with severe mental illness. It begins with a look at population-based studies, which are limited in number, then discusses specific disorders studied in smaller studies with selected populations. While the chapter is largely focused on epidemiology in the United States, selected studies from other regions are cited. Taken together, studies show that people with HIV infection have high rates of HIV-associated neurocognitive disorders, although these disorders tend to be milder than they were before effective antiretroviral therapy. The rates of current alcohol- and drug-related disorders mirror those for the general population, but lifetime rates among people with HIV infection are higher, as are rates of depression, anxiety disorders, posttraumatic stress disorder, bipolar disorder, psychosis and personality disorder. Rates of HIV infection among people with severe mental illness in the U.S. are clearly elevated in comparison to those for the general population. Despite scientific advances, the absence of a strong focus on mental disorders remains a glaring omission in progress on HIV prevention, care, and treatment.

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