scholarly journals Statewide Evaluation of New HIV Diagnoses in Rhode Island: Implications for Prevention

2018 ◽  
Vol 133 (4) ◽  
pp. 489-496
Author(s):  
Philip A. Chan ◽  
Madeline C. Montgomery ◽  
Jennifer Rose ◽  
Alec Tributino ◽  
Christina Crowley ◽  
...  
Keyword(s):  
United States ◽  
Rhode Island ◽  
Latent Class ◽  
Hiv Transmission ◽  
The United States ◽  
Newly Diagnosed ◽  
Foreign Born ◽  
Class 1 ◽  
Sex With Men ◽  
Exposure Prophylaxis

Objectives: Patterns of HIV transmission vary widely across demographic groups. Identifying and engaging these groups are necessary to prevent new infections and diagnose disease among people who are unaware of their infection. The objective of this study was to determine characteristics of newly diagnosed individuals across an entire state to determine patterns of HIV transmission. Methods: We evaluated data on people with new HIV diagnoses in Rhode Island from 2013 through 2015. We performed a latent class analysis (LCA) to identify underlying demographic and behavioral characteristics of people with newly diagnosed HIV. Results: Of 167 people with new HIV diagnoses interviewed in Rhode Island from 2013 through 2015, 132 (79%) were male, 84 (50%) were nonwhite, 112 (67%) were men who have sex with men (MSM), 112 (67%) were born in the United States, and 61 (37%) were born in Rhode Island. LCA revealed 2 major classes. Of the 98 people in class 1, 96% were male, 85% were MSM, 80% were white, 94% were born in the United States, and 80% believed they acquired HIV in Rhode Island. Class 2 was 63% male and 69% Hispanic/Latino; 29% were born in the United States, and 61% believed they acquired HIV in Rhode Island. Conclusions: Most new HIV diagnoses in Rhode Island were among MSM born in the United States, and a substantial number were likely infected in-state. People with newly diagnosed HIV who were foreign-born, including Hispanic/Latino and heterosexual groups, were less likely to have acquired HIV in Rhode Island than were MSM. HIV prevention approaches, including pre-exposure prophylaxis, should be adapted to the needs of specific groups. Rhode Island offers lessons for other states focused on eliminating HIV transmission.

scholarly journals Implementation of a Rapid Entry Program Decreases Time to Viral Suppression Among Vulnerable Persons Living With HIV in the Southern United States

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Jonathan Colasanti ◽  
Jeri Sumitani ◽  
C Christina Mehta ◽  
Yiran Zhang ◽  
Minh Ly Nguyen ◽  
...  
Keyword(s):  
United States ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Positive Impact ◽  
Population Level ◽  
The United States ◽  
Clinic Visit ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Sex With Men

Abstract Background Rapid entry programs (REPs) improve time to antiretroviral therapy (ART) initiation (TAI) and time to viral suppression (TVS). We assessed the feasibility and effectiveness of a REP in a large HIV clinic in Atlanta, Georgia, serving a predominately un- or underinsured population. Methods The Rapid Entry and ART in Clinic for HIV (REACH) program was implemented on May 16, 2016. We performed a retrospective cohort study with the main independent variable being period of enrollment: January 1, 2016, through May 15, 2016 (pre-REACH); May 16, 2016, through July 31, 2016 (post-REACH). Included individuals were HIV-infected and new to the clinic with detectable HIV-1 RNA. Six-month follow-up data were collected for each participant. Survival analyses were conducted for TVS. Logistic and linear regression analyses were used to evaluate secondary outcomes: attendance at first clinic visit, viral suppression, TAI, and time to first attended provider visit. Results There were 117 pre-REACH and 90 post-REACH individuals. Median age (interquartile range [IQR]) was 35 (25–45) years, 80% were male, 91% black, 60% men who have sex with men, 57% uninsured, and 44% active substance users. TVS decreased from 77 (62–96) to 57 (41–70) days (P < .0022). Time to first attended provider visit decreased from 17 to 5 days, and TAI from 21 to 7 days (P < .0001), each remaining significant in adjusted models. Conclusions This is the largest rapid entry cohort described in the United States and suggests that rapid entry is feasible and could have a positive impact on HIV transmission at the population level.

scholarly journals HIV Transmission Dynamics Among Foreign-Born Persons in the United States

2017 ◽  
Vol 76 (5) ◽  
pp. 445-452 ◽  
Author(s):  
Eduardo E. Valverde ◽  
Alexandra M. Oster ◽  
Songli Xu ◽  
Joel O. Wertheim ◽  
Angela L. Hernandez
Keyword(s):  
United States ◽  
Hiv Transmission ◽  
The United States ◽  
Transmission Dynamics ◽  
Foreign Born

scholarly journals Qualitative Consumer Research on Acceptance of Long-Acting Pre-Exposure Prophylaxis Products Among Men Having Sex with Men and Medical Practitioners in the United States

2018 ◽  
Vol 34 (10) ◽  
pp. 849-856 ◽  
Author(s):  
Bobby J. Calder ◽  
Robert J. Schieffer ◽  
Ewa Bryndza Tfaily ◽  
Richard D'Aquila ◽  
George J. Greene ◽  
...  
Keyword(s):  
United States ◽  
Consumer Research ◽  
The United States ◽  
Medical Practitioners ◽  
Sex With Men ◽  
Long Acting ◽  
Exposure Prophylaxis

scholarly journals Estimated Impact of Targeted Pre-Exposure Prophylaxis: Strategies for Men Who Have Sex with Men in the United States

2019 ◽  
Vol 16 (9) ◽  
pp. 1592 ◽  
Author(s):  
Richard A. Elion ◽  
Mina Kabiri ◽  
Kenneth H. Mayer ◽  
David A. Wohl ◽  
Joshua Cohen ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Black Msm ◽  
Number Needed To Treat ◽  
Latino Msm ◽  
Sex With Men ◽  
Young Black Msm ◽  
Exposure Prophylaxis ◽  
The Impact ◽  
Black And Latino

Pre-exposure prophylaxis (PrEP) effectively reduces human immunodeficiency virus (HIV) transmission. We aimed to estimate the impact of different PrEP prioritization strategies among Black and Latino men who have sex with men (MSM) in the United States, populations most disproportionately affected by HIV. We developed an agent-based simulation to model the HIV epidemic among MSM. Individuals were assigned an HIV incidence risk index (HIRI-MSM) based on their sexual behavior. Prioritization strategies included PrEP use for individuals with HIRI-MSM ≥10 among all MSM, all Black MSM, young (≤25 years) Black MSM, Latino MSM, and young Latino MSM. We estimated the number needed to treat (NNT) to prevent one HIV infection, reductions in prevalence and incidence, and subsequent infections in non-PrEP users avoided under these strategies over 5 years (2016–2020). Young Black MSM eligible for PrEP had the lowest NNT (NNT = 10) followed by all Black MSM (NNT = 33) and young Latino MSM (NNT = 35). All Latino MSM and all MSM had NNT values of 63 and 70, respectively. Secondary infection reduction with PrEP was the highest among young Latino MSM (53.2%) followed by young Black MSM (37.8%). Targeting all MSM had the greatest reduction in prevalence (14.7% versus 2.9%–3.9% in other strategies) and incidence (49.4% versus 9.4%–13.9% in other groups). Using data representative of the United States MSM population, we found that a strategy of universal PrEP use by MSM was most effective in reducing HIV prevalence and incidence of MSM. Targeted use of PrEP by Black and Latino MSM, however, especially those ≤25 years, had the greatest impact on HIV prevention.

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.

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