scholarly journals Optimal Allocation of Societal HIV Prevention Resources to Reduce HIV Incidence in the United States

2021 ◽  
Vol 111 (1) ◽  
pp. 150-158
Author(s):  
Stephanie L. Sansom ◽  
Katherine A. Hicks ◽  
Justin Carrico ◽  
Evin U. Jacobson ◽  
Ram K. Shrestha ◽  
...  
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Optimal Allocation ◽  
The United States ◽  
Hiv Care ◽  
Public And Private ◽  
Hiv Model ◽  
Sustained Viral Suppression ◽  
Adherence Support ◽  
Optimal Allocations

Objectives. To optimize combined public and private spending on HIV prevention to achieve maximum reductions in incidence. Methods. We used a national HIV model to estimate new infections from 2018 to 2027 in the United States. We estimated current spending on HIV screening, interventions that move persons with diagnosed HIV along the HIV care continuum, pre-exposure prophylaxis, and syringe services programs. We compared the current funding allocation with 2 optimal scenarios: (1) a limited-reach scenario with expanded efforts to serve eligible persons and (2) an ideal, unlimited-reach scenario in which all eligible persons could be served. Results. A continuation of the current allocation projects 331 000 new HIV cases over the next 10 years. The limited-reach scenario reduces that number by 69%, and the unlimited reach scenario by 94%. The most efficient funding allocations resulted in prompt diagnosis and sustained viral suppression through improved screening of high-risk persons and treatment adherence support for those infected. Conclusions. Optimal allocations of public and private funds for HIV prevention can achieve substantial reductions in new infections. Achieving reductions of more than 90% under current funding will require that virtually all infected receive sustained treatment.

Shifting the Paradigm in HIV Prevention and Treatment Service Delivery Toward Differentiated Care for Youth

2019 ◽  
Author(s):  
Vincent Guilamo-Ramos ◽  
Marco Thimm-Kaiser ◽  
Adam Benzekri ◽  
Donna Futterman
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Service Delivery ◽  
The United States ◽  
Hiv Care ◽  
Health Concern ◽  
Service Needs ◽  
Minority Adolescents ◽  
Prevention And Treatment ◽  
Differentiated Care

Despite significant progress in the fight against HIV/AIDS in the United States, HIV prevention and treatment disparities among key populations remain a national public health concern. While new HIV diagnoses are increasing among people under age 30—in particular among racial, ethnic, and sexual minority adolescents and young adults (AYA)—dominant prevention and treatment paradigms too often inadequately consider the unique HIV service needs of AYA. To address this gap, we characterize persistent and largely overlooked AYA disparities across the HIV prevention and treatment continuum, identify AYA-specific limitations in extant resources for improving HIV service delivery in the United States, and propose a novel AYA-centered differentiated care framework adapted to the unique ecological and developmental factors shaping engagement, adherence, and retention in HIV services among AYA. Shifting the paradigm for AYA to differentiated HIV care is a promising approach that warrants implementation and evaluation as part of reinforced national efforts to end the HIV epidemic in the United States by 2030.

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 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.

“In the Bible Belt:” The role of religion in HIV care and prevention for transgender people in the United States South

2021 ◽  
Vol 70 ◽  
pp. 102613
Author(s):  
Darius Scott ◽  
Nastacia M. Pereira ◽  
Sayward E. Harrison ◽  
Meagan Zarwell ◽  
Kamla Sanasi-Bhola ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Hiv Care ◽  
Bible Belt ◽  
Transgender People ◽  
United States South ◽  
The Bible ◽  
Role Of Religion

HIV Prevention in the United States

2004 ◽  
Vol 37 ◽  
pp. S119-S121 ◽  
Author(s):  
Robert S Janssen ◽  
Ronald O Valdiserri
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
The United States

Cost and Threshold Analysis of Positive Charge, a Multi-site Linkage to HIV Care Program in the United States

2015 ◽  
Vol 19 (10) ◽  
pp. 1735-1741 ◽  
Author(s):  
Jeeyon Janet Kim ◽  
◽  
Cathy Maulsby ◽  
Rose Zulliger ◽  
Kriti Jain ◽  
...  
Keyword(s):  
United States ◽  
Positive Charge ◽  
Care Program ◽  
The United States ◽  
Hiv Care ◽  
Threshold Analysis ◽  
Linkage To Hiv Care

Revitalizing Human Communities and Reclaiming Biological Communities

2017 ◽  
Author(s):  
William R. Burch ◽  
Gary E. Machlis ◽  
Jo Ellen Force
Keyword(s):  
United States ◽  
Natural Resources ◽  
Ecosystem Model ◽  
The United States ◽  
Decision Makers ◽  
Public And Private ◽  
Integrated Network ◽  
Biological Communities ◽  
Human Ecosystem ◽  
Problems And Solutions

This chapter demonstrates how the Human Ecosystem Model (HEM) offers a unity of understanding with shared concepts, a framework, and a model for resolving complex human ecosystem problems. With it, decision-makers from different organizations—public and private—may coordinate their work with that of local citizens. The emphasis is on the whole system, which combines issues such as trends in crime, housing, education, health, natural resources, and community stability into an integrated network. The chapter illustrates how the framework and model was applied in a major city in the United States: Baltimore, Maryland. The Baltimore story emphasizes that certain universal problems and solutions confront all human societies. The universality of problems and the search for integrated solutions required a framework like the HEM to identify, apply, and store learning.

scholarly journals Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics

2014 ◽  
Vol 1 (1) ◽  
pp. e5 ◽  
Author(s):  
John Torous ◽  
Steven Richard Chan ◽  
Shih Yee-Marie Tan ◽  
Jacob Behrens ◽  
Ian Mathew ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Psychiatric Symptoms ◽  
Mobile Apps ◽  
Mental Healthcare ◽  
The United States ◽  
Psychiatric Outpatients ◽  
Public And Private ◽  
Diverse Patient Population ◽  
Mobile Mental Health

Background Despite growing interest in mobile mental health and utilization of smartphone technology to monitor psychiatric symptoms, there remains a lack of knowledge both regarding patient ownership of smartphones and their interest in using such to monitor their mental health. Objective To provide data on psychiatric outpatients’ prevalence of smartphone ownership and interest in using their smartphones to run applications to monitor their mental health. Methods We surveyed 320 psychiatric outpatients from four clinics around the United States in order to capture a geographically and socioeconomically diverse patient population. These comprised a state clinic in Massachusetts (n=108), a county clinic in California (n=56), a hybrid public and private clinic in Louisiana (n=50), and a private/university clinic in Wisconsin (n=106). Results Smartphone ownership and interest in utilizing such to monitor mental health varied by both clinic type and age with overall ownership of 62.5% (200/320), which is slightly higher than the average United States’ rate of ownership of 58% in January 2014. Overall patient interest in utilizing smartphones to monitor symptoms was 70.6% (226/320). Conclusions These results suggest that psychiatric outpatients are interested in using their smartphones to monitor their mental health and own the smartphones capable of running mental healthcare related mobile applications.

scholarly journals The Social Oikos

2021 ◽  
Vol 7 (1) ◽  
pp. 20-32
Author(s):  
Michael Lee Humphrey
Keyword(s):  
United States ◽  
The United States ◽  
The Self ◽  
Ancient World ◽  
Public And Private ◽  
The Public ◽  
The Core ◽  
The Social ◽  
Nuanced Understanding ◽  
Core Points

In one of the foundational articles of persona studies, Marshall and Barbour (2015) look to Hannah Arendt for development of a key concept within the larger persona framework: “Arendt saw the need to construct clear and separate public and private identities. What can be discerned from this understanding of the public and the private is a nuanced sense of the significance of persona: the presentation of the self for public comportment and expression” (2015, p. 3). But as far back as the ancient world from which Arendt draws her insights, the affordance of persona was not evenly distributed. As Gines (2014) argues, the realm of the household, oikos, was a space of subjugation of those who were forced to be “private,” tending to the necessities of life, while others were privileged with life in the public at their expense. To demonstrate the core points of this essay, I use textual analysis of a YouTube family vlog, featuring a Black mother in the United States, whose persona rapidly changed after she and her White husband divorced. By critically examining Arendt’s concepts around public, private, and social, a more nuanced understanding of how personas are formed in unjust cultures can help us theorize persona studies in more egalitarian and robust ways.

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