scholarly journals The Interconnected Dynamics of Partnership and HIV: A Qualitative Exploration of Experiences from Heterosexual Individuals Newly Diagnosed with HIV 

2021 ◽  
Author(s):  
maira sohail ◽  
Emily B. Levitan ◽  
Dustin M. Long ◽  
Michael J. Mugavero ◽  
Akinyemi I. Ojesina ◽  
...  
Keyword(s):  
African American ◽  
Retention In Care ◽  
The United States ◽  
Hiv Care ◽  
Newly Diagnosed ◽  
Hiv Education ◽  
Heterosexual Couples ◽  
Hiv Diagnosis ◽  
Care Outcomes

Abstract Background Recent studies have focused on the role of intimate partnership on HIV care outcomes among men who have sex with men in the United States (US) and heterosexual couples in some African studies, leaving a gap in the recent US-based literature on the role of having an intimate partner on HIV care outcomes among heterosexual couples. Therefore, the objective of this study was to explore the lived experiences of heterosexual individuals newly diagnosed with HIV regarding the role of partnership on HIV care. MethodsThis phenomenological study conducted one time, virtual, in-depth interviews with six heterosexual individuals newly diagnosed with HIV ≥2017. The data analysis followed Moustakas approach to identify themes and sub-themes. ResultsThe participants were predominantly female and African American with median age of 46 years. Four themes identifying association between partnership and HIV care included role of HIV on partnership, under which impact of HIV on partnership and presumed reaction if partner was diagnosed with HIV were identified; Impact of partnership on HIV identified perception on dealing with HIV diagnosis without a partner and role of family vs. partner in HIV care as sub-themes; forms of support from partner in HIV care identified partner support around the time of HIV diagnosis and linkage to HIV care and around retention in care; and perceptions on the types of partner-based clinic services, which identified areas such as couples therapy, assistance with partner communication on sensitive topics such as HIV disclosure, and HIV education of the partner. The findings showed that partnership played a vital role in HIV care among partnered individuals; and the importance of a partner in HIV care was acknowledged by unpartnered participants. Various support practices by partners around HIV diagnosis and retention in care were identified. Quality of partnership played a bigger role in HIV care than presence of partnership. ConclusionThe importance of partner-based interventions in improving the HIV care of the person with HIV (PWH) was acknowledged. While demonstrating views of mainly African American women living with HIV in the Southern US, findings may be transferrable to other heterosexual PWH in other locales.

scholarly journals HIV Infection-Related Care Outcomes among U.S.-Born and Non-U.S.-Born Blacks with Diagnosed HIV in 40 U.S. Areas: The National HIV Surveillance System, 2016

2018 ◽  
Vol 15 (11) ◽  
pp. 2404 ◽  
Author(s):  
Hanna Demeke ◽  
Anna Johnson ◽  
Hong Zhu ◽  
Zanetta Gant ◽  
Wayne Duffus ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Stage ◽  
Surveillance System ◽  
Viral Suppression ◽  
Hiv Infections ◽  
Retention In Care ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Hiv Surveillance ◽  
Care Outcomes

HIV care outcomes must be improved to reduce new human immunodeficiency virus (HIV) infections and health disparities. HIV infection-related care outcome measures were examined for U.S.-born and non-U.S.-born black persons aged ≥13 years by using National HIV Surveillance System data from 40 U.S. areas. These measures include late-stage HIV diagnosis, timing of linkage to medical care after HIV diagnosis, retention in care, and viral suppression. Ninety-five percent of non-U.S.-born blacks had been born in Africa or the Caribbean. Compared with U.S.-born blacks, higher percentages of non-U.S.-born blacks with HIV infection diagnosed during 2016 received a late-stage diagnoses (28.3% versus 19.1%) and were linked to care in ≤1 month after HIV infection diagnosis (76.8% versus 71.3%). Among persons with HIV diagnosed in 2014 and who were alive at year-end 2015, a higher percentage of non-U.S.-born blacks were retained in care (67.8% versus 61.1%) and achieved viral suppression (68.7% versus 57.8%). Care outcomes varied between African- and Caribbean-born blacks. Non-U.S.-born blacks achieved higher care outcomes than U.S.-born blacks, despite delayed entry to care. Possible explanations include a late-stage presentation that requires immediate linkage and optimal treatment and care provided through government-funded programs.

Longitudinal analysis of HIV outcomes for persons living with HIV in non-urban areas in southern Alberta, Canada

2021 ◽  
Author(s):  
Geneviève Kerkerian ◽  
Hartmut B Krentz ◽  
M John Gill
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Retention In Care ◽  
Hiv Care ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Optimal Care ◽  
Persons Living With Hiv ◽  
Retention In Hiv Care ◽  
Southern Alberta

BACKGROUND: Many challenges remain in successfully engaging people with HIV (PWH) into lifelong HIV care. Living in non-urban or rural areas has been associated with worse outcomes. Uncertainties remain regarding how to provide optimal HIV care in non-urban areas. METHODS: Using a retrospective descriptive analysis framework, we compared multiple measurable HIV care metrics over time on the basis of urban versus non-urban residency, under a centralized HIV care model. We examined rates of HIV diagnosis, access to and retention in HIV care, and longitudinal outcomes for all newly diagnosed PWH between January 1, 2008, and January 1, 2020, categorized by their home location at the time of HIV diagnosis in southern Alberta. RESULTS: Of 719 newly diagnosed PWH, 619 (86%) lived in urban areas and 100 (14%) lived in non-urban areas. At HIV diagnosis, the groups had no significant differences in initial CD4 count or clinical characteristics ( p = 0.73). Non-urban PWH, however, had slightly longer times to accessing HIV care and initiating antiretroviral therapy (ART) ( p < 0.01). Non-urban PWH showed trends toward slightly lower retention in care and lower sustained ART use, with higher rates of unsuppressed viral loads at 12, 24, and 36 months after diagnosis ( p < 0.01). However, by 2020 both cohorts had suppression rates above 90%. CONCLUSIONS: Sustained retention in care was more challenging for non-urban PWH; however, adherence to ART and viral suppression rates was more than 90%. Although encouraging, challenges remain in identifying and reducing unique barriers for optimal care of PWH living in non-urban areas.

“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

scholarly journals Situational Breakdowns Beyond Protest Violence

2019 ◽  
pp. 129-168
Author(s):  
Anne Nassauer
Keyword(s):  
United States ◽  
African American ◽  
The United States ◽  
Crucial Importance ◽  
Social Phenomena ◽  
Systemic Racism ◽  
Context Factors ◽  
Social Events ◽  
Micro Level

Chapter 9 explores whether the books’ findings hold in other contexts by examining other instances of surprising outcomes. First, the chapter discusses the outbreak of violence in uprisings after police shootings of African American citizens in the United States, such as Ferguson, Missouri, in 2014 and Baltimore, Maryland, in 2015. The first section takes a detailed look at the role of background and context factors (such as symbolic and systemic racism) and situational patterns in uprisings turning violent. Then the chapter discusses successful and failed armed store robberies. Here the surprising outcome is not violence but armed criminals failing to get the money from an unarmed store clerk. Findings suggest similar patterns of situational breakdowns in these occurrences as in protests and uprisings. Overall, the chapter discusses the crucial importance of the micro-level of social phenomena: if routines of both collective and individual social events are disrupted, surprising outcomes occur.

scholarly journals The Role of Risk Perception in Flu Vaccine Behavior among African-American and White Adults in the United States

Risk Analysis ◽  
2017 ◽  
Vol 37 (11) ◽  
pp. 2150-2163 ◽  
Author(s):  
Vicki S. Freimuth ◽  
Amelia Jamison ◽  
Gregory Hancock ◽  
Donald Musa ◽  
Karen Hilyard ◽  
...  
Keyword(s):  
United States ◽  
African American ◽  
Risk Perception ◽  
The United States ◽  
Flu Vaccine ◽  
White Adults

scholarly journals 1300. Symptom Driven Testing Is not Enough: A Retrospective Review of Patients Enrolled into HIV Care 2015–2018 at a Ryan White Patient-Centered Medical Home in Pittsburgh, Pennsylvania

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S468-S469
Author(s):  
Nicholas Cheronis ◽  
Holly Bean ◽  
Marissa Tremoglie ◽  
Cindy Magrini ◽  
Lucas Blazejewski ◽  
...  
Keyword(s):  
High Risk ◽  
Early Diagnosis ◽  
Cd4 Count ◽  
Hiv Care ◽  
Health Clinic ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Missed Opportunities ◽  
Ryan White

Abstract Background While current CDC guidelines recommend screening between the ages of 13–64 at least once and annually for high-risk individuals, this is often not practiced. Early diagnosis has become key to preventing the spread of HIV. It has been suggested that a late diagnosis, one where a patient is symptomatic, implies a loss of 10.5 years in their lifespan. Methods From January 1, 1, 2015 to December 31, 2018, 113 newly diagnosed HIV-infected patients enrolled in care at The Positive Health Clinic (PHC), a Ryan White funded clinic, located in Pittsburgh, PA. Results The median age was 32, 78% male, 64% MSM (Figure 1). At the time of HIV diagnosis, the median CD4 count was 325 U/L and HIV viral load was 65,000 copies. 32 patients (28%) had a CD4 count <200 and 13 had an AIDS-defining illnesses (Figure 2). Only 50% of HIV diagnoses were based on a provider’s clinical suspicions, 26% were driven by patient request, and 24% were the result of system driven screenings. 90.2% of patients had prior healthcare contact before the HIV diagnoses, suggesting missed opportunities. Of all the newly diagnosed HIV patients, 62% were symptomatic, prompting them to be tested for HIV (Figure 3). In 20% of the symptomatic cases, the patient requested to be tested for HIV, highlighting missed opportunities for clinicians to include HIV in their differential. A previous test for HIV within one year of their HIV diagnosis positively correlated with early diagnosis (CD4 >200 copies) (P = 0.007). System driven screenings for HIV also positively correlated with early diagnosis (CD4 >200 copies) (P < 0.001). Conclusion Waiting for clinical suspicion is not enough. To prevent patients from developing life-threatening AIDS-defining illnesses screening must be done at each interaction with the healthcare system for high-risk patients and annually for patients without risk factors. Disclosures All authors: No reported disclosures.

scholarly journals 1320. HIV Care Continuum Outcomes Among Newly Diagnosed PLWH in Washington, DC

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S477-S477
Author(s):  
Maria J Jaurretche ◽  
Morgan Byrne ◽  
Lindsey J Powers Happ ◽  
Matthew E Levy ◽  
Michael A Horberg ◽  
...  
Keyword(s):  
Hiv Care ◽  
Future Research ◽  
Washington Dc ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Aids Diagnosis

Abstract Background In 2019, the US Administration announced the Ending the HIV Epidemic plan to decrease new infections. A key component is the Test and Treat plan to diagnose early, treat rapidly and achieve viral suppression (VS) among persons living with HIV (PLWH). We assessed retention in care (RIC), antiretroviral therapy (ART) initiation and VS among newly diagnosed PLWH in Washington, DC. Methods We conducted a cross-sectional analysis using data from the DC Cohort, an observational longitudinal cohort of PLWH in care in 14 clinics in DC. We included participants enrolled from 2011 to 2016 whose HIV diagnosis was within 1 year of enrollment and with at least 12 months follow-up. RIC was defined as ≥2 visits or HIV lab results 90 days apart in the first year of follow-up. ART initiation was defined as being prescribed ART, VS was defined as HIV RNA <200 copies/mL, and both these outcomes were assessed at 2 time points: by 3 and 12 months. Adjusted multivariable logistic regression was used to identify clinical and sociodemographic factors associated with RIC, ART initiation and VS. Results Among the 455 newly diagnosed participants (6% of all enrollees), median age was 33 years (IQR 25, 45), 69% were Black, 79% male, 60% MSM. Median duration of HIV at enrollment was 4.9 months (IQR 2.3, 7.7). Median nadir CD4 count was 346 cells/μL (IQR 224, 494). Of the 455, 38% had a history of AIDS, 92% were RIC, 65% initiated ART by 3 months and 17% had VS by 3 months. There were no differences by sex or race for RIC, ART initiation and VS. An AIDS diagnosis at enrollment was associated with RIC (aOR 2.28; 1.01–5.15), ART initiation by 3 months (aOR 2.41; 1.54–3.76), and VS by 12 months (aOR 1.92; 1.06–3.46). Lower nadir CD4 (aOR 0.89 per 50 cell increase; 0.84–0.94) and younger age (aOR 0.747 per 10-year increase; 0.584–0.995) were associated with ART initiation by 12 months. Conclusion Although the majority of newly diagnosed PLWH were RIC, fewer started ART or achieved VS. With a large proportion of our sample having an AIDS diagnosis at enrollment, we illustrate the ongoing challenge of late HIV diagnosis in DC. Those with AIDS at diagnosis were more likely to initiate ART within the first 3 months. As same-day ART initiation is scaled up in DC, future research can evaluate if all PLWH, regardless of AIDS status, will achieve this milestone earlier. Disclosures All authors: No reported disclosures.

Diabetes mellitus, race, and the odds of high-grade prostate cancer in men diagnosed with prostate cancer in the United States.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 180-180 ◽  
Author(s):  
T. Mitin ◽  
M. Chen ◽  
B. J. Moran ◽  
D. E. Dosoretz ◽  
M. J. Katin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diabetes Mellitus ◽  
United States ◽  
Logistic Regression ◽  
African American ◽  
Risk Factor ◽  
The United States ◽  
High Grade ◽  
Newly Diagnosed ◽  
Independent Association

180 Background: African American (AA) men present more frequently with high-grade prostate cancer (PCa) and are also more likely to have diabetes mellitus (DM). We evaluated whether there is an independent association between DM and the risk of high-grade PCa in men diagnosed with PCa, adjusting for the known predictors of high-grade PCa including AA race. Methods: Between 1991 and 2009 15,377 men newly diagnosed with PCa and treated at 1 of 26 centers, were analyzed in 2 cohorts. Multivariable logistic regression was performed to evaluate whether a diagnosis of DM was associated with the odds of Gleason 7 or 8 to 10 PCa, adjusting for AA race, advancing age, PSA level, and DRE findings. Results: AA men (AOR, 1.87; 95% CI, 1.04-3.37, P=0.04) and non-AA men (AOR, 1.61; 95% CI, 1.34-1.93; P<0.001) with diabetes were more likely to have GS 8 to 10 versus GS 6 or less PCa, compared to non-diabetic men. AA as compared to non-AA race was not significantly associated with the odds of having GS 8 to 10 as compared to 6 or less PCa, both in men with a diagnosis of DM (AOR, 1.47; 95% CI, 0.87-2.50; P=0.15) and without DM (AOR, 1.27; 95% CI, 0.92-1.74, P=0.14). AA race, however (AOR, 1.37; 95% CI, 1.17-1.60, P<0.001), but not DM (AOR 1.09; 95% CI, 0.97-1.22, P=0.16), was associated with GS 7 versus 6 or less PCa. Conclusions: A diagnosis of DM is a risk factor for presenting with Gleason 8 to 10 PCa independent of race. [Table: see text] No significant financial relationships to disclose.

scholarly journals Time From HIV Diagnosis to Viral Suppression: Survival Analysis of Statewide Surveillance Data in Alabama, 2012 to 2014 (Preprint)

2019 ◽  
Author(s):  
D Scott Batey ◽  
Xueyuan Dong ◽  
Richard P Rogers ◽  
Anthony Merriweather ◽  
Latesha Elopre ◽  
...  
Keyword(s):  
Public Health ◽  
Median Time ◽  
Viral Suppression ◽  
Geographic Area ◽  
Hiv Care ◽  
Newly Diagnosed ◽  
Geographic Variability ◽  
Hiv Diagnosis ◽  
Public Health Action ◽  
Global Estimate

BACKGROUND Evaluation of the time from HIV diagnosis to viral suppression (VS) captures the collective effectiveness of HIV prevention and treatment activities in a given locale and provides a more global estimate of how effectively the larger HIV care system is working in a given geographic area or jurisdiction. OBJECTIVE This study aimed to evaluate temporal and geographic variability in VS among persons with newly diagnosed HIV infection in Alabama between 2012 and 2014. METHODS With data from the National HIV Surveillance System, we evaluated median time from HIV diagnosis to VS (&lt;200 c/mL) overall and stratified by Alabama public health area (PHA) among persons with HIV diagnosed during 2012 to 2014 using the Kaplan-Meier approach. RESULTS Among 1979 newly diagnosed persons, 1181 (59.67%) achieved VS within 12 months of diagnosis; 52.6% (353/671) in 2012, 59.5% (377/634) in 2013, and 66.9% (451/674) in 2014. Median time from HIV diagnosis to VS was 8 months: 10 months in 2012, 8 months in 2013, and 6 months in 2014. Across 11 PHAs in Alabama, 12-month VS ranged from 45.8% (130/284) to 84% (26/31), and median time from diagnosis to VS ranged from 5 to 13 months. CONCLUSIONS Temporal improvement in persons achieving VS following HIV diagnosis statewide in Alabama is encouraging. However, considerable geographic variability warrants further evaluation to inform public health action. Time from HIV diagnosis to VS represents a meaningful indicator that can be incorporated into public health surveillance and programming.

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