Brief Educational Pre-Exposure Prophylaxis Intervention in an Infectious Disease Clinic: Protocol for a Case Series Study (Preprint)

2021 ◽  
Author(s):  
Cynthia Dalton ◽  
Cynthia Dalton ◽  
Judith Cornelius ◽  
Bernard Davis
Keyword(s):  
Infectious Disease ◽  
African American ◽  
Hiv Infection ◽  
Educational Intervention ◽  
Secondary Outcome ◽  
Sexually Transmitted ◽  
Infectious Disease Clinic ◽  
Awareness Campaigns ◽  
Disease Clinic ◽  
African American Msm

BACKGROUND Men who have sex with men (MSM) remains the highest group infected with HIV despite treatment with medications knows as preexposure prophylaxis (PrEP). PrEP in combination with safer sex practices has shown efficacy in preventing HIV infection. Despite awareness campaigns, PrEP uptake remains low with African American MSM. While brief educational interventions have value in fast-paced clinical settings with limited appointment times a brief PrEP educational intervention had not been initiated with MSM in a fast-paced outpatient infectious disease clinic in North Carolina. OBJECTIVE The purpose of this study is to examine the effect of initiating a brief PrEP brief educational intervention with African American MSM in a sexually transmitted disease clinic. METHODS We will examine the effects of the brief educational PrEP intervention at three time points, baseline, 4 weeks later (first visit) and at the 3-month follow-up (2nd visit). The primary outcomes will be PrEP knowledge, medication adherence, and sexually transmitted infections outcomes. We will also examine a secondary outcome of high-risk sexual behaviors. RESULTS To date, a total of seven participants have consented to participate in the study. Data analysis is ongoing. We anticipate that the results will be published by Fall 2021. CONCLUSIONS This study will report the effectiveness of implementing a brief PrEP educational intervention in a fast-paced clinic setting on reducing the incidences of HIV infection.

scholarly journals 1701. Added Benefits of Pre-exposure Prophylaxis Use on HIV Incidence with Minimal Changes in Efficiency in the Context of High Treatment Engagement among Men Who Have Sex with Men

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S833-S833
Author(s):  
Alyson L Singleton ◽  
Brandon D Marshall ◽  
Xiao Zang ◽  
Amy S Nunn ◽  
William C Goedel
Keyword(s):  
African American ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Treatment Engagement ◽  
Hiv Incidence ◽  
Black African ◽  
African American Msm ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
High Treatment

Abstract Background Although there is ongoing debate over the need for substantial increases in PrEP use when antiretroviral treatment confers the dual benefits of reducing HIV-related morbidity and mortality and the risk of HIV transmission, no studies to date have quantified the potential added benefits of PrEP use in settings with high treatment engagement across variable sub-epidemics in the United States. Methods We used a previously published agent-based network model to simulate HIV transmission in a dynamic network of 17,440 Black/African American and White MSM in Atlanta, Georgia from 2015 to 2024 to understand how the magnitude of reductions in HIV incidence attributable to varying levels of PrEP use (0–90%) changes in potential futures where high levels of treatment engagement (i.e. the UNAIDS ‘90-90-90’ goals and eventual ‘95-95-95’ goals) are achieved and maintained, as compared to current levels of treatment engagement in Atlanta (Figure 1). Model inputs related to HIV treatment engagement among Black/African American and White men who have sex with men in Atlanta. A comparison of current levels of treatment engagement (Panel A) to treatment engagement at ‘90-90-90’ (Panel B) and ‘95-95-95’ goals (Panel C). Results Even at achievement and maintenance of ‘90-90-90’ goals, 75% PrEP coverage reduced incidence rates by an additional 67.9% and 74.2% to 1.53 (SI: 1.39, 1.70) and 0.355 (SI: 0.316, 0.391) per 100 person-years for Black/African American and White MSM, respectively (Figure 2), compared to the same scenario with no PrEP use. Additionally, an increase from 15% PrEP coverage to 75% under ‘90-90-90’ goals only increased person-years of PrEP use per HIV infection averted, a measure of efficiency of PrEP, by 8.1% and 10.5% to 26.7 (SI: 25.6, 28.0) and 73.3 (SI: 70.6, 75.7) among Black/African American MSM and White MSM, respectively (Figure 3). Overall (Panel A) and race-stratified (Panel B and Panel C) marginal changes in HIV incidence over ten years among Black/African American and White men who have sex with men in Atlanta across scenarios of varied levels of treatment engagement among agents living with HIV infection and levels of pre-exposure prophylaxis use among HIV-uninfected agents. Note: All changes are calculated within each set of treatment scenarios relative to a scenario where no agents use pre-exposure prophylaxis. Person-years of pre-exposure prophylaxis use per HIV infection averted among Black/African American (Panel A) and White (Panel B) men who have sex with men in Atlanta across scenarios of varied levels of treatment engagement among agents living with HIV infection and levels of pre-exposure prophylaxis use among HIV-uninfected agents. Note: The number of HIV infections averted is calculated within each set of treatment scenarios relative to a scenario where no agents use pre-exposure prophylaxis. Conclusion Even in the context of high treatment engagement, substantial expansion of PrEP use still contributes to meaningful decreases in HIV incidence among MSM with minimal changes in person-years of PrEP use per HIV infection averted, particularly for Black/African American MSM. Disclosures All Authors: No reported disclosures

scholarly journals Male Circumcision and Risk of HIV Infection among Heterosexual African American Men Attending Baltimore Sexually Transmitted Disease Clinics

2009 ◽  
Vol 199 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Lee Warner ◽  
Khalil G. Ghanem ◽  
Daniel R. Newman ◽  
Maurizio Macaluso ◽  
Patrick S. Sullivan ◽  
...  
Keyword(s):  
African American ◽  
Hiv Infection ◽  
Male Circumcision ◽  
Sexually Transmitted Disease ◽  
African American Men ◽  
Transmitted Disease ◽  
Sexually Transmitted

Implementation of a Collaborative HIV Testing Model Between an Emergency Department and Infectious Disease Clinic

2014 ◽  
Vol 66 (3) ◽  
pp. e67-e70 ◽  
Author(s):  
Brooke E. Hoots ◽  
Pamela W. Klein ◽  
Ian B.K. Martin ◽  
Peter A. Leone ◽  
E. Byrd Quinlivan ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Emergency Department ◽  
Hiv Testing ◽  
Testing Model ◽  
Infectious Disease Clinic ◽  
Disease Clinic

scholarly journals Rare Causes of Pleural Effusion in Children: Differential Diagnosis in a Pediatric Infectious Disease Clinic

2021 ◽  
Vol 15 (1) ◽  
pp. 26-32
Author(s):  
Ayşe Kaman ◽  
Türkan Aydın Teke ◽  
Fatma Nur Öz ◽  
Sevgi Yaşar Durmuş ◽  
Rumeysa Yalçınkaya ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pediatric Infectious Disease ◽  
Infectious Disease Clinic ◽  
Disease Clinic

scholarly journals Clostridium difficile-associated diarrhea in the Clinical Center of Vojvodina, Serbia, in the period 2008 to 2012

2014 ◽  
Vol 66 (1) ◽  
pp. 57-64
Author(s):  
Sandra Stefan-Mikic ◽  
Vedrana Petric ◽  
S. Sevic ◽  
Ivana Hrnjakovic-Cvjetkovic ◽  
Vesna Milosevic ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Clostridium Difficile ◽  
Hospital Costs ◽  
Control Measures ◽  
Infectious Disease Clinic ◽  
Disease Clinic ◽  
Clinical Center ◽  
Number Of Patients ◽  
Costs Of Treatment ◽  
Clostridium Difficile Associated Diarrhea

Clostridium difficile-associated diarrhea (CDAD) has been recognized as the leading cause of diarrhea worldwide. In the last five years, it has become the leading cause of diarrhea in the Clinical Center of Vojvodina (CCV) as well. The aim of this study was to determine the epidemiology and total cost of treatment for all patients with Clostridium difficile-associated diarrhea hospitalized at the Infectious Disease Clinic of the CCV; to analyze the costs of treatment with regard to therapeutic approach; to compare the costs of treatment in each year of the investigated period related to the number of patients, and to analyze the outcome of treatment. The study was retrospective, and the data were collected from the medical records of 472 patients with Clostridium difficile diarrhea treated from 2008 to 2012 and analyzed. Of the total 472 patients with CDAD, 54.23% were female and the average age was 65.84. A statistically significant majority of them had been previously treated in other hospitals and a minority in ambulatory settings (395 inpatients vs. 77 outpatients, p=0.000, p<0.05). Of the 395 previously hospitalized patients, most were from the Clinic of Urology of the CCV (58, 14.68%). When comparing therapeutic options, oral vancomycin was significantly more frequently used than other protocols. The average mortality rate during the study period was 6.51%. In this period, total hospital costs related to Clostridium difficile diarrhea in the Infectious Disease Clinic were $636,679.92. Implementation of infection-control measures and a restricted use of antibiotics would result in a great reduction in material costs.

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