scholarly journals A Novel Approach to Realizing Routine HIV Screening and Enhancing Linkage to Care in the United States: Protocol of the FOCUS Program and Early Results

2014 ◽  
Vol 3 (3) ◽  
pp. e39 ◽  
Author(s):  
Travis H Sanchez ◽  
Patrick S Sullivan ◽  
Richard E Rothman ◽  
Emily H Brown ◽  
Lisa K Fitzpatrick ◽  
...  
Keyword(s):  
United States ◽  
Linkage To Care ◽  
The United States ◽  
Hiv Screening ◽  
Early Results ◽  
Novel Approach ◽  
Routine Hiv Screening

scholarly journals Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis

PEDIATRICS ◽  
2021 ◽  
Author(s):  
Katherine K Hsu ◽  
Natella Yurievna Rakhmanina
Keyword(s):  
United States ◽  
Hiv Testing ◽  
Injection Drug Users ◽  
Drug Users ◽  
The United States ◽  
Clinical Report ◽  
Hiv Screening ◽  
Sexually Active ◽  
Routine Hiv Screening ◽  
Routine Hiv Testing

Most sexually active youth in the United States do not believe that they are at risk for contracting HIV and have never been tested. Creating safe environments that promote confidentiality and respect, obtaining an accurate sexual and reproductive health assessment, and providing nonstigmatizing risk counseling are key components of any youth encounters. Pediatricians can play a key role in preventing and controlling HIV infection by promoting risk-reduction counseling and offering routine HIV testing and prophylaxis to adolescent and young adult (youth) patients. In light of persistently high numbers of people living with HIV in the United States and documented missed opportunities for HIV testing, the Centers for Disease Control and Prevention and the US Preventive Services Task Force recommend universal and routine HIV screening among US populations, including youth. Recent advances in HIV diagnostics, treatment, and prevention help support this recommendation. This clinical report reviews epidemiological data and recommends that routine HIV screening be offered to all youth 15 years or older, at least once, in health care settings. After initial screening, youth at increased risk, including those who are sexually active, should be rescreened at least annually, and potentially as frequently as every 3 to 6 months if at high risk (male youth reporting male sexual contact, active injection drug users, transgender youth; youth having sexual partners who are HIV-infected, of both genders, or injection drug users; youth exchanging sex for drugs or money; or youth who have had a diagnosis of or have requested testing for other sexually transmitted infections). Youth at substantial risk for HIV acquisition should be routinely offered HIV preexposure prophylaxis, and HIV postexposure prophylaxis is also indicated after high-risk exposures. This clinical report also addresses consent, confidentiality, and coverage issues that pediatricians face in promoting routine HIV testing and HIV prophylaxis for their patients.

scholarly journals Routine HIV Screening as a Standard of Care: Implementing HIV Screening in General Medical Settings, 2013-2015

2018 ◽  
Vol 133 (2_suppl) ◽  
pp. 52S-59S ◽  
Author(s):  
Laura Roche ◽  
Saul Zepeda ◽  
Blair Harvey ◽  
Karen A. Reitan ◽  
Raekiela D. Taylor
Keyword(s):  
United States ◽  
Health Care ◽  
Electronic Health Records ◽  
Capacity Building ◽  
Standard Of Care ◽  
The United States ◽  
Hiv Screening ◽  
Health Records ◽  
Medical Settings ◽  
Routine Hiv Screening

Objective: We implemented routine HIV screening as part of the 4-year Care and Prevention in the United States Demonstration Project, whose aim was to reduce HIV/AIDS–related morbidity and mortality among racial/ethnic minority groups in the United States. We describe the capacity-building efforts to implement routine HIV screening and provide lessons learned and implications for practice. Methods: From January 2013 through September 2015, the Public Health Institute of Metropolitan Chicago (PHIMC) implemented routine HIV screening in 7 health care systems in Illinois by providing capacity-building assistance focused on systems and operational infrastructure, staff member skills and organizational structure, and clinic culture. Each site received funding to integrate routine HIV screening into the existing clinic flow, engage the entire health care team in the process, and transform the system and shift clinic culture to sustain HIV screening. Results: All 7 systems established policies and procedures to implement routine screening, 5 systems integrated HIV test ordering and documentation into their electronic health records, and 4 systems established a third-party billing and reimbursement process for testing. The 7 systems conducted a total of 49 285 tests and identified 160 people living with HIV. The number of tests increased by more than 40% each year. Conclusions: PHIMC identified the following practices for consideration when implementing routine HIV screening in general medical settings: create a culture that supports HIV screening, use champions in clinics, integrate HIV screening into clinic flow and electronic health records, and train clinic staff members on HIV messaging. Incorporating these practices can help other clinical settings build capacity to make routine HIV screening a standard of care.

scholarly journals Orexin receptor antagonists reverse aberrant dopamine neuron activity and related behaviors in a rodent model of stress-induced psychosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hannah B. Elam ◽  
Stephanie M. Perez ◽  
Jennifer J. Donegan ◽  
Daniel J. Lodge
Keyword(s):  
United States ◽  
Sensorimotor Gating ◽  
The United States ◽  
Dopamine Neuron ◽  
Neuron Activity ◽  
Sprague Dawley ◽  
Post Traumatic Stress ◽  
Neuron Population ◽  
Population Activity ◽  
Novel Approach

AbstractPost-traumatic stress disorder (PTSD) is a prevalent condition affecting approximately 8% of the United States population and 20% of United States combat veterans. In addition to core symptoms of the disorder, up to 64% of individuals diagnosed with PTSD experience comorbid psychosis. Previous research has demonstrated a positive correlation between symptoms of psychosis and increases in dopamine transmission. We have recently demonstrated projections from the paraventricular nucleus of the thalamus (PVT) to the nucleus accumbens (NAc) can regulate dopamine neuron activity in the ventral tegmental area (VTA). Specifically, inactivation of the PVT leads to a reversal of aberrant dopamine system function and psychosis-like behavior. The PVT receives dense innervation from orexin containing neurons, therefore, targeting orexin receptors may be a novel approach to restore dopamine neuron activity and alleviate PTSD-associated psychosis. In this study, we induced stress-related pathophysiology in male Sprague Dawley rats using an inescapable foot-shock procedure. We observed a significant increase in VTA dopamine neuron population activity, deficits in sensorimotor gating, and hyperresponsivity to psychomotor stimulants. Administration of selective orexin 1 receptor (OX1R) and orexin 2 receptor (OX2R) antagonists (SB334867 and EMPA, respectively) or the FDA-approved, dual-orexin receptor antagonist, Suvorexant, were found to reverse stress-induced increases in dopamine neuron population activity. However, only Suvorexant and SB334867 were able to reverse deficits in behavioral corelates of psychosis. These results suggest that the orexin system may be a novel pharmacological target for the treatment of comorbid psychosis related to PTSD.

Routine HIV Screening in Cancer Patients in the Emergency Department

2018 ◽  
Vol 17 (2) ◽  
pp. 91-95
Author(s):  
Terry W Rice ◽  
◽  
Patricia A. Brock ◽  
Carmen Gonzalez ◽  
Kelly W Merriman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Testing ◽  
Cancer Patients ◽  
Linkage To Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Hiv Screening ◽  
Immunodeficiency Virus ◽  
Routine Hiv Screening ◽  
Incident Cases

Treatment of human immunodeficiency virus(HIV) in cancer patients improves outcomes and reduces transmission of this oncogenic virus. HIV testing rates of cancer patients are similar to the general population (15-40%), despite the association with cancer. Our aim was to increase HIV screening in the Emergency Department(ED) of a comprehensive cancer center through a quality initiative. Testing increased significantly during the intervention (p<0.001; 0.15/day to 2.69/day). Seropositive HIV rate was 1.4% (12/852), with incidence of 0.3%. All patients were linked to care. Incident cases were between 36 and 55 years of age. Barriers encountered included confusion regarding the need for written consent for HIV testing, failure to consider ordering the test, and concerns regarding linkage to care.

scholarly journals Abdominal aortic reconstruction in infected fields: Early results of the United States cryopreserved aortic allograft registry

2002 ◽  
Vol 35 (5) ◽  
pp. 847-852 ◽  
Author(s):  
Audra A. Noel ◽  
Peter Gloviczki ◽  
Kenneth J. Cherry ◽  
Hazim Safi ◽  
Jerry Goldstone ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Aortic Reconstruction ◽  
Aortic Allograft ◽  
Early Results ◽  
Abdominal Aortic

scholarly journals Revised guidelines for HIV testing, counselling, and screening in the United States

2002 ◽  
Vol 6 (1) ◽  
Author(s):  
K. A. Fenton ◽  
C McGarrigle
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Service Providers ◽  
The United States ◽  
Hiv Treatment ◽  
Hiv Screening ◽  
Policy Makers ◽  
Treatment And Prevention ◽  
Perinatally Acquired ◽  
Clinical Advances

The Centers for Disease Control (CDC) in the United States has published a report containing revised guidelines for HIV counselling, testing, and referral (CTR), and revised recommendations for HIV screening of pregnant women (1). The CTR guidelines replace the existing 1994 guidelines (2) and contain recommendations for policy-makers and service providers of HIV CTR. The revised recommendations for HIV screening for pregnant women replace the 1995 guidelines (3). The revision was prompted by recent advances in both HIV CTR and HIV treatment and prevention and clinical advances in preventing perinatally acquired HIV.

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