{"id":508,"date":"2014-12-17T11:00:55","date_gmt":"2014-12-17T11:00:55","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=508"},"modified":"2017-08-21T12:03:51","modified_gmt":"2017-08-21T12:03:51","slug":"primary-care-corner-with-geoffrey-modest-md-cdc-recs-on-hiv-prevention-in-adults-and-adolescents","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/12\/17\/primary-care-corner-with-geoffrey-modest-md-cdc-recs-on-hiv-prevention-in-adults-and-adolescents\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: CDC recs on HIV prevention in adults and adolescents"},"content":{"rendered":"

By: Dr. Geoffrey Modest<\/strong><\/p>\n

\"HIV_CDC\"<\/a>There was a recent update of the CDC’s “recommendations for HIV prevention with adults and adolescents with HIV in the United States” — see here<\/a>\u00a0and you too\u00a0can\u00a0download the 240 page document…). The overall focus of this update\u00a0is to develop systems of care\/infrastructure to facilitate improved access to and retention in care of HIV-positive patients. The underlying\u00a0issue is that recent studies have found that the vast majority of people with HIV are aware of their disease (around 85%, thanks to much more aggressive screening programs and, it seems to me, a broader acceptance of HIV in many communities), but only 2\/3 are linked to care, 40% are\u00a0retained in care, 1\/3 prescribed antiretrovirals, and only 25% were\u00a0effectively treated to suppress their HIV viral load (which has the dual benefit of, first,\u00a0turning HIV infection from pretty much a death sentence\u00a0into a chronic disease, and, second,\u00a0vastly reducing transmissability to others\u00a0— ie treatment as prevention). This update\u00a0\u200bdoes not cover clinical care of HIV or related infections. Basic issues it covers are:<\/p>\n

–Barriers to care and medication adherence, including getting people into care and retention in care.<\/p>\n

–Developing systems to provide integrated medical and social services to support\u00a0HIV-infected individuals<\/p>\n

–Systems to implement a widespread HIV outreach, testing and treatment program, including the creation of collaborative teams of clinical and nonclinical providers. there is a general focus in the paper for shared decision-making, communicating in\u00a0a respectful and culturally-appropriate manner, and developing community-based resources<\/p>\n

–Risk screening and reduction interventions for HIV and sexually-transmitted diseases<\/p>\n

–HIV partner services, including PrEP (preexposure prophyllaxis) and nPEP (nonoccupational postexposure prophylaxis)\u00a0to prevent transmission to noninfected partners, in\u00a0collaboration with local health departments<\/p>\n

–HIV prevention, testing, and procedures related to pregnancy<\/p>\n

–Quality improvement and program monitoring, focusing on improving the delivery and quality of care, with ongoing monitoring (as with all of the above, the recommendations are replete with references)<\/p>\n

We are certainly fortunate in Massachusetts that the Dept of Public Health is very supportive of community initiatives, working with us to provide team-based care, focusing on case management (for nursing and social services) and enrolling people into special insurance programs through which they get free medications.<\/p>\n","protected":false},"excerpt":{"rendered":"

CDC recs on HIV prevention in adults and adolescents […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-508","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/508","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=508"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/508\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=508"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=508"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=508"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}