Yearly Archives: 2012

An intervention in which posters, brochures and brief messages were used in HIV-specialty clinics to encourage patients to come in for their appointments improved clinic attendance among those with HIV, according to recent study data.

“Improving retention of HIV-infected patients in care is a priority from both clinical and public health perspectives and is a major objective of the National HIV/AIDS Strategy,” the researchers for the Retention in Care Study Group wrote. “Yet, few studies have evaluated better methods of conveying to patients the importance of attending all HIV care appointments.”

The researchers launched the first phase of the CDC/Health Resources and Services Administration Retention in Care study in May 1, 2008, with a pre-intervention period that ran until April 30, 2009. During this time, there were 10,018 patients. The intervention period ran from May 1, 2009, until April 30, 2010. During the intervention period, there were posters, brochures and staff verbal messages about the importance of regular care and keeping appointments. During the intervention period, there were 11,039 patients.

In the intervention phase, the overall adjusted percentage of improvement for keeping two consecutive visits was 7%. New or re-engaging patients and patients with a detectable viral load were two subgroups with marked improvement. The overall adjusted relative improvement in the mean proportion of all visits kept was 3%. New or re-engaging patients, patients with a detectable viral load and patients aged 16 to 29 years were subgroups with significant improvement.

“Although, as a percentage, the impact of the intervention was relatively small across all patients, the effect was highly significant and, if generalizable to all other HIV care sites, it provides a relatively low-cost and low-effort clinic-wide process that could improve clinic visit adherence for thousands of patients,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.

click here to read the article on blog.aids.gov

Little is more powerful than taking action to find or help someone else find services for his/her health. Last year on World AIDS Day, people conducted  over 60,000 searches, 30% of which were mobile, on the HIV/AIDS Prevention & Service Provider Locator to help connect people to services offering testing, treatment and care.

Originally launched in June 2010 by members of the Federal HIV/AIDS Web Council, the HIV/AIDS Prevention & Service Provider Locator is a location-based search tool that allows you to search for these service providers near your current location:

• HIV testing
• Housing assistance
• Health centers
• Ryan White HIV Care
• Mental health
• Substance Abuse
• Family planning

Since then, the Locator has gone from the web, to a widget, mobile, Facebook , an API and now it is available as an app  for your iPhone and iPad. Anyone with an iPhone, iPad, or iPod Touch can download and use this free app. Outreach workers, social workers, and other clinicians will be able to find services for their clients anytime and anywhere.

How it works

1. Download the app  from the iTunes store.
2. Allow the app to use your mobile phone GPS to find sites near your current location or type in the ZIP code for another location.
3. The results are populated on a Google map. You can filter your results by selecting one or more of the provider categories.
4. Select any of the results to link to the organization’s webpage and find directions via Google Maps.

New Features

The iPhone app has a few new features that you won’t find on the web or mobile versions.

• The map around the results (map pins) automatically update (in the web version you would have to type in a new address to get new results).
• You can use the app in disconnected mode once data is downloaded for an area. This means you can access the results of your last search even if you aren’t online.

The results

The locator includes data from:

• Housing: HUD’s Housing Opportunities for Persons with AIDS (HOPWA) Program
• Mental Health & Substance Abuse: Substanse Abuse and Mental Health Services Administration (SAMHSA)
• AIDS Care Services & Health Centers: Health Resources and Services Administration(HRSA)
• HIV Testing: CDC
• Family Planning: Office of Population Affairs

Download the app, tell your friends, and take action. We especially recommend the app for social workers, those doing street outreach, and others who link people to services. If you don’t have an iPhone, visit http://locator.aids.gov to use the web or mobile version.

If you have any comments or suggestions, please give us your feedback via a blog comment or by selecting the app’s feedback button in the upper right corner.

By Rich Bockmann  

Although HIV/AIDS rates have generally been on the decline, transgender women of color are still at alarmingly high risk of contracting the disease, although one Jamaica health clinic is hoping a new funding stream will allow it to reduce some of the exposure in the transgender population.

The Queens Health Center, at 97-04 Sutphin Blvd., is part of a network of clinics that will receive $1.5 million over the next five years to provide care and evaluation services to the transgender community.

“This grant is a testament to our leadership in treating the medically under-served and disenfranchised, something we have been doing since our founding in 1981,” said Community Healthcare Network President and CEO Catherine Abate.

The New York City-based organization was of nine in the country to receive the grant from the U.S. Health Resources and Services Administration.

“We are grateful to HRSA for allowing us to lead this demonstration project, but we are most thankful that we will be able to expand our care to the transgender community,” Abate added. “There is great demand for services and we will now be better able to meet it.”

Between 2007 and 2011, the network provided health services to about 700 transgender individuals at its clinic in Jamaica and another in the South Bronx through its Transgender Family Program, with encouraging results.

According to an evaluation by the 2012 International AIDS Conference, over a four-year span one of the program was able to show a reduction in a number of high risk behaviors, including unregulated hormone injection, sex with multiple partners, needle sharing and sex work.

Overall, the network’s program was shown to reduce the prevalence of HIV from 44 percent in 2007 to 28 percent in 2011, the evaluation showed.

According to the U.S. Centers for Disease Control and Prevention, 21 percent of people with HIV are unaware of their status and those individuals account for more than 50 percent of newly transmitted infections.

The health care network will use the grant to implement its Transgender Women Engagement and Entry to Care Project, dubbed the TWEET Care Project, in Jamaica.

Peer leaders will reach out to the transgender community to identify HIV-positive transgender women and attempt to link them with the care they often lack due to stigmas and prejudices.

Community Healthcare Network’s goal is to receive 792 referrals to the project and provide 198 HIV-positive transgender women of color with care over the five-year period.

By Robert Preidt

SOURCE: U.S. Centers for Disease Control and Prevention, news release, Oct. 11, 2012

Fordham University
HIV Prevention Research Ethics Training Institute

Summer Training and Mentored Research Program for Early Career
HIV Prevention and Drug Use Investigators

July 7 – 17, 2013
Fordham University Center for Ethics Education, New York City
Funded by the National Institutes of Health, National Institute on Drug Abuse

Call for Applications

The Fordham University HIV Prevention Research Ethics Training Institute (RETI) offers ethics training and financial support for a mentored research project that will contribute to evidenced-based research ethics practices. The broad aims of the RETI are to: (1) provide fellows with the knowledge and skills to identify, address, and study key ethical issues in HIV prevention research in drug using and other at-risk populations; and (2) create and maintain an ongoing information and collaborative research network fostering grant proposals, research, publications, and pedagogical materials to sustain advancements in national and international HIV research ethics practices and policies involving drug using and other vulnerable groups.

RETI 2-Year Summer Program
RETI fellows are expected to make a 2-year commitment beginning with an intensive 10-day summer program conducted by our interdisciplinary faculty of experts in HIV research ethics and substance abuse. The summer institute offers lectures, discussions, skill-based exercises and mentoring for fellows to: (a) gain knowledge of ethical issues such as recruitment, confidentiality and informed consent in HIV research among drug using and other at-risk populations; (b) acquire skills to empirically examine research ethics challenges; and (c) develop a proposal for a mentored research project. The following summer, fellows will give formal presentations on their mentored research projects and receive intensive guidance in writing for publication, presentation and future funding. Fellows will receive support for travel, lodging, and meals for both summer institutes.

Mentored Research Project (MRP)
During the first summer institute, fellows receive mentoring and faculty and peer feedback on their proposed study. Fellows receive a small grant of up to $18,000 for the MRP upon project approval. Data collection is expected to be completed during year 1 and findings submitted for publication or as pilot data for an NIH grant in year two.

Eligibility
Applicants must have: (a) a doctoral, medical or equivalent degree in social, behavioral, medical, public health or related fields; (b) demonstrated scholarship in HIV prevention research; (c) 6 years or less post-doctoral experience; and (d) meet requirements to apply for NIH funding. Special attention will be given to those applicants whose proposed research ethics plan includes drug using populations.

Application Requirements
· An online application form, an official transcript from your last completed degree, and a current curriculum vitae.
· A 300-word description of your HIV research training and scholarship (i.e. publications, funding presentations), experience working with drug using or other vulnerable populations, and immediate and long-term research and career goals.
· A 150-word statement describing your interest and relevant training or experience in research ethics generally and HIV and/or drug use research ethics specifically.
· A 150-word preliminary description of the mentored HIV prevention research ethics study you would like to conduct, including a description of the proposed participant demographics (Current MRP abstracts are available at www.Fordham.edu/EthicsInstitute < http://www.fordham.edu/EthicsInstitute> )
· 2 letters of recommendation, including 1 from a senior member of your current institution indicating the institution’s endorsement of your 2 year participation in the project.

Deadlines
Applications must be received by March 8, 2013. Applicants will be notified of award decisions by April 12, 2013.

For application and additional information please visit www.Fordham.edu/EthicsInstitute < http://www.fordham.edu/EthicsInstitute>

The use of condoms together with other forms of contraception (dual-method use) reduces the risk of pregnancy and sexually transmitted infections (STIs). Researchers conducted a prospective year-long study of 1,194 sexually active women aged 15–24 years who were clients at Planned Parenthood clinics and who were beginning contraceptive pills, patches, injections, or vaginal rings and not planning pregnancy within the year. They collected data on the participants’ beliefs about condom use, and knowledge of their partners’ beliefs about condom use.

At baseline, 36 percent of the subjects used condoms consistently, but condom use decreased by 27 percent three months later. Some women stopped using hormonal contraception, and more than half of the women did not return to condom use after they stopped other forms of contraception. Rachel Goldstein, MD, of Stanford University School of Medicine and lead author of the study, noted that the single largest predictor of using condoms and other contraception is the attitude of the partner toward condoms. Women whose partners thought condoms were very important and those who did not know how their partner felt about condom use were more likely to continue the dual methods than those whose partners thought condoms were not important.

Goldstein suggests that it may be more useful to advise young women to use longer-acting reversible contraceptives, including IUDs or implants, and about the importance of condoms to prevent STIs as lapses in hormonal contraceptives may lead to unplanned pregnancy. The study concluded that more counseling and greater attention needed to be given to method continuation and contingency planning and the role of the partner in family planning.
The study titled, “With Pills, Patches, Rings, and Shots: Who Still Uses Condoms? A Longitudinal Cohort Study,” was published online in the Journal of Adolescent Health, 2012; DOI: 10.1016/j.jadohealth.2012.08.001

By Michael Smith, North American Correspondent, MedPage Today

By: Stefan D. Barala, Susanne Stromdahla, and Chris Beyrera

Purpose of review
Oral preexposure prophylaxis (PrEP) has shown HIV preventive efficacy for several key populations at risk
for HIV infection including MSM and heterosexual men and women in HIV serodiscordant relationships.
An efficacy trial of daily oral tenofovir among people who inject drugs (IDU) is underway in Thailand.
Recent findings
Although efficacy data is pending, there is emerging biological and public health plausibility data
suggesting the utility of PrEP as an effective component of combination HIV prevention for IDU. Drawing
from studies characterizing adherence to antiretroviral therapy for IDU, there are a range of scientific and
operational considerations for the potential use of PrEP for IDU. We review here the available literature on
the potential use of PrEP for IDU, barriers to uptake and adherence, and potential implementation science
questions, which could address, and potently increase, the effectiveness of this intervention.
Summary
IDU remain the most underserved population in the HIV response worldwide, and have a marked gap in
prevention services, making PrEP a potentially promising addition to the prevention toolkit for people
who use drugs and, for those already living with HIV infection, for their spouses and other sexual partners.

Download full PDF here: [Download not found]

by Bisrat K. Abraham and Roy Gulick

Purpose of review
Clinical trials of oral preexposure prophylaxis (PrEP) have focused on regimens of tenofovir (TDF) with or
without emtricitabine (FTC). However, TDF may be associated with toxicities (renal, bone), and FTC may
select for drug resistance. Both are also first-line drugs for HIV treatment. In this review, we discuss agents
that might serve as alternatives to TDF/FTC for HIV PrEP.
Recent findings
Several drug characteristics are important to consider when selecting agents for PrEP with the most critical
being safety, tolerability, adequate penetration into target tissues for prevention of HIV infection, and longlasting
activity with convenient dosing. With these factors in mind, we review five potentially useful agents
for PrEP. The first group includes drugs that are already Food and Drug Administration approved
(maraviroc, raltegravir) with attributes that make them attractive for PrEP. The second group includes
investigational agents with long-lasting activity that are being developed in parenteral form (rilpivirine-long
acting, S/GSK1265744, ibalizumab).

Download full review pdf here: [Download not found]
Summary
Future PrEP drugs may give clinicians the flexibility to select agents on the basis of individual patient needs
and preferences

blog.AIDS.gov     (10.17.12):: Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS Policy, U.S. Department of Health and Human Services

Dr. Ron Valdiserri, Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS Policy, US Department of Health and Human Services, offers an excellent new resource published as a special supplement to the journal Public Health Reports. Called “Innovations in Oral Health Care for People Living with HIV/AIDS,” it presents findings from the Innovations in Oral Health Care Initiative, which involved 15, five-year demonstration projects supported by the Health Resources and Services Administration’s HIV/AIDS Bureau, in addition to resources from the Ryan White Care Act’s Special Projects of National Significance.

The findings showed that innovative program models can engage and retain people who are living with HIV/AIDS into oral healthcare services in both urban and non-urban settings. Valdiserri emphasizes oral health is crucial for a person’s general health and well-being throughout a lifespan, and it is especially critical for PLWHA. Inadequate oral health care can undermine the success of health outcomes, nutritional intake, and HIV treatment regimens. He notes that oral infections may also spread to other parts of the body, a particularly dangerous occurrence for individuals with compromised immune systems. View this resource at http://www.publichealthreports.org/issuecontents.cfm?Volume=127&Issue=8.