Download or read book Public Policy and Screening written by Kathryn Ann Phillips and published by . This book was released on 1991 with total page 570 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book AIDS Women and the Next Generation written by Ruth R. Faden and published by Oxford University Press, USA. This book was released on 1991 with total page 412 pages. Available in PDF, EPUB and Kindle. Book excerpt: The proliferation of Acquired Immune Deficiency Syndrome (AIDS) among women and children represents one of the gravest health issues confronting contemporary society. Women, most of childbearing age, now constitute 11 percent of all cases, and the U.S. Public Health Service has projected over 3,000 cases of pediatric AIDS by the end of 1991. In the face of these sobering statistics, experts have been called upon to grapple with a difficult, compelling question: under what conditions, if any, should HIV testing of women and children be required? Also at issue are the surreptitious testing for HIV antibodies as part of routine prenatal and neonatal examinations, and whether such testing should be performed on all women and infants, or only those who belong to groups judged at "high risk". In this unique contribution to the debate about HIV screening and testing, Ruth Faden, Madison Powers, and Gail Geller have assembled perspectives from experts in public health, medicine, law, and ethics. Their wide-ranging treatment examines the history of prenatal and neonatal screening programs; informed consent; legal issues and confidentiality; reproductive decision-making; and numerous other aspects of HIV testing. Alternative policy options for both now and the future are discussed in detail. This volume provides a comprehensive analysis of these pressing medical, public health, legal, ethical, and social issues, and is essential reading for AIDS researchers and clinicians, public health specialists, ethicists, health policymakers and analysts, obstetricians, and pediatricians.

Download or read book AIDS Testing written by Gerald Schochetman and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 422 pages. Available in PDF, EPUB and Kindle. Book excerpt: During the two years since the publication of the first edition of this book, the global spread of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has continued. HIV was estimated by the World Health Organization (WHO) in 1993 to have at least 13 million individuals worldwide, with 1 million infected infected in the United States. HIV/AIDS in the United States has become the leading cause of death among men 25 to 44 years of age and the fifth leading cause of death among women of the same age group. Prevention of HIV infection remains a global challenge. Testing for HIV is the cornerstone for surveillance and prevention programs and for the provision of appropriate medical care for those who are infected. Such testing is equally essential to the search for effective antivirus drugs and vaccines. This second edition of AIDS Testing incorporates the most current thinking on test methodology and interpretation, some of which has changed considerably over the past two years. This edition also has been expanded to include a section consisting of six chapters on test applica tions and a section consisting of four chapters on management issues. This edition, like the first, describes in clear terms all the complex ele ments of testing, including applications, scientific principles, quality assurance, safety, and medical, ethical, and legal considerations.

Download or read book Screening for Human Immunodeficiency Virus in Adolescents and Adults written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-06-22 with total page 270 pages. Available in PDF, EPUB and Kindle. Book excerpt: This evidence synthesis focuses on screening for unsuspected human immunodeficiency virus (HIV) using HIV antibody (Ab) tests in non-pregnant adolescents (aged 13 to 18 years old) and adults. The review will be used by the U.S. Preventive Services Task Force (USPSTF) to make recommendations regarding screening in the general adult and adolescent population. An accompanying report will review evidence regarding screening in pregnant women. Since the USPSTF published HIV screening recommendations in 1996, there have been substantial changes in the management and outcomes of chronic HIV infection. Although this report reviews the overall body of evidence regarding screening, it emphasizes recent data regarding the efficacy of highly active antiretroviral therapy (HAART) regimens, the accuracy and acceptability of new test methods, long-term risks of antiretroviral therapy, and the optimal timing of therapy in asymptomatic patients. HIV is an RNA retrovirus of the lentiretrovirus subfamily that was first isolated from a patient with AIDS in 1983. HIV is capable of particularly rapid replication and has a high propensity to mutate. There is significant genetic variation in HIV within individuals as well as populations. These characteristics explain some of the difficulties in developing effective vaccines and treatments. There remains no effective vaccine to prevent HIV infection and no cure for chronic infection. Interventions for HIV-infected patients include antiretroviral therapy, prophylaxis for opportunistic infections, immunizations, Papanicolaou testing, counseling to reduce high-risk behaviors, and routine monitoring and follow-up. HAART, defined as three or more antiretroviral agents used in combination (usually from at least two classes), is the standard of care for antiretroviral therapy.Key questions addressed include: KQ1. Does Screening for HIV Infection in Asymptomatic Adolescents and Adults Reduce Premature Death and Disability or Spread of Disease? KQ2. Can Clinical or Demographic Characteristics (Including Specific Settings) Identify Subgroups of Asymptomatic Adolescents and Adults at Increased Risk for HIV Compared to the General Population? KQ3. What are the Test Characteristics of HIV Antibody Test Strategies? KQ4. What are the Harms (Including Labeling and Anxiety) Associated with Screening? Is Screening Acceptable to Patients? KQ5. How Many Newly Diagnosed HIV-Positive Patients Meet Criteria for Antiretroviral Treatment or Prophylaxis for Opportunistic Infections? How Many Patients Who Meet Criteria for Interventions Receive Them? KQ6. What are the Harms Associated with the Work-Up for HIV Infection? KQ7a. How Effective are Interventions (Antiretroviral Treatment, Counseling on Risky Behaviors, Immunizations, Routine Monitoring and Follow-Up, More Frequent Papanicolaou Testing, or Prophylaxis for Opportunistic Infections) in Improving Clinical Outcomes (Mortality, Functional Status, Quality of Life, Symptoms, Opportunistic Infections, or Transmission Rates)? KQ7b. In Asymptomatic Patients with HIV Infection, Does Immediate Antiretroviral Treatment Result in Improvements in Clinical Outcomes Compared to Delayed Treatment Until Symptomatic? KQ7c. How Well Do Interventions Reduce the Rate of Viremia, Improve CD4 Counts, or Reduce Risky Behaviors? KQ8. What are the Harms Associated with Antiretroviral Therapy? KQ9. Have Improvements in Intermediate Outcomes (CD4 Counts, Viremia, Risky Behaviors) Been Shown to Reduce Premature Death and Disability or Spread of Disease?

Download or read book Human Immunodeficiency Virus written by and published by . This book was released on 2012 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Screening for Human Immunodeficiency Virus in Pregnant Women Evidence Synthesis written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-07-01 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt: This evidence synthesis focuses on screening for unsuspected human immunodeficiency virus (HIV) using HIV antibody (Ab) tests in pregnant women, including adolescents. Since the USPSTF last published recommendations regarding HIV screening of pregnant Women, there have been substantial changes in the management of pregnant women with HIV and in the rates of mother-to-child transmission. Although this report reviews the overall body of evidence regarding screening for HIV infection in pregnant women, it focuses on more recent data regarding the efficacy of combination antiretroviral regimens in prevention of mother-to-child transmission, harms associated with receipt of antiretrovirals in pregnancy, and the accuracy and acceptability of rapid testing. There is no effective vaccine to prevent HIV infection and no cure for chronic infection. In HIV-infected pregnant women, a major goal of interventions is to reduce the risk of mother-to child transmission. Other important goals are to improve clinical outcomes in the mother, facilitate early identification of infected newborns, allow women to make informed future reproductive choices, and prevent horizontal transmission through counseling on risky behaviors. Interventions for HIV-infected pregnant women include antiretroviral therapy, avoidance of breastfeeding, specific labor and delivery management techniques such as cesarean section before labor and before rupture of membranes (elective cesarean section), prophylaxis for opportunistic infections, immunizations, counseling to reduce high-risk behaviors, and regular monitoring and follow-up. In the U.S., receipt of combination antiretrovirals in conjunction with elective cesarean section in selected women and avoidance of breastfeeding is the standard of care to reduce mother-to-child transmission of HIV. Management of HIV infection in pregnancy is a rapidly evolving area. Key Questions addressed include: KQ1. Does Screening for HIV in Asymptomatic Pregnant Women Reduce Mother-to-Child Transmission or Premature Death and Disability? KQ2. Can Clinical or Demographic Characteristics (Including Persons in Specific Settings) Identify Subgroups of Asymptomatic Pregnant Women at Increased Risk for HIV Infection Compared to the General Population of Pregnant Women? KQ3. What Are the Test Characteristics of HIV Antibody Test Strategies in Pregnant Women? KQ4. What Are the Harms (Including Labeling and Anxiety) Associated with Screening? Is Screening Acceptable to Pregnant Women? KQ5. How Many HIV-Infected Pregnant Women Who Meet Criteria for Interventions Receive Them? KQ6. What Are the Harms Associated with the Work-up for HIV Infection in Pregnant Women? KQ7a. How Effective Are Interventions (Antiretroviral Prophylaxis [to Prevent Mother-to-Child Transmission] or Treatment [to Improve Maternal Outcomes], Avoidance of Breastfeeding, Elective Cesarean Section [in Selected Patients] or Other Labor Management Practices, Counseling on Risky Behaviors, Immunizations, Routine Monitoring and Follow-up or Prophylaxis for Opportunistic Infections) in Reducing Transmission Rates or Improving Clinical Outcomes (Mortality, Functional Status, Quality of Life, Symptoms, or Opportunistic Infections) in Pregnant Women with HIV Infection? KQ7b. Does Immediate Antiretroviral Treatment in HIV-Infected Pregnant Women Result in Improvements in Clinical Outcomes Compared to Delayed Treatment until Symptomatic? KQ7c. How Well Do Interventions Reduce the Rate of Viremia, Improve CD4 Counts, and Reduce Risky Behaviors? How Does Identification of HIV Infection in Pregnant Women Affect Future Reproductive Choices? KQ8. What Are the Harms (Including Adverse Effects from In Utero Exposure) Associated with Antiretroviral Intervention and Elective Cesarean Section? KQ9. Have Improvements in Intermediate Outcomes (CD4 Counts, Viremia, or Risky Behaviors) in HIV Infected Pregnant Women Been Shown to Improve Clinical Outcomes or Reduce Mother-to-Child Transmission?

Download or read book HIV and the Brain written by Robert H. Paul and published by Springer Science & Business Media. This book was released on 2009-04-20 with total page 403 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by leading experts, this book offers a picture of how HIV impairs the brain, focusing on emerging areas including genetic strains of the virus, interactions between advanced age and HIV, and the impact of HIV on the brain during antiretroviral therapy.

Download or read book Fundamentals of HIV Medicine 2019 written by W. David Hardy and published by Oxford University Press, USA. This book was released on 2019 with total page 577 pages. Available in PDF, EPUB and Kindle. Book excerpt: The essential work in HIV for providers and pharmacists -- updated with everything they need to know in 2019! Assembled by the leading educational organization in HIV medicine, AAHIVM's Fundamentals of HIV Medicine 2019 is an end-to-end clinical resource for the treatment of individuals with HIV/AIDS. It offers state-of-the-art practical advice for physicians, pharmacists, nurse practitioners, and other professionals working in the care of HIV patients. Along with updates to the classic domains of HIV medicine, this new edition features expanded coverage of emerging topics, including: behavioral and therapeutic interventions to HIV prevention; updates on the pursuit of a cure; new DHHS and IAS guidelines and their clinical implications; and the myriad issues around aging with HIV. Embodying the American Academy of HIV Medicine's commitment to excellence in the care of seropositive patients, Fundamentals of HIV Medicine 2019 is must-have for health professionals across HIV care, treatment, and prevention.

Download or read book AIDS Testing written by Gerald Schochetman and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: Given the continuing high level of concern among health professionals and the general public about issues related to AIDS, this volume on testing for AIDS and related viruses is extremely timely. The book has been written by experts in the area of AIDS testing, many of whom are at the Centers for Disease Control. The book includes several chapters which compare the different laboratory tests available for detecting the AIDS virus (HIV). It also addresses such topics as ethical considerations in AIDS testing, HIV infection in children, testing for other human viruses related to HIV, safety practices in HIV-testing laboratories, and managing occupational exposure to HIV. The book is intended for public health officials involved in HIV testing, hospital administrators and clinical laboratory directors responsible for setting up HIV testing programs, and physicians concerned with testing for AIDS.

Download or read book Voluntary Screening for Human Immunodeficiency Virus HIV Infection written by Bernard Lo and published by . This book was released on 1989 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Current Perspectives in HIV Infection written by Shailendra K. Saxena and published by BoD – Books on Demand. This book was released on 2013-04-10 with total page 484 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book gives a comprehensive overview of HIV and AIDS including NeuroAIDS, as well as general concepts of pathology, immunity and immunopathology, diagnosis, treatment, epidemiology and etiology to current clinical recommendations in management of HIV/AIDS including NeuroAIDS, highlighting the ongoing issues, recent advances and future directions in diagnostic approaches and therapeutic strategies.

Download or read book HIV Screening of Pregnant Women and Newborns written by Institute of Medicine and published by National Academies Press. This book was released on 1991-01-01 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt: Proposals for screening pregnant women and newborns for HIV infection have provoked much controversy. This volume analyzes the possible goals of such screening programs and assesses whether these goals can currently be achieved. It also provides guidance to policymakers in developing and implementing sound screening policy.

Download or read book Reducing the Odds written by National Research Council and published by National Academies Press. This book was released on 1999-02-13 with total page 426 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thousands of HIV-positive women give birth every year. Further, because many pregnant women are not tested for HIV and therefore do not receive treatment, the number of children born with HIV is still unacceptably high. What can we do to eliminate this tragic and costly inheritance? In response to a congressional request, this book evaluates the extent to which state efforts have been effective in reducing the perinatal transmission of HIV. The committee recommends that testing HIV be a routine part of prenatal care, and that health care providers notify women that HIV testing is part of the usual array of prenatal tests and that they have an opportunity to refuse the HIV test. This approach could help both reduce the number of pediatric AIDS cases and improve treatment for mothers with AIDS. Reducing the Odds will be of special interest to federal, state, and local health policymakers, prenatal care providers, maternal and child health specialists, public health practitioners, and advocates for HIV/AIDS patients. January

Download or read book Guidelines for Perinatal Care written by American Academy of Pediatrics and published by . This book was released on 1997 with total page 436 pages. Available in PDF, EPUB and Kindle. Book excerpt: This guide has been developed jointly by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, and is designed for use by all personnel involved in the care of pregnant women, their foetuses, and their neonates.

Download or read book Screening for Human Immunodeficiency Virus in Adolescents and Adults written by Roger Chou and published by . This book was released on 2005 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: CONTEXT: Human immunodeficiency virus infection affects 850,000 to 950,000 persons in the United States, with approximately 40,000 new infections annually. Diagnosis of unsuspected HIV infection could identify those who would benefit from interventions or reduce transmission from those unaware of their status. OBJECTIVE: To synthesize the evidence on risks and benefits of screening for HIV infection. DATA SOURCES: MEDLINE (though June 30, 2004), Cochrane Clinical Trials Registry (2004, Issue 2), reference lists, and experts. STUDY SELECTION: Controlled studies of screening and antiretroviral therapy, counseling, prophylaxis for opportunistic infections, more frequent Papanicolaou smear testing, immunizations, and routine monitoring and follow-up; observational studies on counseling, risk factors, accuracy of antibody testing, work-up, acceptability of screening and uptake of interventions, harms of interventions and screening, and long-term outcomes. DATA EXTRACTION: Using preset criteria, the authors assessed the quality of included studies and abstracted information about settings, patients, interventions, and outcomes. DATA SYNTHESIS: There are no published trials directly linking screening for HIV with clinical outcomes. Approximately 0.3% of U.S. adults have HIV infection, and almost all will progress to AIDS if untreated. Risk factor assessment could identify adults at substantially higher risk, but would miss a significant proportion of infected persons. Screening tests for HIV are extremely accurate. Acceptance rates for screening and use of recommended interventions vary widely. Many persons are currently diagnosed at advanced stages of disease. Highly active antiretroviral treatment (HAART) reduces the risk of clinical progression or death compared to less intense regimens, and can result in sustained improvements in intermediate outcomes. HAART is associated with a significantly greater impact on clinical outcomes than other interventions. Although HAART is associated with significant short-term adverse events, these are usually self-limited and effective alternative regimens can be found. Increased duration of HAART use appears associated with an increased rate of cardiovascular complications over 3-4 years, but background rates of cardiovascular complications appear low. There are insufficient data to estimate the effects of counseling or HAART on transmission rates. CONCLUSIONS: Identification and treatment of unsuspected HIV infection at immunologically advanced stages of disease can result in marked reductions in clinical progression and mortality. Although long-term studies of HAART are not yet available, the estimated three-year benefits of HIV screening appear to greatly outweigh the risks of cardiovascular complications in both low- and high-prevalence settings using conservative estimates of the effectiveness of interventions. The yield from screening in populations with prevalence e1% would be substantially higher, however, than the yield from screening in the general population. Data are insufficient to accurately estimate the benefits (reduced clinical progression or spread of disease) from identifying HIV-infected persons at earlier stages of disease, or the effects of screening on the stage at which patients are diagnosed. KEYWORDS: HIV, HIV infections, HIV seropositivity, mass screening.

Download or read book HIV and the Blood Supply written by Institute of Medicine and published by National Academies Press. This book was released on 1995-10-05 with total page 349 pages. Available in PDF, EPUB and Kindle. Book excerpt: During the early years of the AIDS epidemic, thousands of Americans became infected with HIV through the nation's blood supply. Because little reliable information existed at the time AIDS first began showing up in hemophiliacs and in others who had received transfusions, experts disagreed about whether blood and blood products could transmit the disease. During this period of great uncertainty, decision-making regarding the blood supply became increasingly difficult and fraught with risk. This volume provides a balanced inquiry into the blood safety controversy, which involves private sexual practices, personal tragedy for the victims of HIV/AIDS, and public confidence in America's blood services system. The book focuses on critical decisions as information about the danger to the blood supply emerged. The committee draws conclusions about what was doneâ€"and recommends what should be done to produce better outcomes in the face of future threats to blood safety. The committee frames its analysis around four critical area: Product treatmentâ€"Could effective methods for inactivating HIV in blood have been introduced sooner? Donor screening and referralâ€"including a review of screening to exlude high-risk individuals. Regulations and recall of contaminated bloodâ€"analyzing decisions by federal agencies and the private sector. Risk communicationâ€"examining whether infections could have been averted by better communication of the risks.

Download or read book Screening for Human Immunodeficiency Virus written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-06-22 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report updates an evidence synthesis commissioned by the U.S. Preventive Services Task Force (USPSTF) and completed in March 2005, on screening for unsuspected human immunodeficiency virus (HIV) using HIV antibody (Ab) tests in non-pregnant adolescents (aged 13 to 18 years old) and adults. This brief update was requested by the USPSTF to determine whether there is sufficient new evidence to justify revision of recommendations based on the 2005 evidence synthesis. A key reason for this update is the release in September 2006 of revised Centers for Disease Control and Prevention (CDC) recommendations advising routine voluntary HIV screening of most U.S. adolescents and adults. The 2005 USPSTF recommendations differ from the revised CDC recommendations in that they do not recommend for or against routine screening non-pregnant adults and adolescents who do not report risk factors and are not in high-prevalence (greater than 1%) or other high-risk settings. Staff at the CDC have indicated that the agency's expanded screening recommendations are based primarily on new evidence as to the effects of HIV screening on transmission risk. This report focuses on new or “breakthrough” evidence that could affect the 2005 USPSTF recommendations regarding routine screening of low- or average-risk adults and adolescents. This update reviews new evidence on HIV screening not included in the 2005 evidence synthesis. It focuses on evidence in non-pregnant, adults and adolescents who do not report risk factors and are evaluated in lower-prevalence (less than 1%), low-risk clinical settings (referred to in this report as 'low-risk' persons), because this is the population for which the USPSTF and the 2006 CDC recommendations are discordant. In the 2005 evidence review, we identified several key areas where additional evidence could strengthen the case for screening in low-risk populations. These include gaps in the research regarding uncertainties about the acceptability of routine voluntary screening in low-risk persons; the yield of targeted versus universal screening and optimal methods of risk assessment in low-risk settings; the impact on test uptake and follow-up of abbreviated or streamlined counseling methods and newer testing or sampling methods; and the effects of screening on HIV transmission rates. We therefore focused on studies that could help fill in these gaps. We also evaluated new evidence on the cost-effectiveness of routine HIV screening and studies on the frequency of testing.