Download or read book Structural Barriers to Continuity of HIV Care written by Steven J. Erly and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Ryan White HIV/AIDS Drug Assistance programs (ADAPs) are the largest source of medical care for people living with HIV (PLWH) in the United States. They pay for insurance and medical care for 20% of people living with HIV in the United States, and people on the program have high rates of viral suppression, the central measure of successful HIV treatment. In spite of the benefits of the program, clients have difficulty staying enrolled in the program and subsequently lose benefits. Until recently, federal policy required that ADAP clients provide documentation of their eligibility every 6 months or be removed from the program. In October of 2021, these restrictions were relaxed, and states were given the authority to set their own recertification procedure. Although this policy change has the potential to reduce the burden of recertification, there is a lack of information about how recertification affects clients and the cost of the program. This dissertation sought to fill this knowledge gap by quantifying the effect of disenrollment on the ADAP clients and building a model to project the effect of extending the recertification timeline to every 12-months. First, we used Ryan White data from Washington State to describe the prevalence of ADAP disenrollment and identify factors associated with being removed from the program. We categorized all PLWH enrolled in ADAP clients by the success of their recertification applications as continuously enrolled, ruled ineligible, disenrolled if they failed to recertify. We compared individuals who were disenrolled to those who were continuously enrolled by demographic and socioeconomic characteristics and use of case management services. Next, we sought to quantify the impact of disenrollment from ADAP on viral suppression. Using this same population, we estimated the risk difference of viral suppression before and after enrollment using clients who were continuously enrolled as a comparator. We used quantitative bias analysis to identify how much of the effect of client disenrollment could be attributed to other unmeasured confounders. Lastly, we used the results of the first two aims to develop a Markov model to analyze the cost and health impact of changing the existing 6-month recertification schedule to a 12-month schedule. We predicted the change in annual program costs, program enrollment, and population viral suppression over a 5-year time horizon. We found that disenrollment is common and disproportionately affects marginalized populations in Washington State. Over the two-year study, 26% of clients were disenrolled from the program at least once due to failure to recertify, which is much greater than the 18% of clients who were removed due to ineligibility. Compared to those who were continuously enrolled, disenrolled PLWH were more likely to be Black (prevalence ratio vs White 1.31, 95% CI 1.17-1.46), uninsured (PR vs private insurance 1.24, 95% CI 1.10-1.40), and younger (PR 25-34 vs 35-44 years 1.23 95% CI 1.08-1.41). We also found that disenrollment negatively impacts the viral suppression of PLWH who are removed from the program. Of the 1336 ADAP clients who were disenrolled, 83% were virally suppressed before disenrollment versus 69% after (RD 12%, 95%CI 9-15%). Our quantitative bias analysis suggested that unmeasured confounders are unlikely to explain the entirety of this effect. Our budget impact analysis suggested that a 12-month recertification policy would yield a program that costs 7% more per year ($40.2M vs $37.7M, 95% CI 6-8%), but produces greater health benefits (245 more individuals virally suppressed by the end of 2025). The results of this dissertation demonstrate that the current ADAP recertification policies, which were formerly required by federal policy, are disruptive to the health of a large proportion of ADAP clients. In Washington state, a change to a 12-month recertification policy has the potential to reduce the number of virally unsuppressed PLWH by 10% at a modest cost relative to the overall cost of the program.

Download or read book Consolidated Guideline on Sexual and Reproductive Health and Rights of Women Living with HIV written by World Health Organization and published by World Health Organization. This book was released on 2017-02-20 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: he starting point for this guideline is the point at which a woman has learnt that she is living with HIV and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities as well as from the health-care institutions where they seek care particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.

Download or read book The Social Impact of AIDS in the United States written by National Research Council and published by National Academies Press. This book was released on 1993-02-01 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: Europe's "Black Death" contributed to the rise of nation states, mercantile economies, and even the Reformation. Will the AIDS epidemic have similar dramatic effects on the social and political landscape of the twenty-first century? This readable volume looks at the impact of AIDS since its emergence and suggests its effects in the next decade, when a million or more Americans will likely die of the disease. The Social Impact of AIDS in the United States addresses some of the most sensitive and controversial issues in the public debate over AIDS. This landmark book explores how AIDS has affected fundamental policies and practices in our major institutions, examining: How America's major religious organizations have dealt with sometimes conflicting values: the imperative of care for the sick versus traditional views of homosexuality and drug use. Hotly debated public health measures, such as HIV antibody testing and screening, tracing of sexual contacts, and quarantine. The potential risk of HIV infection to and from health care workers. How AIDS activists have brought about major change in the way new drugs are brought to the marketplace. The impact of AIDS on community-based organizations, from volunteers caring for individuals to the highly political ACT-UP organization. Coping with HIV infection in prisons. Two case studies shed light on HIV and the family relationship. One reports on some efforts to gain legal recognition for nonmarital relationships, and the other examines foster care programs for newborns with the HIV virus. A case study of New York City details how selected institutions interact to give what may be a picture of AIDS in the future. This clear and comprehensive presentation will be of interest to anyone concerned about AIDS and its impact on the country: health professionals, sociologists, psychologists, advocates for at-risk populations, and interested individuals.

Download or read book Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection written by World Health Organization and published by . This book was released on 2016 with total page 429 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care. This edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations in mid-2015, shared at the end of 2015, and now published in full in 2016. It is being published in a changing global context for HIV and for health more broadly.

Download or read book Medications for Opioid Use Disorder Save Lives written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-06-16 with total page 175 pages. Available in PDF, EPUB and Kindle. Book excerpt: The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

Download or read book Essential Environmental Health Standards for Health Care written by John Adams and published by World Health Organization. This book was released on 2008-05-16 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ensuring safe environmental health conditions in health care can reduce the transmission of health care-associated infections. This document provides guidelines on essential environmental health standards required for health care in medium- and low-resource countries and support the development and implementation of national policies.

Download or read book Understanding Racial and Ethnic Differences in Health in Late Life written by National Research Council and published by National Academies Press. This book was released on 2004-09-08 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.

Download or read book Culture and Mental Health written by Leslie Swartz and published by . This book was released on 1998 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book introduces key issues in understanding social and cultural factors as they relate to mental health and illness, and to a southern African understanding and construction of these categories. It lays out central international and local debates in the field of mental health in an accessible way, making use of extensive research and case studies. Central theoretical debates (such as those between relativism and universalism, and between hermeneutical and critical approaches) are presented early in the text, and referred to throughout the more applied chapters. The aim is to equip the reader to assess the strengths and weaknesses of different approaches to understanding specific aspects of mental health and illness. Stressed throughout is the role of the mental health professional in the construction of ideas of mental health and illness.

Download or read book Implementation Research in Health written by David H. Peters and published by World Health Organization. This book was released on 2013 with total page 69 pages. Available in PDF, EPUB and Kindle. Book excerpt: Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.

Download or read book A Guide to the Clinical Care of Women with HIV written by Jean R. Anderson and published by DIANE Publishing Inc.. This book was released on 2005 with total page 636 pages. Available in PDF, EPUB and Kindle. Book excerpt: NOTE: NO FURTHER DISCOUNT FOR THIS PRODUCT ITEM -OVERSRTOCK SALE-- Significantly reduced price. Edited by Jean R. Anderson. This guide addresses the health care needs unique to women with HIV. It targets clinicians who provide primary care to women as well as those seeking an understanding of how to take care of women with HIV/AIDS. This guide includes tables, figures, color plates, resources, references, and indices. This 2005 edition includes new chapters on international issues and nutrition. Edge indexed."

Download or read book Social Research written by Norman Blaikie and published by John Wiley & Sons. This book was released on 2017-01-06 with total page 255 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique book explains the central role that research paradigms play in the design and conduct of social research. The authors argue that social research should not just describe or confirm a social problem but should seek to find an explanation for it and to do so requires research with eyes philosophically wide open. Important philosophical and practice elements of three widely recognized paradigms Neo-Positive, Interpretive and Critical Realist are carefully elaborated and their use in action illustrated with detailed examples. The authors show that the philosophical assumptions of a chosen paradigm must match those embedded in a characterization of a research problem and its context. This paradigm orientation is shown to be fundamental to appropriately framing a problem, formulating research questions, deciding on a logic of inquiry and selecting and using methods to investigate it. Ultimately, an appropriate paradigm orientation to social research provides a dispassionate, rigorous and effective basis for the production of new social scientific knowledge. Following on from Blaikies Approaches to Social Enquiry and Designing Social Research, this innovative book will be invaluable to upper-level and research students, their lecturers and supervisors, and researchers across the social sciences.

Download or read book Reimagining Global Health written by Paul Farmer and published by University of California Press. This book was released on 2013-09-07 with total page 508 pages. Available in PDF, EPUB and Kindle. Book excerpt: Bringing together the experience, perspective and expertise of Paul Farmer, Jim Yong Kim, and Arthur Kleinman, Reimagining Global Health provides an original, compelling introduction to the field of global health. Drawn from a Harvard course developed by their student Matthew Basilico, this work provides an accessible and engaging framework for the study of global health. Insisting on an approach that is historically deep and geographically broad, the authors underline the importance of a transdisciplinary approach, and offer a highly readable distillation of several historical and ethnographic perspectives of contemporary global health problems. The case studies presented throughout Reimagining Global Health bring together ethnographic, theoretical, and historical perspectives into a wholly new and exciting investigation of global health. The interdisciplinary approach outlined in this text should prove useful not only in schools of public health, nursing, and medicine, but also in undergraduate and graduate classes in anthropology, sociology, political economy, and history, among others.

Download or read book Access to Health Care in America written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.

Download or read book Addressing the Sexually Transmitted Infections Epidemic in the United States A Sociomedical Perspective written by Christopher Williams and published by Frontiers Media SA. This book was released on 2023-12-04 with total page 149 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rates of sexually transmitted infections (STIs) have significantly increased in the United States. Per-capita estimates reveal approximately 68 million prevalent and 26 million incident STIs nationally. Gonorrhea, syphilis, and chlamydia—the three reportable STIs—reached levels not seen in the last fifty years and this resurgence is concurrent with increasing antimicrobial resistance and a dearth of viable candidates in the vaccine pipeline. A seminal report by the National Academies of Sciences, Engineering, and Medicine, Sexually Transmitted Infections: Adopting a Sexual Health Paradigm, confirms that STIs rank among the most pressing and intractable public health threats. Furthermore, rising rates of STIs exact a substantial societal, medical, and economic burden that strain public health capacity, which has been substantially debilitated in the wake of the Covid-19 pandemic. STIs can have serious consequences for sexual, reproductive, and overall health. Untreated syphilis, for instance, is directly implicated in neurological, cardiovascular, and dermatological disease. Human papillomavirus is a known cause of cervical cancer and is the most common cancer among women globally. Hepatitis B increases risk for cirrhosis and primary liver cancer. Despite reductions in HIV transmission and improvements in prevention and treatment, infections among women, girls, adolescents, and mother-to-child transmission remain unacceptably high. Marginalized racial/ethnic minorities, LGBTQ persons, vulnerable at-risk adolescents and young adults, and other underrepresented populations are more susceptible to STIs as they negotiate an array of factors that can delay and even preclude access to preventive interventions. The United States spends substantially more on STI prevention and treatment yet it consistently bares a disproportionate burden of sexually transmitted infections compared to other Western industrialized nations. Access to healthcare, erosion and diversion of public health capacity, racism, discrimination, stigma, substandard education, and poverty have all been identified as important contributors to the trajectory of acute sexually transmitted infections. Furthermore, upstream drivers such as national, state, and local public health policies have been associated with population-level STI risk, prevention, and treatment and as such offer opportunities for ecological, observational, and multi-level analyses to assess their direct and indirect impact on sexual health outcomes. In this thematic collection, we aim to present an interdisciplinary collection of high-quality articles centered on the premise that the rise of emerging and re-emerging STIs can be attributed, in part, to a complex interaction of sociomedical factors beyond individual behavioral risk profiles. This Research Topic welcomes a variety of manuscript formats including original research, brief reports, systematic reviews, and perspective manuscripts involving sociomedical factors, social determinants of health, health disparities, infectious disease epidemiology, and other drivers including health policies that act as barriers and facilitators of effective STI prevention and treatment. Manuscripts that examine structural, community, institutional, interpersonal, and broad individual factors linked to STIs are very well suited for this collection. Topic areas include, but are not limited to: • Structural racism, discrimination, and stigma and their influence on prevention, treatment, and support services among vulnerable and marginalized populations; • Housing and income insecurity that impede sexual, reproductive, and overall health; • Biological factors that affect the spread of STIs including their asymptomatic nature and the influence of sex as a biological variable; • Intimate partner violence, harassment, and intimidation; • Substance abuse, sex work, sexual networks, and normative sexual attitudes and beliefs that impede the adoption of preventive health-promoting behaviors; • Priority populations including adolescents, men who have sex with men, youth who are LGBTQ, and the incarcerated; • Impact of HIV pre-exposure prophylaxis (PrEP) uptake on STI incidence; • Culturally-specific biopsychosocial, behavioral, and community-based STI interventions to treat and support those afflicted with STIs; • Community mobilization and community-based organization to reduce STIs; • Community-level prevalence of infectious agents; • Local and holistically-integrated STI clinics; • Public health STI workforce capacity; • Health in All Policies (HiAP) approaches to STI prevention and treatment. Christopher Williams is the Senior Vice President and Director of Research at National Health Promotion Associates, a private research and development firm that specializes in the development, testing and dissemination of evidence-based approaches to target behavioral risk factors associated with major chronic diseases, violence, accidents and preventable injuries. The other Topic Editors declare no competing interests with regard to the Research Topic subject.

Download or read book AIDS and the Family written by Mark A. Belsey and published by United Nations Publications. This book was released on 2005 with total page 170 pages. Available in PDF, EPUB and Kindle. Book excerpt: HIV/AIDS has a profound impact on family well-being and structures. This publication considers issues and challenges of HIV/AIDS from a family perspective, using information and data from sub-Saharan Africa. Issues discussed include: definitions and methodological aspects; knowledge and disclosure of HIV status, including stigma and risk perceptions; caregiving and family living arrangements, including the implications for older family members and children who are forced to assume adult responsibilities; care of orphaned children; changing structures and functions of families affected by HIV/AIDS; traditional and other family practices affecting vulnerability to HIV; and policy implications of the HIV/AIDS epidemic.

Download or read book Best Evidence Structural Interventions for HIV Prevention written by Rachel E Golden and published by Springer Science & Business Media. This book was released on 2013-05-25 with total page 358 pages. Available in PDF, EPUB and Kindle. Book excerpt: ​​​​ ​ Providing detailed information on structural HIV prevention interventions, this book is intended for health care practitioners and researchers to plan, implement, and evaluate such interventions in their own communities. As defined by the CDC, structural interventions focus on the physical, social, cultural, political, economic, legal, and/or policy aspects of the environment. Designed to reach a large number of individuals, structural interventions usually occur across entire communities, cities, or countries. As a result, the resources required to initiate structural interventions can far exceed those required for smaller-scale behavioral programs. However, changes from structural interventions have the potential to last over time, even after the programs have ended, resulting in effective use of public and private prevention resources.​ Because the reach of structural interventions is typically larger than that of individual- or group-focused interventions (for example, the 100% Condom Use Program, which was implemented countrywide in Thailand), their influence may be equally—if not more—significant.This book is a resource for health practitioners, educators, and researchers who seek HIV/AIDS structural prevention programs that have been shown to be effective in their regions or for their target populations (e.g. injection drug users, commercial sex workers, or the general public). With extensive case studies, the book classifies interventions according to the desired outcomes (specific behavior or policy changes) so that the reader may focus on examples of programs with similar goals and target populations to their own. Addresses the quintessential public health ethical dilemma regarding which types of environmental changes should be mandatory via legislation and which should be voluntary, promoted via programmatic, practice, and policy change. ​

Download or read book Global Trends 2040 written by National Intelligence Council and published by Cosimo Reports. This book was released on 2021-03 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The ongoing COVID-19 pandemic marks the most significant, singular global disruption since World War II, with health, economic, political, and security implications that will ripple for years to come." -Global Trends 2040 (2021) Global Trends 2040-A More Contested World (2021), released by the US National Intelligence Council, is the latest report in its series of reports starting in 1997 about megatrends and the world's future. This report, strongly influenced by the COVID-19 pandemic, paints a bleak picture of the future and describes a contested, fragmented and turbulent world. It specifically discusses the four main trends that will shape tomorrow's world: - Demographics-by 2040, 1.4 billion people will be added mostly in Africa and South Asia. - Economics-increased government debt and concentrated economic power will escalate problems for the poor and middleclass. - Climate-a hotter world will increase water, food, and health insecurity. - Technology-the emergence of new technologies could both solve and cause problems for human life. Students of trends, policymakers, entrepreneurs, academics, journalists and anyone eager for a glimpse into the next decades, will find this report, with colored graphs, essential reading.