Download or read book Thinking Ethically about HIV Pre exposure Prophylaxis Retention in Care and Sexually Transmitted Infection Testing in a Southeastern United States Local Health Department in the Time of COVID 19 written by Ellie Purdy and published by . This book was released on 2021 with total page 89 pages. Available in PDF, EPUB and Kindle. Book excerpt: Author's abstract: Local Health Departments (LHDs) are critical providers of Human Immunodeficiency Virus (HIV) and sexually transmitted infection (STI) prevention efforts. HIV Pre-Exposure Prophylaxis (PrEP) is an evolving public health initiative and practitioners should consider PrEP interventions in context of ethical decision-making and a broad STI prevention strategy as global incidence of bacterial STIs remains high and those at-risk for HIV are generally at-risk for other STIs. An evaluation of the Thinking Ethically framework and LHD PrEP services was performed to fill a gap in the literature and support program decision-making. A retrospective review of PrEP user medical records from a LHD in north Georgia from July 2019 to June 2020 was performed and data were assessed using descriptive statistics, negative binomial, and logistic regression. Total STI tests performed by the LHD from July 2018 to June 2020 were calculated to determine the change in STI testing services associated with the onset of the COVID-19 pandemic. The Thinking Ethically framework was valuable to PrEP-related decision-making. There were 63 PrEP users in the study period of which most were White non-Hispanic (60.3%) men who have sex with men (61.9%). Retention in care was associated with clinic site. Most bacterial STI cases diagnosed among PrEP users were asymptomatic (75%). Fifty percent of PrEP users obtained services beyond STI prevention including vaccination and referrals. District STI testing declined between the second quarter of 2020 and 2019 with a decline in HIV testing by 38%, syphilis by 48%, gonorrhea and chlamydia by over 50%. LHD decision-makers can feasibly apply the Thinking Ethically framework to public health practice. Results support the need for LHD continuous quality management as retention in care differed by clinic site, and more resources will be needed to engage hard-to-reach populations at-risk for HIV like injection drug users. The COVID-19 pandemic impacted PrEP and STI services and more data is needed to determine the long-term effects of the COVID-19 pandemic on the STI landscape.
Download or read book HIV Prevention in Primary Care Practice written by Gregory Felzien, MD, AAHIVS and published by Integritas Communications. This book was released on 2020-10-22 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: PrEP is a broad set of clinical tools that can be used to reduce the chances of acquiring HIV. Although it is highly effective, many people who could benefit from PrEP lack access or are not familiar with it. However, primary care providers can remedy this situation and truly make a difference in the lives of their patients who may be at risk of acquiring HIV. This eHealth SourceTM educational activity comprises 5 chapters, covering an overview of HIV epidemiology, practical approaches to sexual history-taking and assessing patient risk of HIV acquisition, initiation and monitoring of PrEP medication, and overcoming the bias and stigma surrounding HIV and PrEP. Throughout the program, our expert faculty will provide their unique insights surrounding sexual health, HIV prevention, and PrEP, and how these may be incorporated into primary care practice.
Download or read book Differentiated and simplified pre exposure prophylaxis for HIV prevention written by and published by World Health Organization. This book was released on 2022-07-31 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book HIV Pre exposure Prophylaxis Additional Insights Through Secondary Analyses of the PROUD Trial written by Ellen White and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This thesis utilises data from PROUD, a randomised controlled trial to evaluate pre-exposure prophylaxis (PrEP) for HIV prevention. PROUD randomised 544 HIV-negative men who have sex with men (MSM) to receive PrEP immediately or deferred for a year. The trial demonstrated that PrEP was highly effective at preventing HIV transmission. In this thesis, I consider four further questions: (1) Who should access PrEP? (2) How appropriate are epidemiological measures that are commonly used for PrEP and other prevention strategies? (3) Is PrEP-use associated with an increased risk of sexually transmitted infections (STIs)? and (4) What is the risk of hepatitis C (HCV) among PrEP-users? The highest risk of HIV acquisition was associated with a rectal STI or syphilis diagnosis in the previous year, or reporting condomless receptive intercourse with two or more partners in the previous three months. MSM meeting these criteria are therefore in most need of PrEP. STI diagnoses were more common among PrEP-users, found in both the randomised and pre-/post-PrEP comparisons. It was unclear whether this was driven by a difference in screening or sexual behaviour. Regardless, PrEP-using MSM are at high risk of STIs, and frequent screening in a PrEP programme would likely help control onward transmission. HCV incidence was high and increased during the four-year period of follow-up, doubling in the final year. Risk varied according to reported risk factors. Thus, the current recommendation of quarterly HCV screening for all PrEP-using MSM may not be appropriate unless there is a localised epidemic. My findings show that MSM seeking PrEP have a high but heterogeneous risk of sexually transmitted diseases, with variation according to individual- and population-level risk factors. PrEP programmes need to allocate sufficient provisions to screen for and treat other clinical outcomes, including STIs and HCV.
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 Optimizing HIV PrEP Implementation in the Primary Care Setting written by Cara P Nalagan and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite compelling evidence behind the efficacy of pre-exposure prophylaxis (PrEP) in preventing human immunodeficiency virus (HIV) acquisition and its introduction in 2012, the prescription of PrEP has remained low (Silapaswan, Krakower, & Mayer, 2016). At the Asian and Pacific Islander Wellness Center (API), an urban primary care clinic in San Francisco, suboptimal PrEP implementation was related to a lack of standardized practice and routine HIV risk screening for PrEP provision. A doctorate of nursing (DNP) project was implemented to initiate a standardized HIV risk screening protocol for identifying HIV risk and PrEP eligibility to increase PrEP implementation at API. The impact of this protocol demonstrated an increase in the PrEP implementation cascade, particularly in HIV risk identification, PrEP offer, and evaluation of at-risk patients for PrEP uptake (initiation). During implementation of the HIV risk screening protocol, however, inconsistent clinical staff compliance with the routine screening tool led to an inadequate increase in PrEP offer for patients who tested positive for a sexually transmitted infection (STI). This indicates a need for further reinforcement of standardized practice and clinical staff education on the importance of combining HIV risk screening and PrEP, with emphasis on the significant risk for HIV infection associated with positive STI, to effectively promote patient outcomes. Implications for further research include validation of the HIV PrEP screening tool used in the HIV risk screening protocol as a model for PrEP implementation in the primary care setting.
Download or read book Post exposure Prophylaxis PEP to Prevent HIV Infection written by Clinical Guidelines Program and published by . This book was released on 2020 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt: This guideline was developed by the New York State Department of Health (NYSDOH) AIDS Institute (AI) for healthcare practitioners in any medical setting (e.g., emergency department, sexual health clinic, urgent care clinic, inpatient unit primary care practice) who manage the care of individuals who request post-exposure prophylaxis (PEP) after a possible exposure to HIV. Despite the availability of prevention measures, exposures occur that pose the risk of transmission. Fortunately, with rapid initiation of PEP, infection can be blocked. Preventing new HIV infections is crucial to the success of New York State's Ending the Epidemic Initiative. HIV transmission can be prevented through use of barrier protection during sex (e.g., latex condoms), safer drug injection techniques, and adherence to universal precautions in the healthcare setting. HIV infection can also be prevented with use of antiretroviral (ARV) medications taken as pre-exposure prophylaxis (PrEP). After an exposure has occurred, HIV infection can be prevented with rapid administration of ARV medications as PEP. The first dose of PEP should be administered within 2 hours of an exposure (ideal) and no later than 72 hours after an exposure.
Download or read book Guide to Public Health Practice written by Association of State and Territorial Health Officials (U.S.) and published by . This book was released on 1988 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Initiating PrEP in Primary Care Addressing the Adolescent and Young Adult High Risk Populations written by Igor G. Mocorro and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Problem: Adolescents and young adults (AYA) ages 13 to 24 comprise a quarter of the new HIV diagnoses in the United States. Lack of access to HIV-preventive therapies such as pre-exposure prophylaxis (PrEP) reduces opportunities to prevent HIV infection in this population. Initiating PrEP in AYA significantly reduces the negative health outcomes of HIV, but it is evident that many clinicians are still reluctant to initiate PrEP in AYA patients based on perceived threats and barriers. Context: Primary care clinics, including school-based clinics, have an opportunity to offer HIV prevention services including PrEP. This project, the Adolescent and Young Adult Comprehensive PrEP Education Project (AYA ComPrEP) is an HIV-prevention quality improvement project that is directed towards providing AYA high-risk populations with access to PrEP in the primary care setting. The project was supposed to be completed at the Balboa Teen Clinic of Balboa High School, a clinic serviced by the Community Health Programs for Youth (CHPY) of the San Francisco Department of Public Health (SFDPH). Due to the COVID-19 pandemic shelter-in-place policy, the training for clinicians and staff, and roll out of PrEP service for adolescent clients of Balboa Teen Clinic was deferred to an unknown date. An online training and simulation for the University of San Francisco clinicians (nurse practitioner students) was conducted instead. Interventions: A site feasibility analysis was conducted, which include consultations with CHPY leadership and management, site assessment, conduct of face-to-face in-depth interviews among staff of Balboa Teen Clinic, and review of literature and best practices to develop recommendations for a pilot PrEP program for AYA. Some interventions were modified to focus on increasing the confidence of providers, nurse practitioners students of the University of San Francisco (USF) to prescribe PrEP to AYA. The focus of this DNP project was shifted to designing modules, conducting and evaluating of an online simulation, a PrEP training workshop for providers. The simulation include didactic, role play, case studies covering information, best practice recommendations on HIV and AIDS, HIV counseling, reproductive health, sexual orientation and gender identity initiative, and PrEP for AYA. Measures: A pre-assessment and post-simulation evaluation was utilized to determine the change in providers' knowledge, enabling attitudes, confidence, and readiness to offer HIV prevention services, and prescribe PrEP in preparation for their integration in clinics that they will be working. Case studies in the form of simulated patients to measure how they would apply the knowledge and confidence gained towards real life practice scenarios. Results: Nineteen clinicians attended the online PrEP simulation training-workshop. The data analysis revealed a 17.11% increase in HIV/AIDS & PrEP knowledge mean score (average scores: 76% for pre-simulation versus 89% for post-simulation) among participants. Likewise, HIV and PrEP enabling or non-stigmatizing attitude scores has increased by 18.3% (average scores: 71% for pre-simulation versus 84% for post-simulation). All the 19 clinicians revealed that their knowledge and confidence to prescribe PrEP to adolescents and young adults in their practice has increased as a result of attending the simulation (13 strongly agreed; 6 agreed) as compared to 2 clinicians prior to the simulation. Conclusions: PrEP targeted for at-risk AYA is necessary to reduce HIV rates. This is possible by breaking barriers to PrEP prescription through education and training of clinicians. PrEP should be included in the training and preparation of clinicians to address the adolescent and young adult populations. Online simulation training workshop for PrEP is an effective alternative means if face-to-face training is not possible.
Download or read book Health Care and the Law written by Rebecca Keenan and published by Thomson Brookers. This book was released on 2010-01-01 with total page 569 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Care and the Law 4th Edition is recognised as one of the leading texts setting out the basic principles of health care law in New Zealand. This book is an easy-to- understand, practical and uncomplicated account of health care law, making it an essential text for health practitioners, lawyers and students. Since 2004 when the 3rd edition of this book was published, there have been a number of legislative changes in the area of health law. This edition keeps you current with these changes, with updates made to all chapters. The inclusion of relevant case law also provides readers a greater understanding of the practicalities of the law, how it has been applied and how it may relate to them.
Download or read book Global Health and the Future Role of the United States written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-10-05 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: While much progress has been made on achieving the Millenium Development Goals over the last decade, the number and complexity of global health challenges has persisted. Growing forces for globalization have increased the interconnectedness of the world and our interdependency on other countries, economies, and cultures. Monumental growth in international travel and trade have brought improved access to goods and services for many, but also carry ongoing and ever-present threats of zoonotic spillover and infectious disease outbreaks that threaten all. Global Health and the Future Role of the United States identifies global health priorities in light of current and emerging world threats. This report assesses the current global health landscape and how challenges, actions, and players have evolved over the last decade across a wide range of issues, and provides recommendations on how to increase responsiveness, coordination, and efficiency â€" both within the U.S. government and across the global health field.
Download or read book WHO Guidelines on Hand Hygiene in Health Care written by World Health Organization and published by World Health Organization. This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants. Definitions of health-care settings are proposed in Appendix 1. These Guidelines and the associated WHO Multimodal Hand Hygiene Improvement Strategy and an Implementation Toolkit (http://www.who.int/gpsc/en/) are designed to offer health-care facilities in Member States a conceptual framework and practical tools for the application of recommendations in practice at the bedside. While ensuring consistency with the Guidelines recommendations, individual adaptation according to local regulations, settings, needs, and resources is desirable. This extensive review includes in one document sufficient technical information to support training materials and help plan implementation strategies. The document comprises six parts.
Download or read book The Global HIV Epidemics among Sex Workers written by Deanna Kerrigan and published by World Bank Publications. This book was released on 2012-12-01 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: A global economic analysis of HIV infection amongst sex workers, finding that evidence based and rights affirming interventions are not implemented to the level that their efficacy warrants, and that doing so at scale would be cost effective and deliver significant returns on investment.
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.
Download or read book WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience written by World Health Organization and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Within the continuum of reproductive health care, antenatal care provides a platform for important health-care functions, including health promotion, screening and diagnosis, and disease prevention. It has been established that, by implementing timely and appropriate evidence-based practices, antenatal care can save lives. Endorsed by the United Nations Secretary-General, this is a comprehensive WHO guideline on routine antenatal care for pregnant women and adolescent girls. It aims to complement existing WHO guidelines on the management of specific pregnancy-related complications. The guidance captures the complex nature of the antenatal care issues surrounding healthcare practices and delivery, and prioritizes person-centered health and well-being --- not only the prevention of death and morbidity --- in accordance with a human rights-based approach.
Download or read book Guideline for Isolation Precautions in Hospitals written by Julia S. Garner and published by . This book was released on 1983 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Promoting Access to Medical Technologies and Innovation Intersections between Public Health Intellectual Property and Trade written by World Intellectual Property Organization and published by WIPO. This book was released on 2013 with total page 259 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study has emerged from an ongoing program of trilateral cooperation between WHO, WTO and WIPO. It responds to an increasing demand, particularly in developing countries, for strengthened capacity for informed policy-making in areas of intersection between health, trade and IP, focusing on access to and innovation of medicines and other medical technologies.
