Download or read book Which Patients May be Eligible for Pre exposure Prophylaxis PrEP for HIV u00a0 written by helen bradshaw and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Title:Which patients may be eligible for pre-exposure prophylaxis (PrEP) for HIV? Background/introduction:HIV diagnoses remain high among men who have sex with men (MSM). Recent studies show promising results with reducing MSM HIV transmission. The PROUD and IPERGAY studies, using daily or u2018on demandu2019 Truvada as PrEP respectively, showed an 86% HIV transmission reduction. Clinical guidance and funding arrangements for PrEP are in development. We assessed PrEP eligibility amongst MSM attending our sexual health service. Aim(s)/objectives:To ascertain the proportion of MSM attending our service eligible for PrEP on clinical grounds and estimate the service and cost implications of introducing PrEP.Methods:97 MSM attending from December 2014 to July 2015 were reviewed, including patients who had attended for post-exposure prophylaxis and STI screening. Patients were assessed against the PROUD study inclusion criteria to identify those who would benefit from PrEP. Results:Inclusion criteriatPercentage of patients who fit the criteriaBorn malet100%Completed HIV and STI screent84%HIV negative within previous 4 weekst95%Unprotected anal intercourse (UPAI) on > one occasion in the previous 90 dayst16%All criteria fulfilled (Having attended at least once previously was not considered as this was felt unnecessary)t14%No patients met any of the PROUD exclusion criteria. In a further 21% of notes, the exact number of episodes of UPAI, if any, was unclear although all other criteria were met. This suggests a range of 14-35% eligible for PrEP. We assumed all patients would continue having UPAI, were willing to comply with additional visits and were able to provide consent. The annual cost of Truvada is u00a3356 per year. Further service cost analyses will be described.Discussion/conclusion:At least 14-35% of MSM attending our service may benefit from PrEP provision. Additional costs include STI screening, monitoring and care pathways will need to be introduced. However, the overall impact of PrEP may be to reduce new HIV diagnoses and the resultant care costs.

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 The Ambiguity of Hiv Risk in Pre exposure Prophylaxis prep Administration in New York written by Elisabeth Arndt and published by . This book was released on 2020 with total page 177 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Risk" has become a ubiquitous concept in American healthcare settings, drawing both on objective biostatistics and on subjective, morally-charged interpretations. In particular, past epidemiological categorizations of a patient's identity or behavior-like their race or sexual practices-as "risk factors" for contracting HIV has promoted the sociocultural interpretation of HIV risk and stigmatized individuals in those groups. Nonetheless, with the advent of the pharmacologic Pre-Exposure Prophylaxis (PrEP) to prevent HIV transmission, such epidemiological categories of HIV risk are being even more broadly applied. The first medication used for PrEP was Truvada (emtricitabine and tenofovir disoproxil fumarate), an antiretroviral manufactured by the pharmaceutical giant Gilead Sciences that was first approved by the FDA in 2004 to treat HIV-positive patients and then approved again in 2012 as PrEP to prevent HIV infection in HIV-negative patients. Currently, the indications for PrEP prescription are impressively broad and vague, allowing much room for interpretation. Given how past identifications of HIV risk factors negatively implicated entire groups of people, there is a significant need to better understand how HIV risk has been conceptualized, how these concepts may be influenced by the interests of public health agencies and healthcare corporations, and how they play out for health professionals and patients in the clinical setting.In this dissertation, I examine the concepts of HIV risk that come into play in the administration of PrEP, considering how these concepts are understood by individual health professionals and patients alike and how such representations may align with the goals of healthcare corporations and public health agencies. Using ethnographic research techniques, I contrast the perspectives of HIV-negative patients identified as candidates for PrEP, HIV- positive patients, and health professionals administering PrEP to capture how they may understand HIV "risk" and PrEP's role in treating it. I conducted the fieldwork for this dissertation in a New York community health center network that provides PrEP and HIV services to diverse patient populations. I interviewed patients, clinic administrators, social workers, public health workers, and pharmaceutical industry members; observed clinical interactions; reviewed medical charts; and analyzed HIV prevention advertisements, publications, and guidelines. Based upon these collected data, I found that the discourse surrounding HIV risk is ambiguous, PrEP distorts and crystallizes this ambiguity, and structural risk (embedded healthcare structures identifying certain people as "at risk") is a reflective "model of" and constructive "model for" this process in a top-down direction. In doing so, I draw attention to the social significance of the pharmaceuticalization of risk by showing how pharmaceutical marketing can impact how risk is conceptualized, communicated, and experienced.

Download or read book A Project Using Pre exposure Prophylaxis PrEP in the Urgent Care Setting written by Tanya Clesie Cavallaro-Moretti and published by . This book was released on 2018 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Pre-Exposure Prophylaxis (PrEP) guidelines 2014, supported by scientific evidence, recommends the use of antiviral therapy (ART) prophylaxis to prevent human immunodeficiency virus (HIV) infection in patients at high-risk for HIV infection. The literature is limited on PrEP guidelines use in the urgent care (UC) settings. The purpose of this project was to determine the knowledge of urgent care providers regarding the PrEP guidelines and their practices of assess patients at high-risk for HIV infection. Additionally, the project aimed to determine the feasibility of providers to prescribe, implement and follow patients to whom they have prescribed the PrEP guidelines. The diffusion of innovation theory was used as the framework of this project to assist in process of the adoption of the PrEP in the urgent care settings. This project used quantitative descriptive methodology using a survey and chart review that identified the current HIV preventive practice in the UC in Arizona. There were four clinical questions (CQs) that investigated the healthcare provider's knowledge, practice, and attitude toward HIV prevention. There were 208 HIV screening tests ordered in 2016 in the UC, and there were 20 patients that received ART prophylaxis prescribed by nurse practitioner and from those, only six prescribed Truvada® were for PrEP. Truvada® was given to 2.88% of 208 of the patients screened for HIV. The project identified barriers to implementation of the PrEP guidelines in UC and the DIT can assist with diffusion of PrEP guidelines. The project identified algorithms to facilitate the application of prep guidelines into urgent care. The applicability of the PrEP guidelines into the UC settings was investigated and the UC is prepared to indicate ART to those who have clinical indications for PrEP, in addition to HIV screening and education.

Download or read book Data Management Analytics and Innovation written by Neha Sharma and published by Springer Nature. This book was released on 2021-08-04 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents the latest findings in the areas of data management and smart computing, machine learning, big data management, artificial intelligence, and data analytics, along with advances in network technologies. The book is a collection of peer-reviewed research papers presented at Fifth International Conference on Data Management, Analytics and Innovation (ICDMAI 2021), held during January 15–17, 2021, in a virtual mode. It addresses state-of-the-art topics and discusses challenges and solutions for future development. Gathering original, unpublished contributions by scientists from around the globe, the book is mainly intended for a professional audience of researchers and practitioners in academia and industry.

Download or read book PrEP Uptake Among Eligible Patients Attending the Largest PrEP Clinic in Jackson Mississippi written by Madison Hollcroft and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Among people at risk for HIV in the United States (US), Black people of all gender identities and sexual orientations have disproportionately high rates of new HIV infection but low uptake of pre-exposure prophylaxis (PrEP), especially in the Southern United States. There is limited research evaluating factors associated with PrEP uptake especially among Black communities. The Open Arms Clinic in Jackson, Mississippi is the largest provider of PrEP in the state with the 6th highest rate of HIV diagnosis in the US. Open Arms systematically documented PrEP eligibility and uptake (i.e., agreed undergo a clinical evaluation for PrEP) from 2017 to mid-2020. In encounter-based analyses, we examined factors associated with PrEP uptake among those eligible based on clinic criteria using bivariate and multivariate log binomial regression. A person-based analysis was conducted using chi-square tests to compare individuals who ever vs. never accepted an offer for PrEP. Among 721 encounters where patients were eligible for PrEP, staff offered PrEP at 680 (94%) of these encounters (526 unique individuals). Eligible patients were mostly ages 25 and older (61.5%), identified as Black (73.1%), and cisgender men who have sex with men (MSM) (63.5%). Individuals accepted a PrEP offer at 58% of encounters; 65.8% of individuals ever accepted an offer. Encounters with individuals that identified as transgender/non-binary were least likely to accept a PrEP offer. Encounters with individuals who reported having sex partners living with HIV or unknown HIV status were more likely to accept PrEP offer. There was no significant difference in accepting an offer by age or race. PrEP uptake in this clinic was suboptimal despite standardized methodical evaluation of eligibility. Our findings signify a critical need to enhance PrEP delivery in this region and enhance PrEP education for key groups such as transgender/non-binary individuals.

Download or read book Data Management Analytics and Innovation written by Neha Sharma and published by Springer Nature. This book was released on 2021-09-19 with total page 530 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents the latest findings in the areas of data management and smart computing, machine learning, big data management, artificial intelligence, and data analytics, along with advances in network technologies. The book is a collection of peer-reviewed research papers presented at Fifth International Conference on Data Management, Analytics and Innovation (ICDMAI 2021), held during January 15–17, 2021, in a virtual mode. It addresses state-of-the-art topics and discusses challenges and solutions for future development. Gathering original, unpublished contributions by scientists from around the globe, the book is mainly intended for a professional audience of researchers and practitioners in academia and industry.