HIV Prevention in Clinical Care Settings

Marrazzo, Jeanne M.; Rı́o, Carlos del; Holtgrave, David R.; Cohen, Myron S.; Kalichman, Seth C.; Mayer, Kenneth H.; Montaner, Julio S. G.; Wheeler, Darrell P.; Grant, Robert M.; Grinsztejn, Beatriz; Kumarasamy, N.; Shoptaw, Steven; Walensky, Rochelle P.; Dabis, François; Sugarman, Jeremy; Benson, Constance A.

doi:10.1001/jama.2014.7999

Cited by 111 publications

(51 citation statements)

References 219 publications

(176 reference statements)

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“…(18, 19) However, requiring food for optimal ART absorption is the only aspect of poverty directly related to the pharmacokinetics of ART. The selection of an ART regimen is individualized on the basis of multiple considerations including virologic efficacy, toxicity, pill burden, dosing frequency, resistance testing results, comorbid conditions, and cost (20)(see http://aidsinfo.nih.gov/guidelines). Given the growing prominence of poverty in HIV epidemics, access to food should be explicitly assessed and prioritized when prescribing ART.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes Among People Living With HIV Who Are Food Insecure and Prescribed Antiretrovirals Taken With Food

Kalichman

Washington

Grebler

et al. 2014

J Prim Care Community Health

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Background Food insecurity is a known barrier to medication adherence among people living with HIV. Antiretroviral therapies (ART) that require food for maximum benefit likely pose added challenges to patients who do not have reliable access to food. This study examines the health implications of prescribing ART that requires food to patients who are food insecure. Method A community sample of 538 men and 221 women currently taking ART to treat their HIV infection completed computerized interviews, biweekly-unannounced pill count adherence assessments, and obtained their CD4 cell count and HIV RNA from medical records. Results Sixty-three percent of participants experienced at least one indicator of food insecurity during the previous month, of which 274 (57%) were prescribed an ART regimen that requires food. Among participants who were food insecure, individuals taking ART requiring food indicated significantly greater HIV symptoms, lower CD4 cell counts, and poorer HIV suppression. For participants who were food secure, those taking ART that requires food were significantly less adherent than those whose ART regimen does not require food. Conclusions People living with HIV who experience food insecurity are significantly more likely to be prescribed ART regimens that require food and experience poorer treatment outcomes. Determination of optimal ART regimens should take patient access to food into account and treatment guidelines should highlight the importance of food access in selecting ART regimens.

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Section: Discussionmentioning

confidence: 99%

Treatment Outcomes Among People Living With HIV Who Are Food Insecure and Prescribed Antiretrovirals Taken With Food

Kalichman

Washington

Grebler

et al. 2014

J Prim Care Community Health

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“…In addition to the new biomedical strategies for HIV prevention that are currently being developed (Marrazzo et al, 2014), the underlying sexual behaviours responsible for most infections are still critical to prevent new transmissions. Thus, HIV prevention programmes must address the avoidance of early sex, the reduction of sexual partners and the correct and consistent condom use among people at risk (Centers for Disease Control and Prevention, 2014;Halperin et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Male condom use, multiple sexual partners and HIV: a prospective case-control study in Kinshasa (DRC)

Carlos

Burgueño

et al. 2016

AIDS Care

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In the Democratic Republic of Congo no previous studies have assessed the factors associated with different patterns of condom use and with multiple sexual partners and the association between condom use simultaneously taking into account multiple sexual partnerships, and HIV infection. We carried out a prospective case-control study. From December 2010 until June 2012, 1,630 participants aged 15-49 getting HIV Voluntary Counseling and Testing in a hospital in Kinshasa were selected. Cases were new HIV diagnosis and controls were HIVnegative participants detected along the study period. We recruited 274 cases and 1,340 controls that were interviewed about HIV-related knowledge, attitudes and behaviours.Among cases there was a high prevalence of multiple lifetime and concurrent sexual partnerships (89.8% and 20.4%, respectively) and most cases never used condoms with only 1.5% using them consistently. Condom use and multiple partnerships were associated with male, single and high-educated participants. An association was found between multiple lifetime partners and `any condom use´ (OR=2.99; 95%CI: 2.14-4.19) but not with consistent use. Both having two or more multiple concurrent sexual partners or not using condoms were variables similarly and highly associated to HIV risk. The association found between having two or more concurrent sexual partners and HIV was slightly higher (OR=3.58, 95%CI:2.31-5-56) than the association found between never condom use and HIV (OR=3.38, 95%CI:1.15-9.93). We found a high prevalence of multiple lifetime sexual partners and an extremely high prevalence of inconsistent condom use, both strongly associated with HIV seropositivity.Local programs would benefit from comprehensive interventions targeting all behavioural and sociocultural determinants.

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“…No obstante, al 65% de los pacientes se les administró TARGA durante la estancia hospitalaria, siguiendo un esquema general con 2 análogos nucleósidos de la transcriptasa reversa y un análogo no nucleósido, de manera semejante a otras series 3 y en concordancia con las guías internacionales de manejo antirretroviral 16,17 .…”

Section: Discussionunclassified

Infecciones oportunistas en pacientes con VIH en el hospital universitario de Neiva, Colombia. 2007-2012

et al. 2015

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HIV Prevention in Clinical Care Settings

Abstract: Data support the integration of biomedical and behavioral approaches for prevention of HIV infection in clinical care settings. A concerted effort to implement combination strategies for HIV prevention is needed to realize the goal of an AIDS-free generation.

Cited by 111 publications

References 219 publications

Treatment Outcomes Among People Living With HIV Who Are Food Insecure and Prescribed Antiretrovirals Taken With Food

Treatment Outcomes Among People Living With HIV Who Are Food Insecure and Prescribed Antiretrovirals Taken With Food

Male condom use, multiple sexual partners and HIV: a prospective case-control study in Kinshasa (DRC)

Infecciones oportunistas en pacientes con VIH en el hospital universitario de Neiva, Colombia. 2007-2012

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