HIV screening in the emergency department: Thoughts on disparities and the next step in ending the epidemic

Haukoos, Jason S.; Hopkins, Emily

doi:10.1002/emp2.12226

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…To achieve an equitable care continuum, there is a need for investment in and prioritization of evidence-based, multilevel interventions developed to meet the needs of Black MSM in different community contexts and that consider local HIV epidemic dynamics. 33 , 34 , 35 , 36 For example, it is essential to address structural issues due to health care infrastructure (eg, dearth of HIV practitioners, lack of Medicaid expansion, and medical mistrust) that are associated with a higher burden of HIV in the US South and to develop tailored interventions focused on the community and cultural context for Black MSM residing in the US South. Such interventions are also likely to provide benefits to the community at large by reducing forward transmission of HIV (eg, treatment as prevention) among other benefits.…”

Section: Discussionmentioning

confidence: 99%

Projected Life Expectancy Gains From Improvements in HIV Care in Black and White Men Who Have Sex With Men

Rich,

Pandya,

Chiosi

et al. 2023

JAMA Netw Open

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ImportanceSubstantial racial inequities exist across the HIV care continuum between non-Hispanic Black and White men who have sex with men (MSM) in the US.ObjectivesTo project years of life gained (YLG) with improving the HIV care continuum among Black MSM and White MSM in the US and to determine the outcomes of achieving health equity goals.Design, Setting, and ParticipantsThe Cost-Effectiveness of Preventing AIDS Complications microsimulation model was used and populated with 2021 race-specific data to simulate HIV care among Black MSM and White MSM in the US who have acquired HIV. Analyses were completed from July 2021 to October 2023.InterventionThe study simulated status quo care using race-specific estimates: age at infection, time to diagnosis, receipt of care, and virologic suppression. The study next projected the outcomes of attaining equity-centered vs non–equity-centered goals by simulating 2 equal improvements in care goals: (10-point increased receipt of care and 5-point increased virologic suppression), 3 equity-centered goals (annual HIV testing, 95% receiving HIV care, and 95% virologic suppression) and lastly, an equitable care continuum that achieves annual HIV testing, 95% receiving care, and 95% virologic suppression in Black MSM and White MSM. One-way and multiway sensitivity and scenario analyses were conducted.Main Outcomes and MeasuresMean age at death and YLG.ResultsIn the simulated cohort, the mean (SD) age at HIV infection was 27.0 (10.8) years for Black MSM and 35.5 (13.6) years for White MSM. In status quo, mean age at death would be 68.8 years for Black MSM and 75.6 years for White MSM. The equal improvements in care goals would result in 0.5 YLG for Black MSM and 0.5 to 0.9 YLG for White MSM. Achieving any 1 equity-centered goal would result in 0.5 to 1.7 YLG for Black MSM and 0.4 to 1.3 YLG for White MSM. With an equitable care continuum compared with the nationally reported status quo, Black MSM and White MSM would gain 3.5 and 2.1 life-years, respectively. If the status quo HIV testing was every 6 years with 75% retained in care and 75% virologically suppressed, Black MSM would gain 4.2 life-years with an equitable care continuum.Conclusions and RelevanceIn this simulation modeling study of HIV care goals, equal improvements in HIV care for Black and White MSM maintained or worsened inequities. These results suggest that equity-centered goals for the HIV care continuum are critical to mitigate long-standing inequities in HIV outcomes.

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Section: Discussionmentioning

confidence: 99%

Projected Life Expectancy Gains From Improvements in HIV Care in Black and White Men Who Have Sex With Men

Rich,

Pandya,

Chiosi

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

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HIV Infection — Screening, Diagnosis, and Treatment

Saag

2021

N Engl J Med

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Pneumocystis Pneumonia in Previously Undiagnosed Advanced HIV/AIDS and Importance of HIV Screening

Boggala,

Junaid,

Zhang

2024

Cureus

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The diagnosis of human immunodeficiency virus (HIV) in its late stages, also known as acquired immunodeficiency syndrome (AIDS), leads to increased morbidity and mortality. This is mostly due to the time given for opportunistic infections to arise, which present with their own complications. In this case report, we present an otherwise healthy 38-year-old male, who presented with general systemic symptoms and was later found to have HIV and AIDS, ultimately resulting in his death during this hospital admission. This case report will discuss HIV-associated opportunistic infections, focusing more on Pneumocystis jirovecii pneumonia (PCP), and the following complications that arose during the course of this patient’s hospitalization. The overarching goal of this case report is to highlight the importance of routine HIV screening in the United States in efforts to decrease mortality from AIDS-related opportunistic infections. In addition to mandating in-hospital screening, educating the public on lifestyle behaviors that can put one at risk for developing HIV is crucial to decreasing the prevalence of cases that go undiagnosed, as well as the disease itself.

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HIV screening in the emergency department: Thoughts on disparities and the next step in ending the epidemic

Cited by 3 publications

References 11 publications

Projected Life Expectancy Gains From Improvements in HIV Care in Black and White Men Who Have Sex With Men

Projected Life Expectancy Gains From Improvements in HIV Care in Black and White Men Who Have Sex With Men

HIV Infection — Screening, Diagnosis, and Treatment

Pneumocystis Pneumonia in Previously Undiagnosed Advanced HIV/AIDS and Importance of HIV Screening

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