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HIV Care Today


Post-Exposure Prophylaxis for HCV Can't Be Cost-Effective -- but We Might End Up Recommending It Anyway
By Paul E. Sax, M.D.
August 23, 2015

An email query from a colleague:

Hi Paul,
Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV+. Any post-exposure prophylaxis recommended?

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The Pain -- and Potential Power -- of Electronic Health Records in One Little Anecdote
By Paul E. Sax, M.D.
August 9, 2015

Here's a scintillating series of events that happened recently on our inpatient consult service.

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Patching the Leaky Cascade: Report From the 2015 Adherence Conference
By David Fawcett, Ph.D., L.C.S.W.
July 27, 2015

Thirty-three million people are infected with HIV worldwide, but less than 50% receive antiretroviral therapy. This was the stark reality addressed in June at the 10th International Conference on HIV Treatment and Prevention Adherence (Adherence 2015), which is jointly provided by the International Association of Providers of AIDS Care (IAPAC) and the Postgraduate Institute for Medicine (PIM). Every aspect of the ubiquitous treatment cascade was addressed in an effort to stop the "leaks" of people not engaging in treatment, falling out of care or not maintaining viral suppression. While access to prevention and treatment has significantly improved worldwide, certain issues such as stigma still impact prevention and treatment, and gender, age, race and sexual orientation continue to make certain populations vulnerable and in need of interventions tailored to their specific needs.

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Really Rapid Review: IAS 2015
By Paul E. Sax, M.D.
July 26, 2015

Vancouver will always have a special place in HIV treatment history. It was here, in 1996, that many of us first saw the potential of combination antiretroviral therapy to control this disease.

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Right Thing, Right Place, Right Time: Utilizing Data to Strengthen the Fight Against HIV
By David Fawcett, Ph.D., L.C.S.W.
July 25, 2015

Because current levels of HIV spending are unsustainable, HIV prevention and intervention efforts must become highly targeted in order to maximize their impact. This was the theme of many presentations at the 10th International Conference on HIV Treatment and Prevention Adherence. The conference, held June 28 to 30 in Miami, Florida, was jointly provided by the International Association of Providers of AIDS Care (IAPAC) and the Postgraduate Institute for Medicine (PIM).

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Top 10 Things Public Health Practitioners, Government Policymakers and Community Advocates Need to Do to Move to the End of HIV and HCV
By Murray Penner
July 14, 2015

Last month, I spoke at the closing plenary of the HIV Forum for Collaborative HIV Research National Summit in Arlington, Virginia. I began with a brief look back at how the fight against the HIV epidemic has evolved. I reflected on a time when there were only a few tools and even fewer resources available to make an impact on the disease. This is in direct contrast to the progress that we have made in today's fight, where we have many tools available to us that work to combat and bring an end to the HIV and HCV epidemics. But I am reminded, and wanted to remind everyone in attendance, that a challenge still remains. We need to work differently and more effectively to bring an end to both of these epidemics. The following is an excerpt from the presentation I gave, where I provided a top 10 list of things that we must consider and incorporate in our work to end both epidemics.

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For HIV in the USA, Not in Care Exceeds the Undiagnosed -- Solutions Welcome
By Paul E. Sax, M.D.
July 7, 2015

In last week's post, I asked about two of the key components of the HIV care cascade -- the "undiagnosed" vs the "diagnosed but not in care," and which group was larger in the USA. Here are your answers as of now:

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Undiagnosed or Not in Care? For HIV, Which Is the Bigger Problem?
By Paul E. Sax, M.D.
July 1, 2015

The information is everywhere -- on your computer, your phone, your tablet -- whatever screen happens to be glowing in front of you.

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Post-Exposure Prophylaxis (PEP): A Pilot Program for Uninsured Patients
By Joel L. Zive, B.S., Pharm.D.
June 12, 2015

Two years ago, the Alachua County Community Support Services, Victim Services and Rape Crisis Center in Gainesville, Florida, contacted me to inquire about Walgreens' partnership in assisting uninsured sexual assault victims to obtain HIV post-exposure prophylaxis (PEP) prescriptions during weekends and holidays. This issue is of great importance because once an individual is sexually assaulted, there is only a 72-hour window to begin PEP. Ideally, it is recommended to start the regimen as soon as possible. I have learned that when a person is sexually assaulted, local emergency rooms only provide a one-day dose of the regimen. As a result, this leaves the victim advocate and patient foraging for medication to cover the remaining days of the typical 28-day regimen. In addition, the problem is further compounded if the assault occurs on a holiday weekend.

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A Slightly Less Painful Way to Learn the 3-Letter Abbreviations for HIV Meds
By Paul E. Sax, M.D.
June 4, 2015

One of the stupid things about being an HIV/ID specialist is the highly arcane code we use to abbreviate HIV treatments.

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