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Background: With NHS PrEP now available for those at risk, we aimed to identify missed opportunities for people newly diagnosed with HIV who attended sexual and reproductive health (SRH) services, and to determine the HIV outcomes associated with people acquiring HIV with previous or recent PrEP use. Method(s): A retrospective observational study reviewed all new HIV diagnoses from the last 2 years to see if they were eligible for PrEP and offered in SRH services. Data was collected using electronic medical records on HIV outcomes - virological suppression, resistance and antiretroviral choice. Result(s): There were 74 new HIV diagnoses. 41 people were eligible but only 10 were known to have accessed PrEP at our services. 21% were heterosexual and of black ethnicity - it was not possible to ascertain whether they were eligible for PrEP from the notes. Of the 10 people with recent PrEP use, 2 stopped due to side effects;headaches, vomiting, fatigue and renal toxicity concerns. For the remaining adherence concerns were reported - taking event based dosing (EBD) incorrectly and difficulty accessing services. 80% of people achieved virological suppression. 90% were put on a second generation integrase or protease inhibitor. No one developed nucleoside reverse transcriptase inhibitor (NRTI) resistance. 6 people eligible for PrEP had attended SRH services but not given PrEP. 2 attended during the IMPACT trial being full and referred to IwantPrEPnow. 2 attended during COVID where baseline bloods were done with follow up but subsequently tested positive. 2 people refused PrEP with 1 deeming themselves to be low risk. Conclusion(s): Our data highlights several missed opportunities for starting same-day PrEP which potentially may have prevented HIV acquisition. If PrEP is not issued on the day, adequate follow up must be ensured. Reassuringly those who acquired HIV with recent PrEP use have achieved good virological control without NRTI mutations. Counselling on potential side effects, EBD dosing and ongoing HIV risk are essential. Despite NHS PrEP available over 2 years, our data shows we are still failing to meet the demand of PrEP not only in men who have sex with men but also in other key at risk groups.
ABSTRACT
Introduction: Interprofessional education projects with pharmacy and medical students (PS and MS) are rare in Germany (Institut fuer Medizinische und Pharmazeutische Pruefungsfragen, 2019). However, for a future trustful collaboration personal contacts and mutual understanding are vital (Weisenborn et al., 2019). Care by an interprofessional team is beneficial for patients. According to the fifth Action Plan 2021 - 2024 to improve medication safety of the Federal Ministry of Health (2021), interprofessional collaboration is an important key element. Objective(s): The authors developed and implemented an interprofessional education project for PS and MS. The pilot study was conducted to understand the students' perceptions and to evaluate whether students were satisfied with their learning progress and would recommend this project. Method(s): The project, developed by an interprofessional team, consisted of three parts: (1) an interprofessional online seminar, (2) practical training at the Medication Management Center (MMC) and (3) a one-day internship in a general practitioner's (GP's) office. In all three parts, PS and MS performed patient-oriented casework and medication reviews together. The project was evaluated using anonymous pre- and post-questionnaires, containing the German version of the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education instrument (SPICE-2D) and open-ended questions to further evaluate the students' perceptions (Pudritz et al., 2020). The post-questionnaire asked for feedback as well as a recommendation of this project for other students, using a five-point Likert scale. Furthermore, the students' satisfaction with their learning progress was assessed. Result(s): Due to the SARS-CoV-2 pandemic, only the seminar (part 1) was performed in each term. The other parts of the project were implemented progressively. The third execution in the winter term 2021/22 was eventually able to contain all three parts. Through all executions, 105 students (46 PS, 59 MS) attended the interprofessional seminar, 64 (29 PS, 35 MS) the practical training at the MMC and nine joined the internship in a GP's office. For the seminar, 41 of 53 participants were satisfied with their learning progress and 64 of 67 students would recommend it to others. Regarding the practical training at the MMC, 37 of 46 students were satisfied with their learning progress and 45 of 47 would recommend it to others. Finally, the internship in a GP's office was mostly rated positive. Conclusion(s): Despite the pandemic, the interprofessional education project was successfully implemented. The insights gained from the evaluation will be used to adapt the project and its evaluation, eventually. Moreover, the development of further interprofessional education projects will benefit from the gained understanding. The focus of the evaluation of the main study will shift to the students' perceptions towards patient-oriented casework and medication reviews. In addition to the questionnaires, guided individual interviews will be used.
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INTRODUCTION AND OBJECTIVE: Conductingresearch during the COVID-19 pandemic remains a challenge for the entireurologic community. We hereby report our effort to use social mediabasedcrowdsourcing methodology to recruit participants from the entire UnitedStates, including Alaska and Hawaii. We developed a novel research model thatcan engage multiple stakeholders and allows for fast and broad participationfor urine biomarker development towards a diagnostic tool for InterstitialCystitis (IC). METHODS: We partneredwith a patient advocacy group, the Interstitial Cystitis Association (ICA), toaid in recruitment efforts. A website with study information and links to theHIPAA-compliant enrollment questionnaire was created. The study was advertisedthough Google, and Beaumont's and ICA's social media using Twitter, emails,YouTube videos, Facebook posts, websites, and TikTok. Enrolled participants wereshipped at-home collection kits containing urine cups with preservative, a prepaidreturn mailing envelope, instructions, and survey materials. RESULTS: National publicparticipation was strong, and enrollment was closed within three months. Menand women of all age groups and ethnicities enrolled in the study, representingall 50 United States. Currently, 1,211 crowdsourced samples have been returned,including 677 asymptomatic control samples. Surprisingly, most participantsaccessed the website via mobile devices, as opposed to via desktop computer ortablet. Potential participants were referred to the website primarily by directlinks (i.e. email links), with other referring sites being Facebook, GoogleAdvertisements, the ICA's website, and Beaumont Hospital's website. CONCLUSIONS: Following COVID-19 safety guidelines, we conducted a nationwide crowdsource collection ofurine samples. Social media and web-based recruitment tools were used torecruit participants. Having a website user-friendly on mobile devices wasessential. Nontraditional recruitment methods, such as TikTok videos,encouraged study participation. Utilizing various social media platforms, it ispossible to crowdsource urine samples from across the United States quickly,economically, and most importantly during the COVID-19 pandemic, safely. (Figure Presented).
ABSTRACT
The Administration has employed the Defense Production Act of 1950 (DPA) as part of federal countermeasures to the Coronavirus Disease 2019 (COVID-19) pandemic. The DPA confers presidential authorities to mobilize domestic industry in service of the national defense, broadly defined, including emergency preparedness. The DPA includes provisions under Title I to prioritize the acceptance of contracts, and to allocate scarce goods, materials, and services;and under Title III, to provide for the expansion of productive capacity. Title VII provides definitions and other supporting provisions.