Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Am J Prev Med ; 61(5 Suppl 1): S151-S159, 2021 11.
Article in English | MEDLINE | ID: mdl-34686284

ABSTRACT

INTRODUCTION: The Ending the HIV Epidemic in the U.S. initiative considers cluster and outbreak response essential. This article describes the design, implementation, and early findings of a Philadelphia-based project to systematically assess sentinel cases among priority populations for improving public health infrastructure and preventing future outbreaks. METHODS: Sentinel HIV cases (i.e., early-stage or acute infection or molecular cluster cases) were identified among priority populations (Black and Hispanic/Latino men who have sex with men, youth aged 18-24 years, and transgender people who have sex with men). Chart abstraction and structured interview data were reviewed to determine themes and service gaps and to identify, prioritize, and implement recommendations. Interdisciplinary review teams included individuals with lived experience, frontline staff, and local agency leadership. RESULTS: Data were collected during July 2019-December 2020 and analyzed for 53 of 126 sentinel cases of HIV diagnosed since July 1, 2018. The majority were men who have sex with men (79.3%), those aged 18-24 years (67.9%), and non-Hispanic Black (67.9%). More than half received sexually transmitted infection and HIV testing ≤3 years preceding HIV diagnosis (56.6% and 54.7%, respectively), had a healthcare visit within 12 months before diagnosis (64.2%), and had no evidence of pre-exposure prophylaxis awareness (58.5%). Project recommendations effectuated actions to improve pre-exposure prophylaxis provision, integrate sexually transmitted infection and HIV testing, and educate primary care providers. CONCLUSIONS: HIV sentinel case review is a model for health departments to rapidly respond to recent transmission, identify missed HIV prevention opportunities, strengthen community partnerships, and implement programmatic and policy changes. Such efforts may prevent outbreaks and inform longer-term strategies.


Subject(s)
HIV Infections , Sexual and Gender Minorities , Adolescent , Disease Outbreaks/prevention & control , Female , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Philadelphia/epidemiology
2.
J Infect Dis ; 222(Suppl 5): S250-S258, 2020 09 02.
Article in English | MEDLINE | ID: mdl-32877552

ABSTRACT

BACKGROUND: In 2018, Philadelphia identified an outbreak of new human immunodeficiency virus (HIV) infections among persons who inject drugs (PWID). Although conventional HIV surveillance systems capture individual-level behavioral risk, they are not able to capture the social and environmental factors contributing to rapid transmission. METHODS: HIV surveillance data were used to assess demographic, clinical, and behavioral factors for PWID with HIV diagnosed during 2017 and 2018. Social factors such as homelessness, disruption of encampments, and trends in sexual behaviors, drug use and syringe availability among PWID were captured through National HIV Behavioral Surveillance, routine hepatitis and sexually transmitted infection surveillance, and shelter and homeless outreach data. RESULTS: In 2018, there were 71 new infections among PWID, an increase of 115% since 2016. During this time, opioid overdose deaths peaked at 59 deaths per 100 000 persons, 85% of which involved the use of fentanyl. While overall reported homelessness increased, rates of those living unsheltered rose by 13%. The Philadelphia Department of Public Health identified increased injection frequency, encampment closures, and lack of syringe access as promoters of continued HIV transmission. CONCLUSION: The use of conventional surveillance methods only is inadequate for determining HIV risk during outbreaks. Incorporation of individual and aggregate level data on social and environmental determinants is necessary to develop effective outbreak response interventions.


Subject(s)
Disease Outbreaks/prevention & control , Drug Users/psychology , HIV Infections/epidemiology , Risk-Taking , Substance Abuse, Intravenous/complications , Adolescent , Adult , Cohort Studies , Death Certificates , Disease Outbreaks/statistics & numerical data , Drug Overdose/mortality , Drug Users/statistics & numerical data , Epidemiological Monitoring , Female , HIV Infections/prevention & control , HIV Infections/transmission , Ill-Housed Persons/psychology , Ill-Housed Persons/statistics & numerical data , Humans , Male , Middle Aged , Philadelphia/epidemiology , Risk Factors , Social Determinants of Health/statistics & numerical data , Socioeconomic Factors , Substance Abuse, Intravenous/epidemiology , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL
...