Technical guidance on HIV counseling

Recommendations for HIV testing services for inpatients and outpatients in acute-care hospital settings / John W. Ward, Robert S. Janssen, Harold W. Jaffe, James W. Curran -- Technical guidance on HIV counselingThese recommendations update previous recommendations regarding human immunodeficiency virus (HIV) counseling and testing of patients in acute-care hospital settings (1). The revision was prompted by additional information regarding both the rates at which patients admitted to some acute-care hospitals have unrecognized HIV infection and the potential medical and public health benefits of recognizing HIV infection in persons who have not developed acquired immunodeficiency syndrome.Includes bibliographical references.Infectious DiseaseDiagnosisSupersede

Background brief on the prevention benefits of HIV treatment

The advent in 1996 of potent combination antiretroviral therapy (ART), sometimes called HAART (highly active antiretroviral therapy) or cART (effective combination antiretroviral therapy), changed the course of the HIV epidemic. These "cocktails" of three or more antiretroviral drugs used in combination gave patients and scientists new hope for fighting the epidemic and have significantly improved life expectancy-to decades rather than months. For many years, scientists believed that treating HIV-infected persons also significantly reduced their risk of transmitting the infection to sexual and drug-using partners who did not have the virus. The circumstantial evidence was substantial, but no one had conducted a randomized clinical trial--the gold standard for proving an intervention works. That changed in 2011 with the publication of findings from_the HIV Prevention Trials Network (HPTN) 052 study, a randomized clinical trial designed in part to evaluate whether the early initiation of ART can prevent the sexual transmission of HIV among heterosexual couples in which one partner is HIV-infected and the other is not. This landmark study validated that early HIV treatment has a profound prevention benefit: results showed that the risk of transmitting HIV to an uninfected partner was reduced by 96%.Introduction - Putting treatment as prevention in perspective - Test and treat - Challenges and the future of HIV prevention - What CDC is doingJanuary 2013CS237317.Mode of access: World Wide Web as an Acrobat .pdf file (333.37 KB, 4 p.).Includes bibliographical references (p. 3-4)

HIV in the United States

"CDC estimates 1.2 million people in the United States (US) are living with HIV infection. One in five (20%) of those people are unaware of their infection. Despite increases in the total number of people in the US living with HIV infection in recent years, the annual number of new HIV infections has remained relatively stable. However, new infections continue at far too high of a level, with approximately 50,000 Americans becoming infected with HIV each year. In 2009, an estimated 42,011 people were diagnosed with HIV infection in the 40 states with confidential name-based HIV infection reporting since at least January 2006. In that same year, an estimated 34,247 people throughout the US (50 states and the District of Columbia) were diagnosed with AIDS. Since the epidemic began, an estimated 1,108,611 people in the US have been diagnosed with AIDS. More than 16,000 people with AIDS were estimated to have died in 2008, and nearly 594,500 people with AIDS in the US have died since the epidemic began." - p. 1"November 2011."Mode of access: World Wide Web as an Acrobat .pdf file (447 KB, 2 p.).Text (PDF), graphic

National Network of Prevention Training Centers

I. Letter from the Capacity Building Branch Chief -- II. Preface -- III. Overview -- Capacity building assistance (CBA) providers -- V. National Network of Prevention Training Centers (NNPTCs) -- VI. Abbreviations -- VII. GlossaryContinues the 2010 Capacity building assistance (CBA) grantee directory."CS210362-B."Available via the World Wide Web as an Acrobat .pdf file (3.54 MB, 177 p.)

HIV among African Americans

African Americans have the most severe burden of HIV of all racial/ethnic groups in the United States. Compared with other races and ethnicities, African Americans account for a higher proportion of HIV infections at all stages of disease- from new infections to deaths.Fast facts -- The numbers -- Prevention challenges-- What CDC is doingFebruary 2013.CS237630.Available via the World Wide Web as an Acrobat .pdf fiel (312.96 KB, 2 p.)

Male circumcision

This fact sheet summarizes information in four areas of male circumcision: 1) male circumcision and risk for HIV transmission; 2) male circumcision and other health conditions; 3) risks associated with male circumcision; and 4) status of HIV infection and male circumcision in the United States.8/17/12- date from document propertiesCS223432-A.Mode of access: Internet as an Acrobat .pdf file (261 KB, 8 p.).Includes bibliographical references (p. 5-8)

HIV and TB

"June 2011."Mode of access: World Wide web.Text (PDF), graphic

Medical Monitoring Project

"Problem: As of December 31, 2008, an estimated 663,084 persons were living with a diagnosis of human immunodeficiency virus (HIV) infection in the 40 U.S. states that have had confidential name-based HIV infection reporting since at least January 2006. Although HIV surveillance programs in the United States collect information about persons who have received a diagnosis of HIV infection and acquired immunodeficiency syndrome (AIDS), supplemental surveillance projects are needed to collect information about care-seeking behaviors, health-care use, and other behaviors among persons living with HIV. Data on the clinical and behavioral characteristics of persons receiving medical care for HIV infection are critical to reduce HIV-related morbidity and mortality and for program planning to allocate services and resources, guide prevention planning, assess unmet medical and ancillary service needs, and help develop intervention programs and health policies at the local, state, and national levels. Reporting Period Covered: Data were collected during June 2007-September 2008 for patients who received medical care in 2007 (sampled from January 1-April 30). Description of the System: The Medical Monitoring Project (MMP) is an ongoing, multisite supplemental surveillance project that assesses behaviors, clinical characteristics, and quality of care of HIV-infected persons who are receiving medical care. Participants must be aged >18 years and have received medical care at sampled facilities that provide HIV medical care within participating MMP project areas. Self-reported behavioral and selected clinical data are collected using an in-person interview. A total of 26 project areas in 19 states and Puerto Rico were funded to collect data during the 2007 MMP data collection cycle. Results: The results from the 2007 MMP cycle indicated that among 3,643 participants, a total of 3,040 (84%) had some form of health insurance or coverage during the 12 months before the interview; of these, 45% reported having Medicaid, 37% reported having private health insurance or coverage through a health maintenance organization, and 30% reported having Medicare. A total of 3,091 (85%) of the participants were currently taking antiretroviral medications. Among 3,609 participants who reported ever having a CD4 T-lymphocyte test, 2,996 (83%) reported having three or more CD4 T-lymphocyte tests in the 12 months before the interview. Among 3,567 participants who reported ever having an HIV viral load test, 2,946 (83%) reported having three or more HIV viral load tests in the 12 months before the interview. Among 3,643 participants, 45% needed HIV case management, 33% needed mental health counseling, and 32% needed assistance finding dental services during the 12 months before the interview; 8%, 13%, and 25% of these participants who needed the services, respectively, had not received these services by the time of the interview. Noninjection drugs were used for nonmedical purposes by 1,117 (31%) participants during the 12 months before the interview, and 122 (3%) participants had used injection drugs for nonmedical purposes. Unprotected anal intercourse was reported by 527 (54%) of 970 men who reported having anal sex with a man during the 12 months before the interview. Unprotected anal or vaginal intercourse was reported by 176 (32%) of the 553 men who reported having anal or vaginal intercourse with a woman during the 12 months before the interview. Unprotected anal or vaginal intercourse was reported by 216 (42%) of the 516 women who reported having anal or vaginal intercourse with a man during the 12 months before the interview. Interpretation: The findings in this report indicate that in 2007, most persons with HIV infection who were receiving medical care were taking antiretroviral therapy and had some form of health insurance or coverage; however, some persons were not receiving needed critical ancillary services, such as HIV case management or help finding dental services. In addition, some persons living with HIV infection engaged in behaviors, such as unprotected sex, that increase the risk for transmitting HIV to sexual partners, and some used noninjection or injection drugs for nonmedical purposes, which might decrease adherence to antiretroviral therapy and increase health-risk behaviors. Public Health Actions: MMP data can be used to monitor the national HIV/AIDS strategy goal of increasing access to care and optimizing health outcomes among persons living with HIV. Persons infected with HIV who are not receiving needed ancillary services highlight missed opportunities for access to care and other supportive services, information that can be used to advocate for additional resources. Drug use among persons with HIV infection underscores the continued need for substance abuse treatment services for this population. In addition, prevention services and programs are needed to decrease the number of HIV-infected persons engaging in unprotected sex. The data in this report can be included in local, state, and national HIV/AIDS epidemiologic profiles and shared with community stakeholders. Although data from the 2007 MMP cycle might not be representative of all persons receiving medical care for HIV infection in the United States or in the individual project areas, future MMP cycles are expected to yield weighted national estimates representing all HIV-infected persons receiving medical care in the United States." - p. 1[Janet M. Blair, A .D. McNaghten, Emma L. Frazier, Jacek Skarbinski, Ping Huang, James D. Heffelfinger ; Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC ; Northrop Grumman, Atlanta, Georgia].Cover title."September 2, 2011.""U.S. Government Printing Office: 2011-723-011/21066, Region IV"--P. [4] of cover.Also available via the World Wide Web as an HTML file or as an Acrobat .pdf file (428.41 KB, 20 p.).Includes bibliographical references (p. 11-12)

HIV prevention progress in the United States

"The Centers for Disease Control and Prevention (CDC) works with other federal agencies, state and local health departments, national organizations, community-based organizations, the private sector, and advocates to reduce the spread of HIV in the U.S. This work encompasses many components, such as: Behavioral interventions, which have proven effective in reducing the risk of acquiring or transmitting HIV. Ensuring people have the information, motivation, and skills necessary to reduce their risk continues to be important. HIV testing, which is critical in preventing the spread of HIV. Most people change behaviors to protect their partners if they know they are infected with HIV. Linkage to treatment and care, which enables individuals with HIV to live longer, healthier lives and reduce their risk of transmitting HIV. It is imperative that individuals with HIV know their HIV status and are linked to ongoing care and prevention services." - p. 1"July 2010."Mode of access: World Wide web.Text (PDF), graphic

HIV testing trends in the United States, 2000-2011

The purpose of this report is to examine HIV testing trends from 2000 to 2011 in the United States in order to consider the impact of CDC's Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings and other factors that may influence HIV testing. This report provides results of the analysis of four data sources (Behavioral Risk Factor Surveillance System (BRFSS), National Health and Nutrition Examination Survey (NHANES), National Health Interview Survey (NHIS), and Youth Risk Behavior Survey (YRBS)) containing HIV testing information for having ever been tested and tested in the last 12 months for HIV among adults, adolescents, and pregnant women, nationally and by state-level Expanded Testing Initiative funding status. SAS version 9.3 and SUDAAN were used in order to account for the complex sample designs. The analyses included descriptive statistics and linear regression modeling to determine if a significant change in testing occurred between the first and last years of data analyzed. Despite increased testing among some populations, testing in the last 12 months, testing among adolescents, and testing among pregnant women did not change significantly. HIV testing is emphasized in the National HIV/AIDS Strategy (NHAS) and the Division of HIV/AIDS Prevention (DHAP) Strategic Plan. One of the targets set forth in the NHAS and the DHAP Strategic Plan is to increase the percentage of people who are living with HIV who know their serostatus from 79% to 90% by 2015. Monitoring and evaluating HIV testing, nationally and at the state-level, is necessary to monitor progress toward this goal and to ensure HIV testing resources are targeted to and reaching persons who are unaware of their infection.Executive summary -- Introduction -- Methodology -- Results -- Commentary -- References -- Appendix A: Results by data source -- Appendix B: Variables and questions from data sourcesReport prepared by: Michelle Van Handel, Christopher Johnson.January 2013.Mode of access: World Wide Web as an Acrobat .pdf file (1.05 MB, 40 p.).Inludes bibliographical reference (p. 17).Centers for Disease Control and Prevention. HIV Testing Trends in the United States, 2000-2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; January 2013