82 research outputs found
HIV and Mass Incarceration: Where Infectious Diseases and Social Justice Meet
More than 1% of all adults in the United States are currently in a jail or prison. This mass incarceration, particularly of African American men, fosters conditions that facilitate the spread of HIV in communities where both HIV and incarceration are endemic. Recognition of the role of mass incarceration in the perpetuation of the HIV epidemic is essential to development of effective HIV prevention policies
Screening of genital fluid for Ebola virus
Moses Soka and colleagues (October,
2016)1 describe their semen testing
programme for survivors of Ebola
virus disease. This programme
provides an important service to male
survivors of this disease in Liberia;
however, we are concerned that the
real-time RT-PCR assay used might
not be validated for the detection of
Ebola virus in semen. Although the
assay was granted emergency use
authorisation by the US Food and
Drug Administration for the detection
of Ebola virus RNA in blood, plasma,
serum, and urine, Soka and colleagues
do not include supporting data for the
use of this assay with semen
Inadequate HIV care after incarceration: case closed
At any given moment, one in 99 adults in the USA
are behind bars in prisons and jails, often for offenses
related to the use or sale of illicit substances.1 This mass
incarceration overwhelmingly affects racial and ethnic
minority men; the lifetime risk of incarceration is more
than 30% for African-American men, compared with
17% for white men.2 Drug laws that strictly penalise
the possession, use, and sale of illicit substances, and
the less overt targeting of minorities for search and
arrest, have led to people with HIV infection also being
disproportionately incarcerated
Moving Lassa Fever Research and Care into the 21st Century
Lassa fever, a viral hemorrhagic disease, is
a growing threat to public health in West
Africa and beyond. While Ebola virus disease
(EVD) recently captured the attention
of the global community, Lassa fever arguably
represents an even more concerning
cause of viral hemorrhagic fever (VHF).
Unlike EVD, which causes sporadic outbreaks,
Lassa virus (LASV) is endemic in
West Africa and is responsible for an estimated
300 000 infections and >5000 deaths
annually—figures that are likely underestimates,
given the challenge of collecting
epidemiologic data due to civil conflict
and limited clinical research infrastructure
in endemic countries
Responding to the global threat of high-consequence pathogens: Protecting health care workers and caring for patients
In the 40 years since the discovery of the
Ebola virus, there have been 24 outbreaks,
none of which has ever infected more
than 450 people at a time (1). The 2014 to
2016 epidemic, which spread quickly across
West Africa, infected more than 28,000
people and killed at least 11,000, quickly
eclipsing all previous outbreaks combined.
What was initially believed to be an isolated
outbreak in Guinea crossed international
borders for the first time, sparking
outbreaks in neighboring Sierra Leone
and Liberia and even in noncontiguous
countries such as Nigeria, Senegal, and
Mali. Sporadic cases among travelers
returning from the region to North
America or Europe elicited tremendous
fear and exposed significant underlying
susceptibilities within the North American
and European infection control systems (1).
Ebola has put the world on notice that
rapid globalization has connected
communities in such a way that emerging
infectious diseases, once categorized as
“tropical” in nature, are now worldwide
threats that require urgent global responses
Reply
To the Editors:
In their letter, Drobeniuc and
Spaulding question the selected analytic
approach to our randomized controlled
trial of a comprehensive intervention to
maintain plasma HIV RNA suppression
after prison release. Specifically, issue is
taken with the use of an intent-to-treat
analysis comparing the rates of virologic
suppression at 24 weeks after prison
release between the 2 study arms
Great Expectations: HIV Risk Behaviors and Misperceptions of Low HIV Risk among Incarcerated Men
Incarcerated populations have relatively high HIV prevalence but little has been reported about their aggregate HIV risk behaviors or perceptions of risk. A random selection of HIV-negative men (n = 855) entering a US state prison system were surveyed to assess five risk behaviors and his self-perceived HIV risk. Using multivariate logistic regression, we identified factors associated with having elevated actual but low perceived risk (EALPR). Of the 826 men with complete data, 88% were at elevated risk. While 64% of the sample had risk perceptions concordant with their actual risk, 14% had EALPR (with the remainder at low actual but high perceived risk). EALPR rates were lower in those with a pre-incarceration HIV test but higher for those with a negative prison entry HIV test. HIV testing counseling should assess for discordance between actual and perceived risk and communicate the continued risk of HIV despite a negative result
Outpatient Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 Infection to Prevent Coronavirus Disease 2019 Progression
As of March 2021, coronavirus disease 2019 (COVID-19) had caused more than 123 million infections and almost 3 million deaths worldwide. Dramatic advances have been made in vaccine development and nonpharmaceutical interventions to stop the spread of infection. However, treatments to stop disease progression are limited. A wide variety of "repurposed"drugs evaluated for treatment of COVID-19 have had little or no benefit. More recently, intravenous monoclonal antibody (mAb) combinations have been authorized by the US Food and Drug Administration for emergency use for outpatients with mild to moderate COVID-19 including some active against emerging severe acute respiratory syndrome coronavirus 2 variants of concern. Easier to administer therapeutics including intramuscular and subcutaneous mAbs and oral antivirals are in clinical trials. Reliable, safe, effective COVID-19 treatment for early infection in the outpatient setting is of urgent and critical importance. Availability of such treatment should lead to reduced progression of COVID-19
Group sex event participation: A link to STI risk among African-American heterosexual men incarcerated in North Carolina
Group sex events (GSEs) among heterosexuals
and other groups may facilitate STI
transmission by contributing to rapid
partner exchange and links to high-risk
partners
Detection of undiagnosed HIV among state prison entrants
substantial proportion of individuals infected with the human
immunodeficiency virus (HIV) in the United States enter
a correctional facility annually.1,2 Therefore, incarceration
presents an opportunity for HIV detection. Even thoughmany
states have adopted policies of mass HIV screening of
inmates,2-4 the extent to which HIV testing on prison entry detects
new infections is unclear
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