Base de dados : MEDLINE
Pesquisa : Doenças and Sexualmente and Transmissíveis [Palavras]
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  1 / 20200 MEDLINE  
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[PMID]:22183836
[Au] Autor:Mayer KH; Bush T; Henry K; Overton ET; Hammer J; Richardson J; Wood K; Conley L; Papp J; Caliendo AM; Patel P; Brooks JT; SUN Investigators
[Ad] Endereço:Brown University and Miriam Hospital, Providence, RI, USA. Khmayer@gmail.com
[Ti] Título:Ongoing sexually transmitted disease acquisition and risk-taking behavior among US HIV-infected patients in primary care: implications for prevention interventions.
[So] Source:Sex Transm Dis;39(1):1-7, 2012 Jan.
[Is] ISSN:1537-4521
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To better understand the factors associated with HIV- and sexually transmitted disease (STD)-transmitting behavior among HIV-infected persons, we estimated STD prevalence and incidence and associated risk factors among a diverse sample of HIV-infected patients in primary care. METHODS: We analyzed data from 557 participants in the SUN Study, a prospective observational cohort of HIV-infected adults in primary care in 4 US cities. At enrollment and 6 months thereafter, participants completed an audio computer-assisted self-interview about their sexual behavior, and were screened for genitourinary, rectal, and pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections by nucleic acid amplification testing, and for serologic evidence of syphilis. Women provided cervicovaginal samples and men provided urine to screen for Trichomonas vaginalis by polymerase chain reaction. RESULTS: Thirteen percent of participants had a prevalent STD at enrollment and 7% an incident STD 6 months later. The most commonly diagnosed infections were rectal chlamydia, oropharyngeal gonorrhea, and chlamydial urethritis among the men and trichomoniasis among the women. Other than trichomoniasis, 94% of incident STDs were identified in men who have sex with men. Polysubstance abuse other than marijuana, and having ≥4 sex partners in the 6 months before testing were associated with diagnosis of an incident STD. CONCLUSIONS: STDs were commonly diagnosed among contemporary HIV-infected patients receiving routine outpatient care, particularly among sexually active men who have sex with men who used recreational drugs. These findings underscore the need for frequent STD screening, prevention counseling, and substance abuse treatment for HIV-infected persons in care.
[Mh] Termos MeSH primário: Infecções por HIV/complicações
Doenças Sexualmente Transmissíveis/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Terapia Antirretroviral de Alta Atividade
Doenças Assintomáticas
Centers for Disease Control and Prevention (U.S.)
Estudos de Coortes
Feminino
Seguimentos
Infecções por HIV/quimioterapia
Infecções por HIV/epidemiologia
Infecções por HIV/virologia
Homossexualidade Masculina
Humanos
Incidência
Masculino
Meia-Idade
Prevalência
Atenção Primária à Saúde
Estudos Prospectivos
Fatores de Risco
Assunção de Riscos
Comportamento Sexual
Doenças Sexualmente Transmissíveis/complicações
Doenças Sexualmente Transmissíveis/quimioterapia
Doenças Sexualmente Transmissíveis/prevenção & controle
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Em] Mês de entrada:1405
[Cu] Atualização por classe:140919
[Lr] Data última revisão:
140919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:111220
[St] Status:MEDLINE
[do] DOI:10.1097/OLQ.0b013e31823b1922


  2 / 20200 MEDLINE  
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[PMID]:24411488
[Au] Autor:Althaus CL; Turner KM; Mercer CH; Auguste P; Roberts TE; Bell G; Herzog SA; Cassell JA; Edmunds WJ; White PJ; Ward H; Low N
[Ad] Endereço:Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland....
[Ti] Título:Effectiveness and cost-effectiveness of traditional and new partner notification technologies for curable sexually transmitted infections: observational study, systematic reviews and mathematical modelling.
[So] Source:Health Technol Assess;18(2):1-100, vii-viii, 2014 Jan.
[Is] ISSN:2046-4924
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Partner notification is essential to the comprehensive case management of sexually transmitted infections. Systematic reviews and mathematical modelling can be used to synthesise information about the effects of new interventions to enhance the outcomes of partner notification. OBJECTIVE: To study the effectiveness and cost-effectiveness of traditional and new partner notification technologies for curable sexually transmitted infections (STIs). DESIGN: Secondary data analysis of clinical audit data; systematic reviews of randomised controlled trials (MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials) published from 1 January 1966 to 31 August 2012 and of studies of health-related quality of life (HRQL) [MEDLINE, EMBASE, ISI Web of Knowledge, NHS Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA)] published from 1 January 1980 to 31 December 2011; static models of clinical effectiveness and cost-effectiveness; and dynamic modelling studies to improve parameter estimation and examine effectiveness. SETTING: General population and genitourinary medicine clinic attenders. PARTICIPANTS: Heterosexual women and men. INTERVENTIONS: Traditional partner notification by patient or provider referral, and new partner notification by expedited partner therapy (EPT) or its UK equivalent, accelerated partner therapy (APT). MAIN OUTCOME MEASURES: Population prevalence; index case reinfection; and partners treated per index case. RESULTS: Enhanced partner therapy reduced reinfection in index cases with curable STIs more than simple patient referral [risk ratio (RR) 0.71; 95% confidence interval (CI) 0.56 to 0.89]. There are no randomised trials of APT. The median number of partners treated for chlamydia per index case in UK clinics was 0.60. The number of partners needed to treat to interrupt transmission of chlamydia was lower for casual than for regular partners. In dynamic model simulations, >10% of partners are chlamydia positive with look-back periods of up to 18 months. In the presence of a chlamydia screening programme that reduces population prevalence, treatment of current partners achieves most of the additional reduction in prevalence attributable to partner notification. Dynamic model simulations show that cotesting and treatment for chlamydia and gonorrhoea reduce the prevalence of both STIs. APT has a limited additional effect on prevalence but reduces the rate of index case reinfection. Published quality-adjusted life-year (QALY) weights were of insufficient quality to be used in a cost-effectiveness study of partner notification in this project. Using an intermediate outcome of cost per infection diagnosed, doubling the efficacy of partner notification from 0.4 to 0.8 partners treated per index case was more cost-effective than increasing chlamydia screening coverage. CONCLUSIONS: There is evidence to support the improved clinical effectiveness of EPT in reducing index case reinfection. In a general heterosexual population, partner notification identifies new infected cases but the impact on chlamydia prevalence is limited. Partner notification to notify casual partners might have a greater impact than for regular partners in genitourinary clinic populations. Recommendations for future research are (1) to conduct randomised controlled trials using biological outcomes of the effectiveness of APT and of methods to increase testing for human immunodeficiency virus (HIV) and STIs after APT; (2) collection of HRQL data should be a priority to determine QALYs associated with the sequelae of curable STIs; and (3) standardised parameter sets for curable STIs should be developed for mathematical models of STI transmission that are used for policy-making. FUNDING: The National Institute for Health Research Health Technology Assessment programme.
[Mh] Termos MeSH primário: Busca de Comunicante/economia
Doenças Sexualmente Transmissíveis/prevenção & controle
Medicina Estatal/economia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Busca de Comunicante/métodos
Análise Custo-Benefício
Feminino
Reino Unido/epidemiologia
Humanos
Masculino
Modelos Biológicos
Modelos Estatísticos
Anos de Vida Ajustados por Qualidade de Vida
Recidiva/prevenção & controle
Doenças Sexualmente Transmissíveis/economia
Doenças Sexualmente Transmissíveis/epidemiologia
Medicina Estatal/normas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1409
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140113
[St] Status:MEDLINE
[do] DOI:10.3310/hta18020


  3 / 20200 MEDLINE  
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[PMID]:24237008
[Au] Autor:Poteat T; Logie C; Adams D; Lebona J; Letsie P; Beyrer C; Baral S
[Ad] Endereço:a Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA.
[Ti] Título:Sexual practices, identities and health among women who have sex with women in Lesotho - a mixed-methods study.
[So] Source:Cult Health Sex;16(2):120-35, 2014.
[Is] ISSN:1464-5351
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Despite the high prevalence of HIV and STIs among women in Africa and the growing literature on HIV and STIs among women who have sex with women, research on the sexual health of women who have sex with women in Africa is scant. This study used mixed methods to describe sexual identity, practices and health among women who have sex with women in Lesotho. Most respondents (48%) described themselves as lesbian, 29% as bisexual and 23% as heterosexual. Almost half (45%) had disclosed their same-sex attraction to family, but only 25% had done so with healthcare workers. A total of 8% reported having HIV. Self-reported HIV was associated with having three or more male partners, having male and female partners at the same time and having a history of STIs. Gender norms, the criminalisation of homosexuality, varied knowledge of, and access to, safer-sex strategies, and mixed experiences of HIV/STI testing and sexual healthcare provided social and structural contexts for HIV- and STI-related vulnerability.
[Mh] Termos MeSH primário: Bissexualidade
Identidade de Gênero
Infecções por HIV
Homossexualidade Feminina
Saúde Reprodutiva
Comportamento Sexual
Mulheres
[Mh] Termos MeSH secundário: Adolescente
Adulto
Pesquisa Participativa Baseada na Comunidade
Estudos Transversais
Feminino
Humanos
Lesoto
Meia-Idade
Pesquisa Qualitativa
Sexo Seguro
Parceiros Sexuais
Doenças Sexualmente Transmissíveis
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1409
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140113
[St] Status:MEDLINE
[do] DOI:10.1080/13691058.2013.841291


  4 / 20200 MEDLINE  
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[PMID]:24236895
[Au] Autor:McClarty LM; Bhattacharjee P; Blanchard JF; Lorway RR; Ramanaik S; Mishra S; Isac S; Ramesh BM; Washington R; Moses S; Becker ML
[Ad] Endereço:a Department of Community Health Sciences , University of Manitoba , Winnipeg , Canada.
[Ti] Título:Circumstances, experiences and processes surrounding women's entry into sex work in India.
[So] Source:Cult Health Sex;16(2):149-63, 2014.
[Is] ISSN:1464-5351
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Evidence suggests that in India, the early stages of a woman's career as a sex worker may be an important period to target for HIV and sexually transmitted infection prevention. Before such an intervention is designed and implemented, it is necessary to first understand the life circumstances of women at the start of their sex work careers. We performed a review to bring together available literature pertaining to entry into sex work in India and to highlight knowledge gaps. We found that historical traditions of dedication into sex work, financial insecurity, family discord, violence and coercion, and desire for financial independence are commonly reported reasons for entering into sex work. We also found that families and the broader sex worker community play an important role in the early stages of a woman's sex work career. We suggest that HIV-prevention programmes in India would substantially benefit from a deeper understanding of the life circumstances of new and young women sex workers. Further research should be conducted focusing on family and community involvement in women's entry into sex work, and on the important period of time after a woman's first commercial sex encounter, but before self-identification as a sex worker.
[Mh] Termos MeSH primário: Conflito Familiar
Pobreza
Prostituição
Violência
Mulheres
[Mh] Termos MeSH secundário: Coerção
Feminino
Infecções por HIV/prevenção & controle
Tráfico de Pessoas
Humanos
Índia
Profissionais do Sexo
Doenças Sexualmente Transmissíveis/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1409
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140113
[St] Status:MEDLINE
[do] DOI:10.1080/13691058.2013.845692


  5 / 20200 MEDLINE  
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[PMID]:24405570
[Au] Autor:Kaltenthaler E; Pandor A; Wong R
[Ad] Endereço:School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
[Ti] Título:The effectiveness of sexual health interventions for people with severe mental illness: a systematic review.
[So] Source:Health Technol Assess;18(1):1-74, 2014 Jan.
[Is] ISSN:2046-4924
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Severe mental illnesses (SMIs), such as schizophrenia and bipolar disorder, persist over time and can cause extensive disability leading to impairments in social and occupational functioning. People with SMI have higher morbidity and mortality due to physical illness than the general population and may be more likely to engage in high-risk sexual behaviour (e.g. unprotected intercourse, having multiple partners, involvement in the sex trade and illicit drug use), putting them at risk of poorer sexual health outcomes including sexually transmitted infections. Sexual health promotion interventions, developed and implemented for people with SMI, may improve participants' knowledge, attitudes, beliefs or behavioural practices and could lead to a reduction in risky sexual behaviour. OBJECTIVES: To evaluate the effectiveness of sexual health interventions for people with SMI compared with usual care and their applicability to the UK NHS setting. DATA SOURCES: Thirteen electronic databases were searched from inception to December 2012. All controlled trials (randomised or non-randomised) that met the following criteria were included: any sexual health promotion intervention or combination of interventions intended to change the knowledge, attitudes, beliefs, behaviours or practices of individuals with SMI (defined as adults aged ≥ 18 years who have received a diagnosis of schizophrenia or bipolar disorder) living in the community. REVIEW METHODS: A systematic review of the clinical evidence was undertaken following recommended guidelines. Data were tabulated and discussed in a narrative review. RESULTS: Thirteen randomised controlled studies met the inclusion criteria. The methodological quality of the included studies varied considerably, with only a minority of studies (n = 2) being considered as having very few methodological limitations. Despite wide variations in the study populations, interventions, comparators and outcomes, four studies showed significant improvements in all measured sexual risk behaviour outcomes (e.g. human immunodeficiency virus knowledge and behaviour change) in the intervention groups compared with the control groups. In contrast, four studies found significant improvements in the intervention groups for some outcomes only and three studies found significant improvements in certain subgroups only, based on either gender or ethnicity. Finally, two studies reported no significant differences in any sexual risk behaviour outcomes between the intervention and control groups. Moreover, positive findings were not consistently sustained at follow-up in many studies. LIMITATIONS: Little detail was provided in the studies regarding the content of interventions, how they were delivered and by whom, making replication or generalisability difficult. CONCLUSIONS: Owing to the large between-study variability (especially in the populations, interventions, comparators and reported outcomes) and mixed results, there is insufficient evidence to fully support or reject the identified sexual health interventions for people with SMI. In addition, there are considerable uncertainties around the generalisability of these findings to the UK setting. Further research recommendations include well-designed, UK-based trials of sexual health interventions for people with SMI as well as training and support for staff implementing sexual health interventions. STUDY REGISTRATION: PROSPERO number CRD42013003674. FUNDING: The National Institute for Health Research Health Technology Assessment Programme.
[Mh] Termos MeSH primário: Promoção da Saúde/métodos
Transtornos Mentais/psicologia
Saúde Reprodutiva/educação
Comportamento Sexual/psicologia
Doenças Sexualmente Transmissíveis/prevenção & controle
Medicina Estatal/economia
[Mh] Termos MeSH secundário: Adulto
Análise Custo-Benefício
Bases de Dados Bibliográficas
Feminino
Reino Unido
Promoção da Saúde/economia
Humanos
Masculino
Transtornos Mentais/economia
Transtornos Mentais/reabilitação
Meia-Idade
Saúde Reprodutiva/economia
Índice de Gravidade de Doença
Doenças Sexualmente Transmissíveis/complicações
Doenças Sexualmente Transmissíveis/economia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1409
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140110
[St] Status:MEDLINE
[do] DOI:10.3310/hta18010


  6 / 20200 MEDLINE  
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[PMID]:24188607
[Au] Autor:Schott CK; Lo B
[Ad] Endereço:Departments of Emergency Medicine and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
[Ti] Título:Reply to drs. Hafner and Schaefer.
[So] Source:J Emerg Med;46(1):84, 2014 Jan.
[Is] ISSN:0736-4679
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Técnicas de Tipagem Bacteriana
Infecções por Chlamydia/microbiologia
Chlamydia trachomatis/isolamento & purificação
Gonorreia/microbiologia
Neisseria gonorrhoeae/isolamento & purificação
Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico
Doenças Vaginais/microbiologia
[Mh] Termos MeSH secundário: Feminino
Humanos
[Pt] Tipo de publicação:COMMENT; LETTER
[Em] Mês de entrada:1409
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:131224
[St] Status:MEDLINE


  7 / 20200 MEDLINE  
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[PMID]:24188598
[Au] Autor:Hafner JW; Schaefer TJ
[Ti] Título:Sensitivity and specificity of the vaginal wet prep.
[So] Source:J Emerg Med;46(1):83-4, 2014 Jan.
[Is] ISSN:0736-4679
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Técnicas de Tipagem Bacteriana
Infecções por Chlamydia/microbiologia
Chlamydia trachomatis/isolamento & purificação
Gonorreia/microbiologia
Neisseria gonorrhoeae/isolamento & purificação
Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico
Doenças Vaginais/microbiologia
[Mh] Termos MeSH secundário: Feminino
Humanos
[Pt] Tipo de publicação:COMMENT; LETTER
[Em] Mês de entrada:1409
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:131224
[St] Status:MEDLINE


  8 / 20200 MEDLINE  
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[PMID]:24112441
[Au] Autor:Taylor D; Lunny C; Wong T; Gilbert M; Li N; Lester R; Krajden M; Hoang L; Ogilvie G
[Ad] Endereço:BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4, Canada. Carole.Lunny@bccdc.ca.
[Ti] Título:Self-collected versus clinician-collected sampling for sexually transmitted infections: a systematic review and meta-analysis protocol.
[So] Source:Syst Rev;2:93, 2013.
[Is] ISSN:2046-4053
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Three meta-analyses and one systematic review have been conducted on the question of whether self-collected specimens are as accurate as clinician-collected specimens for STI screening. However, these reviews predate 2007 and did not analyze rectal or pharyngeal collection sites. Currently, there is no consensus on which sampling method is the most effective for the diagnosis of genital chlamydia (CT), gonorrhea (GC) or human papillomavirus (HPV) infection. Our meta-analysis aims to be comprehensive in that it will examine the evidence of whether self-collected vaginal, urine, pharyngeal and rectal specimens provide as accurate a clinical diagnosis as clinician-collected samples (reference standard). INCLUSION AND EXCLUSION CRITERIA: Eligible studies include both randomized and non-randomized controlled trials, pre- and post-test designs, and controlled observational studies. SEARCH STRATEGY: The databases that will be searched include the Cochrane Database of Systematic Reviews, Web of Science, Database of Abstracts of Reviews of Effects (DARE), EMBASE and PubMed/Medline. DATA COLLECTION AND ANALYSIS: Data will be abstracted independently by two reviewers using a standardized pre-tested data abstraction form. Heterogeneity will be assessed using the Q2 test. Sensitivity and specificity estimates with 95% confidence intervals as well as negative and positive likelihood ratios will be pooled and weighted using random effects meta-analysis, if appropriate. A hierarchical summary receiver operating characteristics curve for self-collected specimens will be generated. DISCUSSION: This synthesis involves a meta-analysis of self-collected samples (urine, vaginal, pharyngeal and rectal swabs) versus clinician-collected samples for the diagnosis of CT, GC and HPV, the most prevalent STIs. Our systematic review will allow patients, clinicians and researchers to determine the diagnostic accuracy of specimens collected by patients compared to those collected by clinicians in the detection of chlamydia, gonorrhea and HPV.
[Mh] Termos MeSH primário: Metanálise como Assunto
Projetos de Pesquisa
Literatura de Revisão como Assunto
Doenças Sexualmente Transmissíveis/diagnóstico
Manejo de Espécimes/métodos
[Mh] Termos MeSH secundário: Feminino
Humanos
Masculino
Faringe/microbiologia
Reto/microbiologia
Autocuidado
Doenças Sexualmente Transmissíveis/microbiologia
Doenças Sexualmente Transmissíveis/urina
Manejo de Espécimes/normas
Vagina/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1409
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:131115
[St] Status:MEDLINE
[do] DOI:10.1186/2046-4053-2-93


  9 / 20200 MEDLINE  
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[PMID]:25038358
[Au] Autor:Marrazzo JM; del Rio C; Holtgrave DR; Cohen MS; Kalichman SC; Mayer KH; Montaner JS; Wheeler DP; Grant RM; Grinsztejn B; Kumarasamy N; Shoptaw S; Walensky RP; Dabis F; Sugarman J; Benson CA; International Antiviral Society-USA Panel
[Ad] Endereço:University of Washington, Seattle....
[Ti] Título:HIV prevention in clinical care settings: 2014 recommendations of the International Antiviral Society-USA Panel.
[So] Source:JAMA;312(4):390-409, 2014 Jul 23-30.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:IMPORTANCE: Emerging data warrant the integration of biomedical and behavioral recommendations for human immunodeficiency virus (HIV) prevention in clinical care settings. OBJECTIVE: To provide current recommendations for the prevention of HIV infection in adults and adolescents for integration in clinical care settings. DATA SOURCES, STUDY SELECTION, AND DATA SYNTHESIS: Data published or presented as abstracts at scientific conferences (past 17 years) were systematically searched and reviewed by the International Antiviral (formerly AIDS) Society-USA HIV Prevention Recommendations Panel. Panel members supplied additional relevant publications, reviewed available data, and formed recommendations by full-panel consensus. RESULTS: Testing for HIV is recommended at least once for all adults and adolescents, with repeated testing for those at increased risk of acquiring HIV. Clinicians should be alert to the possibility of acute HIV infection and promptly pursue diagnostic testing if suspected. At diagnosis of HIV, all individuals should be linked to care for timely initiation of antiretroviral therapy (ART). Support for adherence and retention in care, individualized risk assessment and counseling, assistance with partner notification, and periodic screening for common sexually transmitted infections (STIs) is recommended for HIV-infected individuals as part of care. In HIV-uninfected patients, those persons at high risk of HIV infection should be prioritized for delivery of interventions such as preexposure prophylaxis and individualized counseling on risk reduction. Daily emtricitabine/tenofovir disoproxil fumarate is recommended as preexposure prophylaxis for persons at high risk for HIV based on background incidence or recent diagnosis of incident STIs, use of injection drugs or shared needles, or recent use of nonoccupational postexposure prophylaxis; ongoing use of preexposure prophylaxis should be guided by regular risk assessment. For persons who inject drugs, harm reduction services should be provided (needle and syringe exchange programs, supervised injection, and available medically assisted therapies, including opioid agonists and antagonists); low-threshold detoxification and drug cessation programs should be made available. Postexposure prophylaxis is recommended for all persons who have sustained a mucosal or parenteral exposure to HIV from a known infected source and should be initiated as soon as possible. CONCLUSIONS AND RELEVANCE: Data support the integration of biomedical and behavioral approaches for prevention of HIV infection in clinical care settings. A concerted effort to implement combination strategies for HIV prevention is needed to realize the goal of an AIDS-free generation.
[Mh] Termos MeSH primário: Infecções por HIV/diagnóstico
Infecções por HIV/prevenção & controle
HIV-1
[Mh] Termos MeSH secundário: Adolescente
Adulto
Antirretrovirais/uso terapêutico
Aconselhamento
Feminino
Infecções por HIV/quimioterapia
Redução do Dano
Humanos
Masculino
Profilaxia Pós-Exposição
Risco
Comportamento de Redução do Risco
Doenças Sexualmente Transmissíveis/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Retroviral Agents)
[Em] Mês de entrada:1408
[Cu] Atualização por classe:140917
[Lr] Data última revisão:
140917
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:140720
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2014.7999


  10 / 20200 MEDLINE  
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[PMID]:24368468
[Au] Autor:Bachhuber MA; Cunningham CO
[Ad] Endereço:Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, New York.
[Ti] Título:Changes in testing for human immunodeficiency virus, sexually transmitted infections, and hepatitis C virus in opioid treatment programs.
[So] Source:JAMA;310(24):2671-2, 2013 Dec 25.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Infecções por HIV/diagnóstico
Hepatite C/diagnóstico
Transtornos Relacionados ao Uso de Opioides
Doenças Sexualmente Transmissíveis/diagnóstico
Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos
[Mh] Termos MeSH secundário: Feminino
Pesquisas sobre Serviços de Saúde
Humanos
Masculino
Programas de Rastreamento/tendências
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1312
[Cu] Atualização por classe:140917
[Lr] Data última revisão:
140917
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:131225
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2013.278456



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