Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA

Marks, Gary; Crepaz, Nicole; Janssen, Robert S.

doi:10.1097/01.aids.0000233579.79714.8d

Cited by 973 publications

(744 citation statements)

References 12 publications

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“…They are also less likely to take precautions to avoid transmitting HIV to others. Potentially, individuals who are unaware of their HIV-infected status may account for 54%-70% of all new sexually transmitted HIV infections in the United States of America (Marks et al, 2006). There is a special need for targeted interventions that are specifically designed for Aboriginal youth, especially women.…”

Section: Brazil's Dual Emphasis On Prevention and Treatment Has Helpementioning

confidence: 99%

Grand challenges in chronic non-communicable diseases

Daar

Сингер

Persad

et al. 2007

Nature

552

379

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Section: Brazil's Dual Emphasis On Prevention and Treatment Has Helpementioning

confidence: 99%

Grand challenges in chronic non-communicable diseases

Daar

Сингер

Persad

et al. 2007

Nature

552

379

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“…The CDC has estimated that the approximately 25% of HIV-infected persons who are unaware of their infection account for 54% of new infection transmissions. 17 It is estimated that knowledge of HIV serostatus in unaware persons could reduce new infections by greater than 30%. A recent meta-analysis estimated that unprotected anal or vaginal intercourse with HIV-seronegative partners was reduced by 68% among HIVinfected persons who knew of their positive serostatus compared with those who were unaware.…”

Section: Individuals With Dates Of Initial Hiv Diagnosis In Southmentioning

confidence: 99%

Risk-Based HIV Testing in South Carolina Health Care Settings Failed to Identify the Majority of Infected Individuals

Duffus

Weis

Kettinger

et al. 2009

AIDS Patient Care and STDs

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To provide evidence of large numbers of missed opportunities for early HIV diagnosis we designed a retrospective cohort study linking surveillance data from the South Carolina HIV=AIDS Reporting System to a statewide all payer health care database. We determined visits and diagnoses occurring before the date of the first positive HIV test and medical encounters were categorized to distinguish visits that were likely versus unlikely to have prompted an HIV test. Of the 4117 HIV-positive individuals newly diagnosed between 2001 and 2005, 3021 (73.4%) visited a South Carolina health care facility one or more times prior to testing HIV positive. Of these 3021, 1311 (43.4%) were late testers, and 1425 (47.2%) were early testers. Females were less likely than males to be late testers (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.45-0.68), blacks were more likely than whites to be late testers (OR 1.37, 95% CI 1.10-1.71), and persons 50 years of age and older more likely to be late testers (OR 7.16,. A total of 78.8% of the 13,448 health care visits for both late and early testers were for health care diagnoses unlikely to prompt an HIV test. These findings underscore the need for more routine HIV testing of adults and adolescents visiting health care facilities in order to facilitate early diagnosis.

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“…This is especially important for 2 reasons: late diagnosis and under-diagnosis of HIV are concentrated in racial-ethnic minorities, the elderly, and other potentially vulnerable populations; 1 and the estimated one quarter of infected patients who are unaware of their status are believed to account for 50-70% of new (sexually acquired) infections. 7,8 However, much is unknown about current HIV care delivery, namely: (1) whether and how HIV providers are meeting patients' primary care needs; and (2) how structures and models of care can be improved to combine HIV-specific expertise with comprehensiveness, continuity, coordination, and accessibility-four key elements of primary care.…”

mentioning

confidence: 99%

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

2011

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Since the beginning of the AIDS epidemic, models of HIV care have needed to be invented or modified as the needs of patients and communities evolved. Early in the epidemic, primary care and palliative care predominated; subsequently, the emergence of effective therapy for HIV infection led to further specialization and a focus on increasingly complex antiretroviral therapy as the cornerstone of effective HIV care. Over the past decade, factors including (1) an aging, long-surviving population; (2) multiple co-morbidities; (3) polypharmacy; and (4) the need for chronic disease management have led to a need for further evolution of HIV care models. Moreover, geographic diffusion; persistent disparities in timely HIV diagnosis, treatment access, and outcomes; and the aging of the HIV provider workforce also suggest the importance of reincorporating primary care providers into the spectrum of HIV care in the current era. Although some HIV-dedicated treatment centers offer comprehensive medical services, other models of HIV care potentially exist and should be developed and evaluated. In particular, primary care-and community-based collaborative practices-where HIV experts or specialists are incorporated into existing health centers-are one approach that combines the benefits of HIV-specific expertise and comprehensive primary care using an integrated, patient-centered approach.

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Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA

Abstract: The results indicate that the HIV/AIDS epidemic can be lessened substantially by increasing the number of HIV-positive persons who are aware of their status.

Cited by 973 publications

References 12 publications

Grand challenges in chronic non-communicable diseases

Grand challenges in chronic non-communicable diseases

Risk-Based HIV Testing in South Carolina Health Care Settings Failed to Identify the Majority of Infected Individuals

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

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