From 2004-2008, Nevada saw a shift in the HIV/AIDS epidemic toward blacks, youth, and heterosexual adults. To effectively plan prevention and care, it is important to identify at-risk populations. The document discusses Nevada's HIV epidemiology, including increases in infections among blacks, Hispanics, youth, MSM, and older age groups. It also summarizes community input that identified priority populations as MSM, HIV-positive individuals, youth/young adults, and minorities. Goals and strategies focused on increasing awareness, testing, interventions, condom access, and linkages to care for these at-risk groups.
Friday, February 7, 2014 Nonprofit Commons was happy to feature members of the nonprofit Protect Yourself1 (PY1), Executive Director, Monique Richert (Chayenn in SL), and PY1 Development Consultant, Tom Kujawski (Incarn8 in SL) who presented facts and statistics and PY1 Safe2Live Program in support of the National Black HIV/AIDS Awareness Day.
Global Medical Cures™ | HIV Among Women
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Friday, February 7, 2014 Nonprofit Commons was happy to feature members of the nonprofit Protect Yourself1 (PY1), Executive Director, Monique Richert (Chayenn in SL), and PY1 Development Consultant, Tom Kujawski (Incarn8 in SL) who presented facts and statistics and PY1 Safe2Live Program in support of the National Black HIV/AIDS Awareness Day.
Global Medical Cures™ | HIV Among Women
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
This is technical writing Assignment, no emotions go straight to t.docxchristalgrieg
This is technical writing Assignment, no emotions go straight to the point.
Section 1: Introduction
The rise in the numbers of Human Immunodeficiency Virus (HIV) diagnoses is notable especially for racial and ethnic minority youth and adolescents aged 13 to 19 years (National Institute of Health, 2013). Approximately one half of all new HIV infections in the United States occur among person(s) younger than 25 years. Nearly 4 million new sexually transmitted infection (STI) cases each year occur among youth and adolescents (NIH, 2013). Reconciling data of 2015, 54.2% of high school students reported having sexual intercourse; of students reported sex during the previous months, 39% stated they didn’t use a condom during their last sexual encounter (United States Census Bureau, 2014). The number of sexually active among youth and adolescents, from 2001 to 2014, there’s been a significant increase in the percentage of youth and adolescents who were never taught about HIV/AIDS. Unified national HIV/AIDS surveillance system has enhanced the ability to monitor and characterize racial and ethnic minority youth populations affected by the HIV epidemic and provide information on the entire population of HIV infected persons who have been tested confidentially (NIH, 2014). Approximately 1.2 million people were living with HIV in the United States in 2014, 49% and 51% undiagnosed infections. Almost 50,000 people become newly infected each year, and in 2014, the estimated rate of diagnoses of HIV infection was 13.8 per 100,000 population (National Institute of Health, 2014). Social trust is associated with lowering the of course mortality rates and that associated HIV infection varied within racial and ethnic minority youth and adolescents. The risk factors that will be addressed in this paper are unprotected vaginal or anal sex, improving access to prevention and care services, inadequate sex education and drug use
Unprotected vaginal and anal sex
Participating in unprotected vaginal and anal sex, or sex without latex or polyurethane condoms is a major contributing factor of HIV rate in racial and ethnic minority youth and adolescents. In an infected youth or adolescents, the semen and blood contains high amount of HIV. During unprotected vaginal and anal sex HIV can easily pass from one person to another. Several studies link alcohol and drug use to higher rates of unprotected anal intercourse, higher numbers of sex partners, and inconsistent condom use (NIH, 2014). With these trends among racial and ethnic minority National HIV Behavioral Surveillance (2015) reported 21% minority youth and adolescent are infected with HIV while 79% youth and adolescent don’t know their status (National HIV Behavioral Surveillance, 2015).
Improving access to prevention and care services
Access to HIV prevention and treatment is an important step in helping achieve an HIV free generation, especially among racial and ethnic minority youth and adolescent. If someone ...
Global Medical Cures™ | HIV among YOUTH
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
America cares hiv-aids in black america#GOMOJO, INC.
Increase community awareness of HIV/AIDS and HIV prevention strategies.
Increase community understanding of the clinical research process.
Develop and strengthen relationships with community stakeholders, including (but not limited to) medical care providers, STD/HIV counseling and testing providers, faith leaders, Non Governmental Organizations and Community Based Organizations.
Increasingly, African Americans in general are recognizing that HIV is wreaking devastation across our communities. Those who have joined the fight against HIV and AIDS in Black communities are coming to understand that it is a difficult and multifaceted problem—but that it is also a winnable war. With this report, we aim to arm those people with the information they need to get there.
This is technical writing Assignment, no emotions go straight to t.docxchristalgrieg
This is technical writing Assignment, no emotions go straight to the point.
Section 1: Introduction
The rise in the numbers of Human Immunodeficiency Virus (HIV) diagnoses is notable especially for racial and ethnic minority youth and adolescents aged 13 to 19 years (National Institute of Health, 2013). Approximately one half of all new HIV infections in the United States occur among person(s) younger than 25 years. Nearly 4 million new sexually transmitted infection (STI) cases each year occur among youth and adolescents (NIH, 2013). Reconciling data of 2015, 54.2% of high school students reported having sexual intercourse; of students reported sex during the previous months, 39% stated they didn’t use a condom during their last sexual encounter (United States Census Bureau, 2014). The number of sexually active among youth and adolescents, from 2001 to 2014, there’s been a significant increase in the percentage of youth and adolescents who were never taught about HIV/AIDS. Unified national HIV/AIDS surveillance system has enhanced the ability to monitor and characterize racial and ethnic minority youth populations affected by the HIV epidemic and provide information on the entire population of HIV infected persons who have been tested confidentially (NIH, 2014). Approximately 1.2 million people were living with HIV in the United States in 2014, 49% and 51% undiagnosed infections. Almost 50,000 people become newly infected each year, and in 2014, the estimated rate of diagnoses of HIV infection was 13.8 per 100,000 population (National Institute of Health, 2014). Social trust is associated with lowering the of course mortality rates and that associated HIV infection varied within racial and ethnic minority youth and adolescents. The risk factors that will be addressed in this paper are unprotected vaginal or anal sex, improving access to prevention and care services, inadequate sex education and drug use
Unprotected vaginal and anal sex
Participating in unprotected vaginal and anal sex, or sex without latex or polyurethane condoms is a major contributing factor of HIV rate in racial and ethnic minority youth and adolescents. In an infected youth or adolescents, the semen and blood contains high amount of HIV. During unprotected vaginal and anal sex HIV can easily pass from one person to another. Several studies link alcohol and drug use to higher rates of unprotected anal intercourse, higher numbers of sex partners, and inconsistent condom use (NIH, 2014). With these trends among racial and ethnic minority National HIV Behavioral Surveillance (2015) reported 21% minority youth and adolescent are infected with HIV while 79% youth and adolescent don’t know their status (National HIV Behavioral Surveillance, 2015).
Improving access to prevention and care services
Access to HIV prevention and treatment is an important step in helping achieve an HIV free generation, especially among racial and ethnic minority youth and adolescent. If someone ...
Global Medical Cures™ | HIV among YOUTH
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
America cares hiv-aids in black america#GOMOJO, INC.
Increase community awareness of HIV/AIDS and HIV prevention strategies.
Increase community understanding of the clinical research process.
Develop and strengthen relationships with community stakeholders, including (but not limited to) medical care providers, STD/HIV counseling and testing providers, faith leaders, Non Governmental Organizations and Community Based Organizations.
Increasingly, African Americans in general are recognizing that HIV is wreaking devastation across our communities. Those who have joined the fight against HIV and AIDS in Black communities are coming to understand that it is a difficult and multifaceted problem—but that it is also a winnable war. With this report, we aim to arm those people with the information they need to get there.
Running Head: COMMUNITY ANALYSIS 1
Community Analysis
The most prevalent risk factors among racial and ethnic minorities are unprotected vaginal or anal sex, inadequate sex education, improving access to prevention and care services and drug use. Jackson, MS has a population of 173,212, with median household income of $32,250. Poverty is one of the major contributing factors to the risky behaviors and the rise of HIV infections within racial/ethnic minority youths. The residents with incomes below the poverty level in Jackson, MS by 2015 was 39.9%, and those with income below 50% of the poverty level was 19.2%, the breakdown is between ages 13 to 19 years of poor residents in Jackson, MS and the percentage is below half of poverty level of 20%. The most common race or ethnicity living below the poverty line in Jackson, MS is Black or African American, followed by White and Hispanic or Latino. The state of homelessness is on the rise and many of these shelters in Jackson, MS now have waiting lists with majority of its occupants are racial/ethnic minority. Even with the waiting lists, those that need to be sheltered will have to call ahead to confirm (City Data, 2015).
Mississippi is one of the most rustic states in the United States and its population is perhaps the poorest. According to the 2010 Census, Mississippi has a population of 2,967,297 people, with a racial distribution of 59% white, 37% black, 3% Hispanic, and 2% other. Mississippi ranks second in the nation (after the District of Columbia) for the highest proportion of African Americans. Through U.S. Census Bureau 2011 American Community Surveys, Mississippi levels the first in the country for the number of people living in poverty (22.6% of the total population) and the lowest middle household revenue ($36,919) (United State Census Bureau, 2011). According to the 2011 National HIV Surveillance Report, Mississippi had the 4th highest rate of HIV infection in the United States. The state’s capital city, Jackson, had the third highest rate of HIV diagnoses within aged 13 to 19 years and the eighth highest AIDS diagnosis by metropolitan statistical area (MSA) in 2011. For the past twenty years, numbers of peoples living with HIV in Mississippi has risen yearly. By the end of December 31, 2013, there was approximately 10,473 Mississippians living with HIV (National HIV Surveillance Report, 2013).
Secondary data
Jackson, MS the state’s capital city and with the most new HIV disease cases are identified in the West Central Public Health District V, which includes the metropolitan Jackson Hinds area, where 47% of all persons with HIV disease in Mississippi reside presently (Mississippi State Department of Health, 2015). According to data for states and metropolitan areas, it’s shown that racial and ethnic minority youths aged between 13 to 19 years rank 4th in the diagnose of HIV at 44.7%. The education b ...
The Effect Race and Income on HIV AIDS infection in African-Americans - Sunil...Sunil Nair
Race and Income has a significant influence on susceptibility to HIV/AIDS infections; Afro-Americans (Blacks) are 1.33 times more likely to be infected than whites. A significant finding is that the income level didn't change race's effect on HIV infections. Race has a significant effect on HIV infections or is an important predictor of incidence of HIV infections independent of the income. In other words, irrespective of the income level being black and poor increases the changes of being infected with HIV/AIDS.
Hiv Prevention Nevada #ENDHIV #AIDSFREE#GOMOJO, INC.
Quality Management
The Nevada Ryan White Part B Program is committed to improving the quality of care and services for persons living with HIV and AIDS through continuous quality monitoring and improvement in a comprehensive performance measurement program.
NEVADA STATEWIDE HIV CONTINUUM OF CARE
The Nevada Statewide HIV Care Continuum and HIV Fast Facts shows all HIV/AIDS positive persons in the State of Nevada. This data includes persons who are engaged in care either in private clinics or a Ryan White Program, as well as, persons who are not engaged in care or not connected to a Ryan White Program.
Nevada Statewide HIV Continuum of Care 2017
Nevada Statewide HIV Continuum of Care 2016
2017 HIV Fast Facts
NEVADA RYAN WHITE PART B HIV CONTINUUM OF CARE
The Nevada Ryan White Part B Program HIV Care Cascade shows HIV/AIDS positive persons who have engaged in care and received at lease one service from the Nevada Ryan White Part B Program during the reported year.
HIV Care Cascade Calendar Year 2017
HIV Prevention Data Calendar Year 2017
NEVADA RYAN WHITE PART B QUALITY MANAGEMENT
The mission of the Nevada Ryan White Part B Program Quality Management Program is to improve access and ensure the highest quality medical care and supportive services through continuous evaluation, strategic planning and assessment, and the implementation of quality management and quality improvement projects.
Quality Management Plan 2018-2019
Quality Plan Performance Review 2018 Mid-Year Report
Calendar Year 2018 Reports
Viral Suppression by Disparities CY 2018- Age
Viral Suppression by Disparities CY 2018- Gender
Viral Suppression by Disparities CY 2018- HIV Risk Factor
Viral Suppression by Disparities CY 2018- Housing Status
Viral Suppression by Disparities CY 2018- Race and Ethnicity
Viral Suppression by Disparities CY 2018- All Disparity Data
Viral Suppression by Disparities CY 2018- ADAP Assistance
Grant Year 2018-2019 Mid-Year Reports
Viral Suppression by Disparities 2018 Mid-Year Report
Viral Suppression by Disparities 2018 Mid-Year Report-Age
Viral Suppression by Disparities 2018 Mid-Year Report-Gender
Viral Suppression by Disparities 2018 Mid-Year Report-HIV Risk Factor
Viral Suppression by Disparities 2018 Mid-Year Report-Housing
Viral Suppression by Disparities 2018 Mid-Year Report-Race and Ethnicity
Ryan White Part B Calendar Year 2017 Statistics
If you have any questions concerning Quality Management, please contact the person(s) below:
Samantha Penn, MBA
Management Analyst I
(Quality Assurance & Evaluation Analyst)
Phone: (702) 486-8103
Email: spenn@health.nv.gov
Core practices that are moving from a pilot state to implementation at scale: Many of the
barriers facing HIV programs are common across countries. PEPFAR’s ECTs (described below in
Sections 2.3.2 and 2.3.3) identified common issues affecting countries at various levels of
epidemic control and then developed a compendium of evidence-based solutions, approaches
and case-studies that highlight successful means of addressing common barriers. Additional
evidence-based approaches and case-studies will be incorporated into this living compendium
over time. As highlighted in this PEPFAR Solutions Platform, these practices can be rapidly
adapted and scaled to move countries forward.
Key considerations for all PEPFAR programs include:
• Bringing Interventions to Scale with Fidelity: Getting to HIV epidemic control is dependent on
several factors; not the least of which is the ability to rapidly scale successful interventions with
fidelity and demonstrated impact. However, the logistics of cost- effective programmatic scale
have proven challenging, with several implementation barriers. Implementation science
defines scalability as the capacity to expand or extend an intervention to account for a growth
factor that aims to fill a gap or address unmet need in a defined population group/geographic
area.
• Data and Information Technology: The enabling environment for data and information
technology is rapidly maturing across countries, creating space, opportunity, and needed
political will to harness the Data Revolution for epidemic control. OUs should consider
innovative ways to use data and information technology to improve efficiency and
sustainability in achieving epidemic control, beyond immediate PEPFAR indicator data
collection needs. As highlighted in the Data Revolution Innovation Toolkit, available on the
PEPFAR SharePoint, OUs are encouraged to explore, adapt, and scale these and other data
driven approaches to move country epidemic control forward.
Nevada profile 2015 stda re'port for cdc#GOMOJO, INC.
Core practices that are moving from a pilot state to implementation at scale: Many of the
barriers facing HIV programs are common across countries. PEPFAR’s ECTs (described below in
Sections 2.3.2 and 2.3.3) identified common issues affecting countries at various levels of
epidemic control and then developed a compendium of evidence-based solutions, approaches
and case-studies that highlight successful means of addressing common barriers. Additional
evidence-based approaches and case-studies will be incorporated into this living compendium
over time. As highlighted in this PEPFAR Solutions Platform, these practices can be rapidly
adapted and scaled to move countries forward.
Key considerations for all PEPFAR programs include:
• Bringing Interventions to Scale with Fidelity: Getting to HIV epidemic control is dependent on
several factors; not the least of which is the ability to rapidly scale successful interventions with
fidelity and demonstrated impact. However, the logistics of cost- effective programmatic scale
have proven challenging, with several implementation barriers. Implementation science
defines scalability as the capacity to expand or extend an intervention to account for a growth
factor that aims to fill a gap or address unmet need in a defined population group/geographic
area.
• Data and Information Technology: The enabling environment for data and information
technology is rapidly maturing across countries, creating space, opportunity, and needed
political will to harness the Data Revolution for epidemic control. OUs should consider
innovative ways to use data and information technology to improve efficiency and
sustainability in achieving epidemic control, beyond immediate PEPFAR indicator data
collection needs. As highlighted in the Data Revolution Innovation Toolkit, available on the
PEPFAR SharePoint, OUs are encouraged to explore, adapt, and scale these and other data
driven approaches to move country epidemic control forward.
Nevada state health division screen shot of site #GOMOJO, INC.
Nevada Prevention and Care Programs
Core practices that are moving from a pilot state to implementation at scale: Many of the
barriers facing HIV programs are common across countries. PEPFAR’s ECTs (described below in
Sections 2.3.2 and 2.3.3) identified common issues affecting countries at various levels of
epidemic control and then developed a compendium of evidence-based solutions, approaches
and case-studies that highlight successful means of addressing common barriers. Additional
evidence-based approaches and case-studies will be incorporated into this living compendium
over time. As highlighted in this PEPFAR Solutions Platform, these practices can be rapidly
adapted and scaled to move countries forward.
Key considerations for all PEPFAR programs include:
• Bringing Interventions to Scale with Fidelity: Getting to HIV epidemic control is dependent on
several factors; not the least of which is the ability to rapidly scale successful interventions with
fidelity and demonstrated impact. However, the logistics of cost- effective programmatic scale
have proven challenging, with several implementation barriers. Implementation science
defines scalability as the capacity to expand or extend an intervention to account for a growth
factor that aims to fill a gap or address unmet need in a defined population group/geographic
area.
• Data and Information Technology: The enabling environment for data and information
technology is rapidly maturing across countries, creating space, opportunity, and needed
political will to harness the Data Revolution for epidemic control. OUs should consider
innovative ways to use data and information technology to improve efficiency and
sustainability in achieving epidemic control, beyond immediate PEPFAR indicator data
collection needs. As highlighted in the Data Revolution Innovation Toolkit, available on the
PEPFAR SharePoint, OUs are encouraged to explore, adapt, and scale these and other data
driven approaches to move country epidemic control forward.
Core practices that are moving from a pilot state to implementation at scale: Many of the
barriers facing HIV programs are common across countries. PEPFAR’s ECTs (described below in
Sections 2.3.2 and 2.3.3) identified common issues affecting countries at various levels of
epidemic control and then developed a compendium of evidence-based solutions, approaches
and case-studies that highlight successful means of addressing common barriers. Additional
evidence-based approaches and case-studies will be incorporated into this living compendium
over time. As highlighted in this PEPFAR Solutions Platform, these practices can be rapidly
adapted and scaled to move countries forward.
Key considerations for all PEPFAR programs include:
• Bringing Interventions to Scale with Fidelity: Getting to HIV epidemic control is dependent on
several factors; not the least of which is the ability to rapidly scale successful interventions with
fidelity and demonstrated impact. However, the logistics of cost- effective programmatic scale
have proven challenging, with several implementation barriers. Implementation science
defines scalability as the capacity to expand or extend an intervention to account for a growth
factor that aims to fill a gap or address unmet need in a defined population group/geographic
area.
• Data and Information Technology: The enabling environment for data and information
technology is rapidly maturing across countries, creating space, opportunity, and needed
political will to harness the Data Revolution for epidemic control. OUs should consider
innovative ways to use data and information technology to improve efficiency and
sustainability in achieving epidemic control, beyond immediate PEPFAR indicator data
collection needs. As highlighted in the Data Revolution Innovation Toolkit, available on the
PEPFAR SharePoint, OUs are encouraged to explore, adapt, and scale these and other data
driven approaches to move country epidemic control forward.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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State of nevada historical stats
1. STATE OF NEVADA HISTORICAL
STATS
2004-2008
a shift in the HIV/AIDS epidemic toward, Blacks, youth, and heterosexual adults.
To plan for HIV prevention and care and to allocate limited resources as the epidemic
continues to change and the number of persons living with HIV continues to grow, it is
extremely important to identify those populations most affected and most at risk for HIV
infection.
2. CDC’s HIV Prevention Community Planning Guidance there are
three goals in community planning:
• The community planning process supports a
broad-based community participation in HIV
prevention planning.
• Community planning identifies priority HIV
prevention needs in each jurisdiction.
• Community planning ensures that HIV
prevention resources target priority
populations and interventions set forth in the
comprehensive HIV prevention plan.
3. What is a Comprehensive HIV Prevention Plan?
NEVADANS
The primary responsibility of a CPG is to develop a
comprehensive HIV prevention plan that includes prioritized
target populations, community services assessment, gap
analysis, and effective activities/interventions targeting the
priority populations. The priority populations are determined
based on epidemiological data and on the ability to provide
the greatest impact on the number of new HIV infections.
This plan assists local health authorities and state policy
makers on making health care decisions to best meet the
needs of its citizens.
4. How Does Nevada rank?
According to Henry J. Keiser Family Foundation Health Statistics (2007), Nevada ranked 26th
in the nation for the number of new AIDS cases; the annual AIDS case rate for males was higher
than the national AIDS case rate (25.6 vs. 22.9); ranking males 10th in the nation for AIDS cases
in Nevada. Additionally, Nevada ranked 29th in the nation among HIV Infection Cases Reported
among States with Confidential Name-Based Reporting, 2007 (1=High, 51=Low).
5.
6. Figure 5:
From 2004 to 2008, the number of new HIV
infections increased among males.
In 2008, the number of new HIV infections
among males was 368; representing a 9%
increase since 2004.
The most significant increase was from 2004
to 2005, followed by a steady decline.
From 2004 to 2008, the number of new HIV
infections decreased among females.
In 2008, the number of new HIV infections
among females was 67; representing a 22%
decrease since 2004.
7. increased
among Blacks
and Hispanics.
declined
among Whites
Figure 6:
• In 2008, the number of new
infections among Whites was
191; representing a 15%
decrease since 2004.
• In 2008, new infections among
Blacks was 116 and 107 among
Hispanics; representing a 13%
and 25% increases since 2004,
respectively. Among all other
races there were no significant
changes from 2004 to 2008.
Asian/Pacific Is23
From 2004 to 2008, the number of
new HIV infections
8. Figure 7: In 2008, there were no new HIV infections among individuals less than 13
years old. From 2004 to 2008, the number of new HIV infections increased most
significantly among 13-24 and 25-34.
In 2008, the number of new infections among individuals 13-24 was 64 and among 25
to 34 years olds was 120; representing a 15% and 9% increase since
2004, respectively.
9. Figure 8: MSM accounted for more than two thirds (67%) of the new HIV infections in
Nevada in 2008. MSM increased 11% annually from 2004 to 2008. Although
heterosexual contact only accounted for 18% of the new HIV infections in 2008, it
increased from 53 cases in 2004 to 80 in 2008; representing a 51% increase.
10. Annual number of Persons Living with
HIV/AIDS BY SEX 2004-2008
• Figure 9: From 2004 to 2008, the
number of males living with HIV/AIDS
in Nevada increased 27% from 5,210
cases in 2004 to 6,617 in 2008.
• Among females living with HIV/AIDS
in Nevada, in 2004 there were 1,051
females living with HIV/AIDS in
Nevada and in 2008 there were
1,323; representing a 6% increase.
• Although a greater proportion of the
male cases are AIDS compared to
females; for both males and females,
there was a greater increase among
HIV (not AIDS) compared to AIDS
cases from 2004 to 2008.
• This could suggest improved case
management.
11. From 2004 to 2008, among persons
living with HIV in Nevada
The most significant increase (with the exception of multi-race with an 83% annual increase) was among API, which
increased 59% from 113 cases living with HIV/AIDS in 2004 to 180 in 2008
Whites which
increased 20%
among the
Persons living
with HIV/AIDS
American
Indians/Alaskan
Natives, which
increased 21%,
Blacks, which
increased 28%,
Hispanics which
increased 44%
12. Annual number of persons living with HIV/AIDS Nevada
by age at diagnosis 2004-2008
Figure 11: Among persons living with HIV/
AIDS in Nevada there was an upward trend
in all age groups. The most significant annual
increases were among 55-64 year olds which
increased from 161 cases in 2004 to 274 cases
in 2008; representing a 70% increase.
This was followed by 13-24 year olds which
increased
44%, 45-54 year olds which increased
36%, 35-44 year olds which increased 27%, less
than 13 year olds increased 25%, and 25-34 year
olds increased 16% from 2004 to 2008 among
persons living with HIV/AIDS in Nevada.
These trends show that individuals are living
longer with HIV/AIDS as we are seeing
a significant increase among older individuals.
MSM and IDU have increased 7% and 12%
respectively during this time period. Perinatal
exposure has increased 22% from 2004-
2008, though there were no positive perinatal
HIV cases in 2008.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24. Participants in the MSM focus groups (N=96)
also completed an anonymous quantitative
survey that assessed demographics, sexual
and drug risk behaviors, and HIV testing history.
Because little is known about use of the
internet and HIV risk among MSM in Nevada,
sexual behavior questions were asked separately
for partners met online and those met
offline. In addition, patterns of internet use
(number of hours spent online per week and
websites most commonly used) and attitudes
about online HIV prevention were assessed.
RESULTS
Sexual Behaviors and Use of the Internet
Half the participants reported using the internet
to meet sex partners during the past six
months and 60% met partners offline (bars,
clubs, friends, or organizations) (Figure 79).
Over one fifth of MSM who used the internet
to meet sex partners the past six months said
they spend 10 hours or more searching for
partners online each week (Figure 80).
25.
26. Over half (58%) of participants believed that internet sites used to meet sex partners do not
have
enough HIV/STD information and 56% said that they would use a website for MSM who are
only
interested in having safe sex.
27. Overall, there were not large differences
between
in the number of partners that participants
reported meeting online compared to
offline during the past six months (Figure 79).
However, consistent condom use was much
less frequent when MSM had sex with online
partners compared to offline partners:
receptive
anal sex (53% vs. 74%), insertive anal sex
(54.5% vs. 69%), and oral sex (3% vs. 25.5%).
28.
29.
30.
31.
32.
33. Youth (13-24) accounted for 15% (n=60), and there were no new HIV cases among individuals less than 13 years of age.
Overall, half of the new HIV infections among
Whites are among youth and young adults
(13-34 year olds); however, upward trends
over the past five years suggest that older
White individuals are experiencing increases
in new HIV infections in Nevada.
Youth ages 13-24 accounted for 19% of the new HIV infections among BlacksYouth ages 13-24 accounted for
19% of the new HIV infections among Blacks,
15% were 45-54, 11% were 55-64, and about
1% were above 65 years of age at the time of
HIV diagnosis.
Overall, half of the new HIV infections among
Hispanics are among youth and young adults
(13-34 year olds); 14% were 13-24 and 36%
were 25-34. From 2004-2008 the number of
new HIV infections among Hispanic youth (13-
24) experienced the most notable increase;
10 cases in this group in 2004 to 15 cases in
2008, a 50% increase.
In 2008, 16% of the new HIV infections among
the MSM risk group were among youth 13-24
years of age.
34. Youth and Young Adults are defined as those between the ages of 13
and 34.
The two subpopulations among this priority group would be:
1. MSM Youth and Young Adults, ages 13 – 34
2. Heterosexual Youth and Young Adults, ages 13 – 34
Key focus areas within this population would include:
1. Youth/Young Adults who seek out sexual partners via the
internet, including
• chats rooms and
• classified postings.
2. Youth/Young Adults engaging in high-risk sexual activity under the
influence of alcohol and/or drugs. Special emphasis should be placed
on minority populations, with a special emphasis on AfricanAmerican
and Latino/a groups, who are disproportionately affected by HIV.
35. Young people in the United States are at persistent risk for HIV
infection. This risk is especially notable for youth of minority
races and ethnicities.
Continual HIV prevention outreach and education
efforts, including programs on abstinence and on delaying the
initiation of sex, are required as new generations replace the
generations that benefited from earlier prevention strategies.
Unless otherwise noted, youth are persons who are 13–24 years
of age.
In Nevada, the proportion of youth living with HIV/AIDS in 2008
was 15% of the total; moreover, the prevalence rate of persons
living with HIV/AIDS between 13-24 was 175.0 per 100,000
population.
Additionally, the rate of new HIV infections among this age
group was 13.6 per 100,000 population. From 2004 to 2008
there has been a 12% annual increase in number of new HIV
infections among youth in Nevada. In 2008, the majority (94%)
of the new HIV infections among youth were in Clark County and
from 2004 to 2008 increased 20% in this area.
In 2008, only 5% of the Whites and Blacks each made up more
than one-third (34%) of the new HIV infections among youth in
Nevada; Hispanics accounted for 23% of the new HIV
infections, those who identified as multi-race accounted for
6%, and APIs accounted for 2% in 2008. Hispanics experienced
the greatest increase in number of new HIV infections among
youth, from 2004 to 2008 there was a 50% annual increase
among this group.
36.
37. Description and Justification of
Priority Populations
Special emphasis should be placed on
minority populations, with a special
emphasis on African-American And
Latino/a groups, who are
disproportionately affected by HIV.
HIV+
Due to increase in treatment options for
individuals infected with HIV, people
have been living longer, healthier lives
with HIV and AIDS. There are
approximately 7,940 people living with
HIV/AIDS in Nevada in 2008, over
half (52 percent) of the cases are AIDS
cases.
MSM
In Nevada in 2008, 71 percent of the newly diagnosed HIV infections had a primary risk of MSM. Over the past five years (2005-
2008), the number of newly diagnosed cases reporting MSM as primary risk factor has increased 33 percent. Although Whites
accounted for the greatest proportion of new cases among MSM, Nevada is experiencing significant increases among new MSM
cases for both Blacks and Hispanics. Additionally, over half (60 percent) of the persons identified living with HIV and AIDS in
Nevada reported MSM as the primary risk of transmission. The high prevalence of HIV among gay and bisexual men means
MSM are at elevated risk for being exposed to the infection during each sexual encounter. Therefore, MSM was determined to
be the top priority population for the Nevada State HIV Prevention plan due to the rates of HIV infection among this population.
Key focus areas within this population would
include:
1. MSM who seek out sexual partners via the
internet, including chats rooms and classified
postings (ie:
craigslist.org, gay.com, manhunt.net, etc)
2. Partners of MSM, including female sex
partners of non-identifying MSM
3. MSM engaging in high-risk sexual activity
under the influence of Alcohol and/or drugs.
38. Key questions included:
• Which populations are being served?
• Which populations are not being served?
• Which populations are hardest to reach?
• What key behaviors are placing individuals at risk for HIV?
• What barriers exist that prevent individuals from protecting themselves
against HIV?
• Which HIV prevention services in the community are effective?
• Which HIV prevention services do individuals need that are not available or
accessible?
The community services assessment attempts to answer these questions while
creating a picture of
the HIV prevention needs in Nevada and serving as a guide for identifying and
setting HIV prevention
priorities.
The community services assessment is comprised of three key parts:
• Needs Assessment
• Resource Inventory
• Gap Analysis
39. GOAL ONE
Increase the number of people receiving HIV prevention awareness and
education messages throughout Nevada, with a special emphasis on identified
target populations.
GOAL TWO
Increase the number of people receiving HIV testing services throughout
Nevada, with a special emphasis on identified target populations.
GOAL THREE
Increase the community capacity to provide referrals, supportive services, and
linkages to care to those community
40. BEHAVIORAL INTERVENTIONS
Target Population Intervention Type
Men who have Sex with
Men (MSM)*
*includes partners and
internet
Many Men Many Voices
D-Up: Defend Yourself
Mpowerment
Promise
Project Explore
HIV Positive*
*includes partners
Changes Project
Holistic Health Recovery
Willow
Healthy Relationship
Partnership for Health
Clear
Injection Drug Users MIP: Modelo de Intervención Psicomedica
Safety Counts
Shield
Real Men Are Safe: REMAS
Youth/Young Adults* * includes MSM and Heterosexual
Sihle: Sisters Informing, Healing, Living,
and Empowering
Focus on Youth
Be Proud, Be Responsible
Street Smart
Draw the Line, Respect the Line
Together Learning Choices
41. STRATEGIES
1. Increase the availability and reach of media campaigns
2. Increase the availability of online interventions
3. Increase the number and availability of interventions that address substance use
4. Expand the availability of free and low cost HIV testing
5. Increase condom availability and appeal
6. Increase the number and availability of youth-specific interventions
42. INCREASE THE AVAILABILITY AND REACH OF MEDIA
CAMPAIGNS
THE NEED
• Community member frustration over lack of media attention on HIV/AIDS
• Current media campaigns only target the GLBTQI community and reinforce the
stigma that associates HIV as a “gay disease”
• Pharmaceutical companies heavily promote HIV as a manageable chronic disease
• Sexuality and condom use still portrayed as negative, dirty, and unhealthy.
INCREASE THE AVAILABILITY AND REACH OF MEDIA CAMPAIGNS
THE CURRENT RESOURCES
NEVADANS WORKING TOGETHER | SECTION
Print (Q Vegas, LV Weekly),
Online (twitter, facebook), Promo
Materials
South
MSM, Y/YA
Narrowcast Campaign:
Print
South
MSM, Y/YA
43. THE CURRENT RESOURCES
EZ 2 Stop Campaign:
Online
(twitter, facebook, myspace)
South
MSM, Y/YA
WELLcumReno Campaign:
Online (gay.com, manhunt.net)
Website
North
MSM
Spread Negativity Campaign:
Website
North
Y/YA
InSpot:
Website
Statewide
HIV+, Y/YA, MSM
Disease Investigation
Profiles:
gay.com, adam4adam, manhunt,
facebook, myspace
South
MSM, Y/YA, HIV+
Peer Education Profiles:
gay.com, manhunt, adam4adam,
facebook, myspace
Statewide
MSM, Y/YA
GYT Campaign:
Print, Online (facebook,
myspace), Television, Promotional
Statewide
Y/YA
Bang It Out Safely Campaign:
Promotional
South
Y/YA
WELLcumReno Campaign:
Print, Online (gay.com, manhunt.net),
Website, Promotional
North
MSM
TurnOnReno Campaign:
Print, Online (myspace), Promotional
North
Y/YA
Spread Negativity Campaign:
Print, Website, Promotional
North
Y/YA
InSpot:
Website, Promotional
Statewide
HIV+, Y/YA, MSM
Step Up, Get Tested Campaign:
Print, Promotional
North
Y/YA (African American)
44. INCREASE THE AVAILABILITY AND REACH OF MEDIA
CAMPAIGNS
THE GAPS
• No current media campaigns targeting injection drug users
• Campaigns targeting specific minority communities and HIV+
populations need to be expanded
• No current radio campaigns and limited television marketing
• No current campaigns that feature celebrities, athletes, and
politicians getting tested for HIV
• No current campaigns that demonstrate that while HIV can be treated
effectively, living with
HIV is not easy and drugs have many side effects.
• Expand media campaigns to portray safe sex in a healthy, fun, sexy way
• Reinforce safer sex messaging on a variety of media outlets to reach diverse populations,
including those with a focus on Latinos/as and African-Americans
• Encourage discussion of condoms in movies and television shows
• Develop campaigns that feature celebrities, athletes, and politicians getting tested for HIV
• Flash statistics of the number of people who are unaware of their HIV infection to reinforce
testing messages
• Create advertisements that demonstrate that while HIV can be treated effectively, living with
HIV is not easy and drugs have many side effects
• Include prevention messages in restrooms of bars/clubs, airports, and casinos
• Include information about HIV/AIDS prevention at gas stations, grocery stores, and bus stops
• Develop more HIV prevention materials in Spanish.
45. INCREASE THE AVAILABILITY
OF ONLINE INTERVENTIONS
THE NEED
• Increase in the availability and use of internet sites
and phone applications that people use for the
purpose of seeking sexual partners (ie: gay.com,
adam4adam, craigslist, grindr, etc.)
• Increase in the availability and use of social
networking and dating sites that people use for the
purpose of seeking sexual partners (ie: facebook,
myspace, match.com, etc.)
• Advances in technology allow people easier access
to meet sexual partners in a private and efficient
manner
THE GAPS
• Limited staffing for active peer education
• Limited staffing for disease investigation
• No coordinated statewide internet interventions/marketing
campaigns
• No active online intervention on craigslist
• Lack of interventions reaching out to MSM population in
non-MSM online venues
• Limited educational outreach on online sites, such as chat
room educational sessions
46. THE RECOMMENDED STRATEGIES
Increased online HIV prevention interventions may be the most efficient way to reach sexually active MSM, particularly those who do not
self-identify as gay or bisexual, as well as younger populations.
• Require users of dating or sexual networking websites to click on a pop-up that acknowledges the importance of using condoms
• Display local links for HIV testing and services on the first page of websites
• Have peer educators create profiles and respond to ads with information about where to obtain free condoms and/or free testing
• Have peer educators set up an educational profile on social networking sites and ‘friend’ others
• Create social networking profiles (myspace, facebook, twitter) that send information about HIV prevention• Have public health
professionals host live chats where individuals can ask questions about HIV and other STDs
• Display HIV risk reduction pop-ups that will catch the attention of target populations (ie: using attractive models and positive promotion
of safer sex)
• Randomly display innovative and diverse condom advertisements
• Include a standard place for HIV status disclosure on all sites
• Development of a sex-positive branding strategy that promotes safer sex and harm reduction approaches
47. INCREASE THE NUMBER AND AVAILABILITY OF YOUTH-SPECIFIC INTERVENTIONS
THE NEED
• Community frustration with the quality and content of
sexual health education that is
delivered in schools
• Urgent need to develop sexual health programs that
involve parents and include the roles of home and
community
• Youth have become de-sensitized to HIV prevention
messages
• Youth see HIV as a chronic manageable disease
• Youth are more concerned with pregnancy prevention
than HIV/STD prevention
THE GAPS
• Limited resources and programming that target youth and young adults
• Lack of coordination and collaboration with sexual health education
programming
in school districts
• Lack of parent/child intervention programs
• Lack of peer sexual health education programs for youth
• Limited support groups for HIV+ youth and youth adults
THE RECOMMENDED STRATEGIES
• Develop sexual health education programs for parents and increase parent involvement in
sexual health interventions.
• Advocate for consistent and comprehensive sexual health education programs throughout
all school districts in Nevada.
• Include a discussion of homosexuality in sexual health programs
• Address the stigma associated with discussion of sexuality, birth control and HIV/STD testing
• Create programs were HIV-positive youth share their experience with other youth
• Create a “tip sheet” on how to bring up condoms with a partner distributed at
youth-focused events
• Provide opportunities for youth to role-play condom negotiation
• Create peer education and mentorship programs for young MSM, as well as
heterosexual youth
48. EXPAND THE AVAILABILITY OF FREE AND
LOW COST HIV TESTING
THE NEED
• Community members are engaging in risky sexual
and/or needle sharing behavior; yet,
these people are not getting tested for HIV due to
barriers in cost and availability
• Minority communities, although disproportionately
at risk for HIV, report less availability of
free or low cost HIV testing options in their
communities
• The Centers for Disease Control and Prevention
recommend routine screening of HIV in
health care settings for all adults
• There is community stigma around HIV testing; HIV
testing has not yet been “normalized”
THE CURRENT RESOURCES
Free and low cost HIV testing
is available at on-site and
limited off-site locations
statewide targeting
MSM, Y/YA, and IDU.
HOPES
Rapid and Oral Standard
Free on-site testing
Free limited off-site testing
North
Washoe County Health
District
Rapid, Oral Standard, and
Blood Standard
Low cost on-site testing
Free limited off-site testing
North
Planned Parenthood
Rapid and Blood Standard
Low cost on-site testing
Statewide
Northern Nevada Outreach
Team
Oral Standard
Free limited off-site testing
North
Southern Nevada Health
District
Rapid, Oral Standard, and
Blood Standard
Low cost on-site testing
Free limited off-site testing
South
THE GAPS
• No rapid testing in the field | North
• Limited diversity in HIV testing providers |
South
• No online HIV test result options
• Limited education to providers about routine
HIV testing
• Lack of testing incentives for high risk
populations
• Limited free off-site testing outreach to
minority and heterosexual communities
THE RECOMMENDED STRATEGIES
• Offer more rapid testing to increase the number of people who receive their test results
• Offer more oral testing options to increase the number of people who are willing to test
• Test where straight-identifying people hang out (e.g., “straight” bars, clubs, and concerts) to
reach MSM who are not “out” and high-risk heterosexuals
• Encourage testing at fraternities, sororities, and the dorms
• Offer testing in more “mainstream” locations (farmers markets, grocery stores, schools)
• Encourage providers to make HIV testing a routine part of medical exams
• Increase street-based HIV testing to reach sex workers and their partners
• Encourage testing with one’s partner
• Give incentives for testing (discounted admission to shows, free drinks, vouchers for STD
screening and/or birth control)
• Offer testing at special events and/or host new community events for targeted populations
at risk (i.e., block parties, Cinco de Mayo, and community barbecues)
• Expanding testing and outreach in the jails and in collaboration with probation and parole services
49. INCREASE CONDOM AVAILABILITY AND APPEAL
THE NEED
• Community members stated lack of accessible, free
condom distribution locations
• Community stigma surrounding the purchase and/or
use of condoms result in less frequent use
• Few bars and clubs offer free condoms
• Free condoms that are available lack appeal The
Current Resources: Free, yet limited,
condom availability in the Reno and Las Vegas areas at
MSM and Y/YA targeted sites.
THE GAPS
• Lack of funding and resources for widespread condom availability
• Limited locations for free condom distribution sites
• Limited hours of operations for many free condom distribution sites
• Lack of funding and resources for “appealing” condoms
THE RECOMMENDED STRATEGIES:
• Widely distribute condoms in both gay and non-gay establishments, including mainstream
locations such as barber shops, bus stops, movie theaters, dorms, bars, and clubs
• Advertise and provide a wider variety of condoms (range of flavors, colors, sizes)
• Couple condom distribution with campaigns that promote condom use as sexy and desirable
• Advertise locations of free/reduced-cost condoms
• Have nightclub bouncers hand out condoms as people enter the establishment
• Install condom machines at bars, clubs, and gyms
• Distribute condoms at locations frequented by youth such as skate parks, schools, Boys & Girls Club
• Actively hand out condoms in places of high-risk activity
50. INCREASE THE NUMBER AND AVAILABILITY OF INTERVENTIONS
THAT ADDRESS
SUBSTANCE USE
THE GAPS
• No statewide needle exchange program
• Lack of substance use interventions in Spanish
• Lack of online substance use interventions
• Lack of coordination between substance abuse agencies
and HIV prevention efforts
THE RECOMMENDED STRATEGIES
• Implement a statewide needle exchange program
• Develop campaigns that highlight substance use as a risk factor for HIV
• Develop more substance use educational materials in Spanish
• Promote online substance abuse prevention efforts Increase the availability of
substance abuse treatment for diverse populations
• Decrease the stigma surrounding addiction
THE CURRENT
RESOURCES
Street Smart
North
Y/YA
FACT
South
Y/YA
SAPTA Testing
Sites
South
IDU
Street Outreach
(bleach kits,
disbursement and
education)
North
IDU
THE NEED
• Substance use is a growing issue in all communities
throughout Nevada
• Used syringes are being found on streets and in parks
throughout Nevada
• Community members stated that they engaged in the
“most risky” sexual behavior while
under the influence of alcohol and/or drugs
• Syringe access (needle exchange) is illegal in the state
of Nevada