Alex Shirreffs, the HIV/HCV Project Coordinator at the Philadelphia Department of Public Health, presented on Hepatitis C and HIV co-infection at the April 2017 meeting of the Positive Committee.
C-YA! Philadelphia EMA's Plan to Connect our Co-infected Community to a Cure ...Office of HIV Planning
Alex Shirreffs of the Philadelphia Department of Public Health provided this overview of the Philadelphia area's plan to end HIV and Hepatitis C coinfections to the HIV Integrated Planning Council on May 10, 2018.
HIV self-testing and linkage in Africa. The document summarizes a presentation on HIV self-testing research in Africa. It discusses (1) the need for HIV self-testing in Africa due to low testing rates and knowledge of HIV status, (2) completed and ongoing studies of HIV self-testing in various African countries, and (3) priorities for future research including improving accuracy, evaluating new models for linkage to care, and assessing implementation in different populations and settings.
The Kenya HIV Testing Services Guidelines 2015Cheryl Johnson
The document provides guidelines for HIV Testing Services in Kenya. It outlines the background of HIV testing in Kenya since the first diagnosis over 30 years ago. It notes that testing approaches have evolved from expensive laboratory tests requiring complex procedures to more simplified point-of-care testing kits, resulting in more Kenyans knowing their status. The guidelines aim to ensure quality services are provided to all clients accessing health facilities for HIV services. It emphasizes updated guidance on HIV Testing Services in line with current knowledge and the country's 90-90-90 strategy to identify people living with HIV so they can access treatment.
HIV self-testing among transgender women in San Francisco - a pilotCheryl Johnson
This pilot study explored the acceptability and feasibility of HIV self-testing among 50 transgender women in San Francisco. The results showed that HIV self-testing was found to be feasible and acceptable, with 88% returning for a follow up at least once and 72% returning at 3 months. Participants reported that using the self-test kits was easy and the instructions were clear. However, the women noted that the current price of self-test kits is too high and free or low-cost options would be needed to make self-testing a realistic option. There was also interest in enhancing opportunities for partner testing and linking self-testing to social and resource support.
Integrating HCV Screening within an HIV CTR Framework: Highly Accepted Interv...CDC NPIN
This document summarizes a pilot program that integrated hepatitis C virus (HCV) screening within an existing HIV counseling, testing, and referral (CTR) framework at the Barnstable County House of Corrections in Massachusetts. Key findings included that HCV screening was highly accepted when paired with HIV screening, HCV prevalence among inmates was high, and pairing the screenings increased HIV testing rates. Next steps discussed expanding integrated HCV/HIV screening and prevention to other correctional facilities in Massachusetts.
PPT Castelli "Dall'HIV all'AIDS fino alla coinfezione: una diagnosi difficile?"StopTb Italia
This document discusses the challenges of diagnosing HIV, AIDS, and co-infections. It notes that distinguishing between HIV infection, AIDS, and co-infections can be difficult. Point-of-care rapid tests have helped increase HIV testing, though they cannot identify acute HIV infections. The document emphasizes the importance of confirming positive rapid HIV tests with supplemental tests due to the potential for false positives in low prevalence populations.
Global Medical Cures™ | HIV TESTING IN USA
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.
C-YA! Philadelphia EMA's Plan to Connect our Co-infected Community to a Cure ...Office of HIV Planning
Alex Shirreffs of the Philadelphia Department of Public Health provided this overview of the Philadelphia area's plan to end HIV and Hepatitis C coinfections to the HIV Integrated Planning Council on May 10, 2018.
HIV self-testing and linkage in Africa. The document summarizes a presentation on HIV self-testing research in Africa. It discusses (1) the need for HIV self-testing in Africa due to low testing rates and knowledge of HIV status, (2) completed and ongoing studies of HIV self-testing in various African countries, and (3) priorities for future research including improving accuracy, evaluating new models for linkage to care, and assessing implementation in different populations and settings.
The Kenya HIV Testing Services Guidelines 2015Cheryl Johnson
The document provides guidelines for HIV Testing Services in Kenya. It outlines the background of HIV testing in Kenya since the first diagnosis over 30 years ago. It notes that testing approaches have evolved from expensive laboratory tests requiring complex procedures to more simplified point-of-care testing kits, resulting in more Kenyans knowing their status. The guidelines aim to ensure quality services are provided to all clients accessing health facilities for HIV services. It emphasizes updated guidance on HIV Testing Services in line with current knowledge and the country's 90-90-90 strategy to identify people living with HIV so they can access treatment.
HIV self-testing among transgender women in San Francisco - a pilotCheryl Johnson
This pilot study explored the acceptability and feasibility of HIV self-testing among 50 transgender women in San Francisco. The results showed that HIV self-testing was found to be feasible and acceptable, with 88% returning for a follow up at least once and 72% returning at 3 months. Participants reported that using the self-test kits was easy and the instructions were clear. However, the women noted that the current price of self-test kits is too high and free or low-cost options would be needed to make self-testing a realistic option. There was also interest in enhancing opportunities for partner testing and linking self-testing to social and resource support.
Integrating HCV Screening within an HIV CTR Framework: Highly Accepted Interv...CDC NPIN
This document summarizes a pilot program that integrated hepatitis C virus (HCV) screening within an existing HIV counseling, testing, and referral (CTR) framework at the Barnstable County House of Corrections in Massachusetts. Key findings included that HCV screening was highly accepted when paired with HIV screening, HCV prevalence among inmates was high, and pairing the screenings increased HIV testing rates. Next steps discussed expanding integrated HCV/HIV screening and prevention to other correctional facilities in Massachusetts.
PPT Castelli "Dall'HIV all'AIDS fino alla coinfezione: una diagnosi difficile?"StopTb Italia
This document discusses the challenges of diagnosing HIV, AIDS, and co-infections. It notes that distinguishing between HIV infection, AIDS, and co-infections can be difficult. Point-of-care rapid tests have helped increase HIV testing, though they cannot identify acute HIV infections. The document emphasizes the importance of confirming positive rapid HIV tests with supplemental tests due to the potential for false positives in low prevalence populations.
Global Medical Cures™ | HIV TESTING IN USA
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.
Where are we on HIV testing services - the achievements and the gapsCheryl Johnson
This document discusses achievements and gaps in HIV testing services globally. It finds that approximately 17 million people with HIV still do not know their status, and linkage to treatment after testing is suboptimal. While over 150 million people received HIV testing in 2014, nearly half of all people with HIV remain undiagnosed globally, with lower testing rates among men, adolescents, and key populations. The document calls for new approaches to testing like self-testing and lay providers, as well as improving quality, coverage, and focus on missing populations and areas with ongoing high risk.
Michael Tang, MD
Infectious Disease Fellow
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
1) HIV self-testing has potential to increase testing among men who have sex with men (MSM) by providing privacy and convenience. However, questions remain about its impact on linkage to care, risk behavior, and accuracy.
2) Studies show high acceptability of HIV self-testing among MSM, but optimal distribution methods and support for interpretation and counseling are still unclear.
3) While early research found little evidence of harm, more data is needed on how self-testing may influence sexual behavior and accuracy given the test's window period. Effective instruction and support strategies could help address these issues.
This document summarizes a community-based HIV/STI case management project in a First Nations community in Saskatchewan. The project aims to decrease new HIV/STI cases, reduce stigma, and build community and professional capacity. A multi-disciplinary mobile team provides culturally-competent care, including testing, treatment, counseling and referrals. Key lessons learned include the importance of community readiness, aligning resources to meet client needs, and effective ongoing partnerships. Evaluation found the project achieved its goals through a quality improvement and evidence-based approach.
This document provides an overview of the President's Emergency Plan for AIDS Relief (PEPFAR) program, including its goals, strategies, and challenges. PEPFAR aims to control the HIV/AIDS epidemic through strategies like testing and treatment (95-95-95 goals), focusing on high-risk populations and geographic hotspots, and strengthening HIV testing services. However, PEPFAR faces ongoing challenges like ensuring accurate HIV testing and achieving viral suppression targets among youth. The document discusses ongoing efforts to address weaknesses in HIV testing practices and increase testing quality through proficiency testing, monitoring, and training.
Cost of testing per new HIV diagnosis as a metric for monitoring cost-effecti...Carmen Figueroa
This document analyzes the cost-effectiveness of additional HIV testing programs in southern Africa beyond core testing through mathematical modeling. It finds that using the cost-per-new-HIV-diagnosis as a metric, additional testing programs for men are likely cost-effective if the cost is below $585 per diagnosis. However, additional testing programs for women are unlikely to be cost-effective. The analysis is based on simulating 1000 scenarios of HIV epidemics and testing programs in southern Africa to examine outcomes and costs over 50 years.
Optimal HIV testing strategies to achieve high levels of HIV diagnosis in Sou...Carmen Figueroa
This document discusses optimal HIV testing strategies to achieve high levels of HIV diagnosis in South Africa. It summarizes that while South Africa has made progress towards diagnosing 90% of HIV cases by 2020, testing gaps remain, particularly for men, youth, and key populations. The document outlines using an agent-based model to assess the efficiency and cost-effectiveness of various testing strategies, such as home-based testing, mobile testing, and targeted testing of sex workers and partners of diagnosed individuals. Preliminary findings suggest strategies like assisted partner notification and testing sex workers and men who have sex with men could be highly cost-effective in increasing diagnoses and reducing undiagnosed cases.
Kathleen Brady of the PDPH presented the annual report on the HIV epidemic in Philadelphia at the February 2017 meeting of the Philadelphia Ryan White Part A Planning Council.
This document summarizes information about hepatitis C in Ireland, including epidemiology, natural history, burden, treatment programs, and guidelines. Some key points:
- An estimated 20,000-30,000 people in Ireland have chronic hepatitis C infection, though about 60% are undiagnosed.
- Most infections are in people who inject drugs, though cases in men who have sex with men are increasing.
- A national hepatitis C treatment program was established in 2015 to treat all infected individuals over several phases, with a goal of eliminating hepatitis C in Ireland by 2026.
- National hepatitis C screening guidelines were developed using an evidence-based process and are due to be launched in July 2017 to facilitate increased
In Zimbabwe, only 57% of adult women and 34% of adult men have been tested for HIV and received their results. To address this testing gap, HIV self-testing is being introduced to complement current HIV testing strategies and help Zimbabwe achieve its goal of having 90% of people living with HIV know their status. A pilot study is underway to evaluate the acceptability, feasibility, accuracy, and ability to link people to care, treatment or prevention services of HIV self-testing using the OraQuick Advance oral test. Results are expected in June and will inform the larger UNITAID HIV STAR project starting that month aimed at further increasing HIV testing rates in Zimbabwe.
Representatives from the Philadelphia Department of Public Health (PDPH) presented an update on their strategic plan for sexual health at the February 2015 meeting of the Philadelphia Ryan White Part A Planning Council.
This presentation on research about HIV self-testing in Australia was given by A/Prof Rebecca Guy, The Kirby Institute, at the AFAO Members Forum - May 2015.
Iowa TelePrEP: Delivering PrEP through Telemedicine and Public Health Partner...YTH
Telemedicine is a collection of means or methods for enhancing health care, public health and health education delivery and support using telecommunications technologies. With more than 95% of adults, and 100% of young adults between the age of 18-29 owning a cell phone in the United States, a technology-based health intervention can be available to hard-to-reach populations or underserved areas.
Panelists will engage a rich dialogue and showcase innovative and effective ways to create prevention programs for HIV and STDs using the potential telehealth can offer, specifically with linking young people to HIV pre-exposure prophylaxis, or PrEP. This plenary brings together leaders in the field of HIV prevention, research and policy along with private organizations and companies that are currently active on the field of biomedical prevention.
ABSTRACT for successful SAMHSA Hepatitus C Grantlbricco
PEER Services proposes a hepatitis C testing, treatment, and care management program to address inadequate resources for at-risk populations. The objectives are to strengthen testing capabilities and develop referral networks for patients in their opioid treatment program. Most patients are baby boomers or African American, groups with higher hepatitis C rates, and have a history of illicit drug use. The program will provide hepatitis C education, rapid screening, diagnostic referrals, treatment access, counseling, medical monitoring and maintenance for their 250 annual patients. They will expand referral networks where patients live and coordinate with primary providers. They aim to screen and refer all undiagnosed clients, enroll 40 in the first year, and facilitate affordable insurance and care for uninsured patients.
Hepatitis C elimination in HIV-infected men who have sex with men: reality and challenges
Edward Cachay MD, MAS
February 23rd, 2018
UCSD HIV & Global Health Rounds
Theodoros F. Katsivas, M.D., M.A.S., of UC San Diego Owen Clinic, presents "San Diego Primary Care Providers' Attitudes to HIV and HIV Testing" at AIDS Clinical Rounds
Philadelphia Department of Public Health HIV Prevention ActivitiesOffice of HIV Planning
Coleman Terrell of the Philadelphia Department of Public Health presented on the PDPH's HIV Prevention Activities at the Philadelphia HIV Prevention Planning Group's December 2014 meeting.
Where are we on HIV testing services - the achievements and the gapsCheryl Johnson
This document discusses achievements and gaps in HIV testing services globally. It finds that approximately 17 million people with HIV still do not know their status, and linkage to treatment after testing is suboptimal. While over 150 million people received HIV testing in 2014, nearly half of all people with HIV remain undiagnosed globally, with lower testing rates among men, adolescents, and key populations. The document calls for new approaches to testing like self-testing and lay providers, as well as improving quality, coverage, and focus on missing populations and areas with ongoing high risk.
Michael Tang, MD
Infectious Disease Fellow
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
1) HIV self-testing has potential to increase testing among men who have sex with men (MSM) by providing privacy and convenience. However, questions remain about its impact on linkage to care, risk behavior, and accuracy.
2) Studies show high acceptability of HIV self-testing among MSM, but optimal distribution methods and support for interpretation and counseling are still unclear.
3) While early research found little evidence of harm, more data is needed on how self-testing may influence sexual behavior and accuracy given the test's window period. Effective instruction and support strategies could help address these issues.
This document summarizes a community-based HIV/STI case management project in a First Nations community in Saskatchewan. The project aims to decrease new HIV/STI cases, reduce stigma, and build community and professional capacity. A multi-disciplinary mobile team provides culturally-competent care, including testing, treatment, counseling and referrals. Key lessons learned include the importance of community readiness, aligning resources to meet client needs, and effective ongoing partnerships. Evaluation found the project achieved its goals through a quality improvement and evidence-based approach.
This document provides an overview of the President's Emergency Plan for AIDS Relief (PEPFAR) program, including its goals, strategies, and challenges. PEPFAR aims to control the HIV/AIDS epidemic through strategies like testing and treatment (95-95-95 goals), focusing on high-risk populations and geographic hotspots, and strengthening HIV testing services. However, PEPFAR faces ongoing challenges like ensuring accurate HIV testing and achieving viral suppression targets among youth. The document discusses ongoing efforts to address weaknesses in HIV testing practices and increase testing quality through proficiency testing, monitoring, and training.
Cost of testing per new HIV diagnosis as a metric for monitoring cost-effecti...Carmen Figueroa
This document analyzes the cost-effectiveness of additional HIV testing programs in southern Africa beyond core testing through mathematical modeling. It finds that using the cost-per-new-HIV-diagnosis as a metric, additional testing programs for men are likely cost-effective if the cost is below $585 per diagnosis. However, additional testing programs for women are unlikely to be cost-effective. The analysis is based on simulating 1000 scenarios of HIV epidemics and testing programs in southern Africa to examine outcomes and costs over 50 years.
Optimal HIV testing strategies to achieve high levels of HIV diagnosis in Sou...Carmen Figueroa
This document discusses optimal HIV testing strategies to achieve high levels of HIV diagnosis in South Africa. It summarizes that while South Africa has made progress towards diagnosing 90% of HIV cases by 2020, testing gaps remain, particularly for men, youth, and key populations. The document outlines using an agent-based model to assess the efficiency and cost-effectiveness of various testing strategies, such as home-based testing, mobile testing, and targeted testing of sex workers and partners of diagnosed individuals. Preliminary findings suggest strategies like assisted partner notification and testing sex workers and men who have sex with men could be highly cost-effective in increasing diagnoses and reducing undiagnosed cases.
Kathleen Brady of the PDPH presented the annual report on the HIV epidemic in Philadelphia at the February 2017 meeting of the Philadelphia Ryan White Part A Planning Council.
This document summarizes information about hepatitis C in Ireland, including epidemiology, natural history, burden, treatment programs, and guidelines. Some key points:
- An estimated 20,000-30,000 people in Ireland have chronic hepatitis C infection, though about 60% are undiagnosed.
- Most infections are in people who inject drugs, though cases in men who have sex with men are increasing.
- A national hepatitis C treatment program was established in 2015 to treat all infected individuals over several phases, with a goal of eliminating hepatitis C in Ireland by 2026.
- National hepatitis C screening guidelines were developed using an evidence-based process and are due to be launched in July 2017 to facilitate increased
In Zimbabwe, only 57% of adult women and 34% of adult men have been tested for HIV and received their results. To address this testing gap, HIV self-testing is being introduced to complement current HIV testing strategies and help Zimbabwe achieve its goal of having 90% of people living with HIV know their status. A pilot study is underway to evaluate the acceptability, feasibility, accuracy, and ability to link people to care, treatment or prevention services of HIV self-testing using the OraQuick Advance oral test. Results are expected in June and will inform the larger UNITAID HIV STAR project starting that month aimed at further increasing HIV testing rates in Zimbabwe.
Representatives from the Philadelphia Department of Public Health (PDPH) presented an update on their strategic plan for sexual health at the February 2015 meeting of the Philadelphia Ryan White Part A Planning Council.
This presentation on research about HIV self-testing in Australia was given by A/Prof Rebecca Guy, The Kirby Institute, at the AFAO Members Forum - May 2015.
Iowa TelePrEP: Delivering PrEP through Telemedicine and Public Health Partner...YTH
Telemedicine is a collection of means or methods for enhancing health care, public health and health education delivery and support using telecommunications technologies. With more than 95% of adults, and 100% of young adults between the age of 18-29 owning a cell phone in the United States, a technology-based health intervention can be available to hard-to-reach populations or underserved areas.
Panelists will engage a rich dialogue and showcase innovative and effective ways to create prevention programs for HIV and STDs using the potential telehealth can offer, specifically with linking young people to HIV pre-exposure prophylaxis, or PrEP. This plenary brings together leaders in the field of HIV prevention, research and policy along with private organizations and companies that are currently active on the field of biomedical prevention.
ABSTRACT for successful SAMHSA Hepatitus C Grantlbricco
PEER Services proposes a hepatitis C testing, treatment, and care management program to address inadequate resources for at-risk populations. The objectives are to strengthen testing capabilities and develop referral networks for patients in their opioid treatment program. Most patients are baby boomers or African American, groups with higher hepatitis C rates, and have a history of illicit drug use. The program will provide hepatitis C education, rapid screening, diagnostic referrals, treatment access, counseling, medical monitoring and maintenance for their 250 annual patients. They will expand referral networks where patients live and coordinate with primary providers. They aim to screen and refer all undiagnosed clients, enroll 40 in the first year, and facilitate affordable insurance and care for uninsured patients.
Hepatitis C elimination in HIV-infected men who have sex with men: reality and challenges
Edward Cachay MD, MAS
February 23rd, 2018
UCSD HIV & Global Health Rounds
Theodoros F. Katsivas, M.D., M.A.S., of UC San Diego Owen Clinic, presents "San Diego Primary Care Providers' Attitudes to HIV and HIV Testing" at AIDS Clinical Rounds
Philadelphia Department of Public Health HIV Prevention ActivitiesOffice of HIV Planning
Coleman Terrell of the Philadelphia Department of Public Health presented on the PDPH's HIV Prevention Activities at the Philadelphia HIV Prevention Planning Group's December 2014 meeting.
This document discusses hepatitis prevention and the burden of hepatitis globally and in Sri Lanka. Some key points:
- Globally, 400 million people live with chronic hepatitis B or C, causing over 1.4 million deaths per year. Chronic hepatitis B prevalence is highest in East Asia and Africa, while HCV prevalence is high in Central/East Asia and North Africa.
- In Sri Lanka, over 7,000 hepatitis cases were reported from 2010-2014, with over half occurring in 4 districts. The disease affects males more than females and incidence increases with age. Overall HBV and HCV seroprevalence is low (<2% and <1%).
- Transmission occurs through blood and body fluids. At-
STOP HIV/AIDS Pilot: Program Science and Systems Transformationamusten
This document discusses the STOP HIV/AIDS Pilot project in British Columbia. The key points are:
1. It is a 3-year, $48 million pilot project across two sites - Vancouver and Prince George - to enhance early diagnosis and treatment of HIV.
2. The goals are to reduce HIV/AIDS cases, improve early detection of HIV, ensure timely access to treatment, improve client experience, and demonstrate system and cost optimization.
3. The project uses data and performance monitoring to establish baseline performance, identify gaps, set common goals and measures, and evaluate individual initiatives on a population level.
This document summarizes the results of a clinical model for improving linkage and navigation of patients within the hepatitis C virus (HCV) care cascade. Key points:
- A specialized multidisciplinary navigation team at MedStar Washington Hospital Center increased rates of linkage to care, retention in care, and HCV treatment compared to other reported models.
- Gaps still existed in initial engagement, HCC screening completion, and treatment initiation/approval rates.
- Between 2014-2015, the median time between a specialist visit and treatment initiation decreased by 50%. However, treatment delays were still primarily due to insurance issues.
- Over 40% of patients had advanced liver disease upon re-engagement in care, highlighting
Integrating HIV Prevention with Hepatitis C Co‐Infection ProgramsCDC NPIN
This document discusses integrating hepatitis C screening and prevention programs into existing HIV/AIDS and other health services. It provides an overview of hepatitis C and its prevalence among people living with HIV. Integrating hepatitis C services can meet more client needs, reduce barriers, and leverage existing infrastructure. Modules cover hepatitis basics, risk assessment, harm reduction, and strategies for different settings like HIV/AIDS programs, LGBT organizations, and corrections. Lessons learned indicate developing HIV/hepatitis co-infection curricula and integrating hepatitis services can better meet client needs. Next steps include creating more inclusive HIV programs and training non-medical providers.
This document discusses hepatitis control in Pakistan. It notes that hepatitis B and C are major problems, with 18 million Pakistanis infected. The goals of the Prime Minister's Emergency Action Plan are to make Pakistan hepatitis-free through prevention, diagnosis, and treatment programs. Key components include vaccinating high-risk groups, improving injection safety, increasing diagnostic services, and strengthening support systems. Challenges include focusing more on prevention, developing surveillance systems, and increasing public awareness. WHO is assisting the national program through guidelines, training, and resources to help control hepatitis in Pakistan.
Working Toward Eradication (Hepatitis C/HIV Coinfection Presentation) - Alex ...Office of HIV Planning
At the October 2016 meeting of the Philadelphia Ryan White Part A Planning Council, Alex Shirreffs of the Philadelphia Department of Public Health discussed an ongoing project to improve the care continuum for HIV/HCV co-infected people of color.
WHO recommends offering hepatitis C virus (HCV) self-testing as an additional approach to testing services. HCV self-testing could increase testing uptake and diagnoses by reaching those who may not otherwise test. While no direct evidence was found on HCV self-testing effectiveness, evidence from HIV self-testing shows it increases testing uptake and diagnoses compared to facility-based testing, with comparable linkage to care. Implementation of HCV self-testing requires support services and confirmation of viraemic infections.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Sophocles Chanos
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
The document discusses using HIV program data to evaluate gaps and disparities in linkage to care. It provides examples of how Louisiana measures linkage, retention, and viral suppression, and presents continuum of care data for the state overall and by region, race/ethnicity, and testing site. Linkage to care rates for newly diagnosed individuals are shown to be improving over time but still vary between regions and community-based organizations. The document encourages evaluating one's own agency's linkage data and identifying opportunities for the State HIV Program to provide more useful data support.
The document discusses using HIV program data to evaluate gaps and disparities in linkage to care. It provides examples of how Louisiana measures linkage, retention, and viral suppression, and presents HIV continuum of care data for the state overall and by region, race/ethnicity, and testing site. Linkage to care rates for newly diagnosed individuals are shown to be improving over time but still lag the national goal of 85% linked within 90 days. Community-based organizations see variation in their linkage rates that could be improved. The presentation raises questions about how agencies evaluate their own linkage efforts and ways state assistance could strengthen local data collection and use.
Planning, implementation and evaluation of education program on HIV/AIDS. .SanjayChaudhary27
1) The document outlines a plan for an education program on HIV/AIDS in Nepal. It includes an introduction to HIV/AIDS, problem statement on prevalence in Nepal, objectives to reduce transmission and stigma through education, and an evaluation plan.
2) A needs assessment identifies risk factors like unsafe sex, lack of access to healthcare, and stigma. The program's goals are to reduce infection rates, increase access to treatment, and coordinate national response.
3) The education program will provide information on transmission, prevention, treatment services, and address stigma through activities like discussion, counseling, and role-playing with targets like key populations and the community.
The document presents a progress report from the Fulton County Task Force on HIV/AIDS on developing a strategy to end AIDS in the county. It outlines goals to reduce new infections, increase access to care and health outcomes, reduce disparities, and coordinate the local response. Data shows high rates of HIV among Black residents and rising diagnoses among Black gay and bisexual men. Objectives are presented to increase HIV testing, linkage to and retention in care, viral suppression, housing support, and addressing social determinants. The strategy aims to eliminate perinatal transmission and decrease new diagnoses by at least 25% by 2020.
The document summarizes the proceedings of the Positive Persons' Forum held in Glasgow on February 13, 2016. It includes:
- An overview and welcome from the chair Wullie Irvine.
- A presentation from George Valiotis on changes since the last forum.
- Presentations from various speakers on topics like education, peer support, involvement workshops, and cure research.
- Information on Project 100, a peer support initiative, and the changing role of peer support.
- Details of the 2015 People Living with HIV Stigma Index survey that involved over 1,500 people living with HIV across the UK.
Evaluation of the TB-HIV Integration Strategy on Treatment OutcomesMEASURE Evaluation
Shared at a data dissemination and data use workshop on the results of the impact evaluation of the Strengthening Tuberculosis Control in Ukraine project. Access another presentation at https://www.slideshare.net/measureevaluation/evaluation-of-the-impact-of-a-social-support-strategy-on-treatment-outcomes/.
Similar to The Beginning of the End? (Hepatitis C and HIV Presentation) (20)
Overview of the 2018 Update to the Integrated Plan and PrEP Workgroup Draft R...Office of HIV Planning
Mari Ross-Russell (Office of HIV Planning) and Matthew McClain (Public Health Policy & Planning Consultant) presented these slides to the PrEP Workgroup of the Philadelphia EMA HIV Integrated Planning Council on January 16, 2019.
Dr. William R. Short presented this review of PrEP research from the Conference on Retroviruses and Opportunistic Infections to the PrEP Workgroup of the HIPC's Prevention Committee in April 2018.
Sebastian Branca of the AIDS Activities Coordinating Office provided this overview of AACO's quality management program to the HIV Integrated Planning Council on May 10, 2018. This presentation includes discussion of secret shoppers, quality improvement plans, and quality management initiatives.
The document outlines information about the Client Services Unit (CSU) of the AIDS Activities Coordinating Office (AACO) in Philadelphia. It discusses the CSU's mission to help and advocate for people living with HIV/AIDS. It provides data on the 1976 client intakes completed in 2017, including demographics and most common needs. It also describes the transition of AACO's Housing Services Program to the City's Office of Homeless Services and details the consumer feedback process for AACO-funded services.
This presentation was provided to the Philadelphia EMA HIV Integrated Planning Council by Briana Morgan of the Office of HIV Planning. It includes data related to population-level data, race/ethnicity, STIs, risk behaviors, HIV, and more.
This document summarizes disparities in Philadelphia's HIV continuum of care. It identifies several priority populations that experience lower rates of HIV status awareness, retention in medical care, and viral load suppression. These include racial/ethnic minority youth, transgender persons who have sex with men, heterosexual men of color, and persons who inject drugs. The document also finds geographic disparities, with lower continuum measures in collar counties surrounding Philadelphia. It concludes by recommending several areas for action to decrease disparities, such as increasing PrEP access, HIV testing, and linkage to and retention in medical care.
Increasing Treatment Access and Saving Lives in the Dual Opioid and Overdose ...Office of HIV Planning
Silvana Mazzella of Prevention Point Philadelphia gave this presentation on medication assisted treatment to the Philadelphia EMA HIV Integrated Planning Council on March 8, 2018.
Dr. Kathleen Brady of the AIDS Activities Coordinating Office discussed three cycles of the National HIV Behavioral Surveillance in Philadelphia, including cycles with men who have sex with men (MSM), high-risk heterosexuals, and injection drug users. This presentation took place at the Philadelphia EMA HIV Integrated Planning Council meeting on Thursday, January 11, 2018.
Caitlin Conyngham and Erika Aaron of the AIDS Activities Coordinating Office began the initial meeting of the PrEP Working Group with this presentation on November 15, 2017.
Antonio Boone of the Office of HIV Planning reviewed major points from the Mayor's Task Force to Combat the Opioid Epidemic in Philadelphia at the June 12, 2017 Positive Committee meeting.
Marcy Witherspoon, MSW, LSW of the Health Federation of Philadelphia discussed trauma-informed care with the Philadelphia EMA HIV Integrated Planning Council on November 9, 2018.
OHP's Antonio Boone gave this presentation on different prevention continuum examples at the July meeting of the Prevention Committee of the Philadelphia EMA HIV Integrated Planning Council.
Integrated HIV Surveillance and Prevention Programs for Health Departments - ...Office of HIV Planning
Caitlin Conyngham, Prevention Coordinator at the AIDS Activities Coordinating Office at the Philadelphia Department of Public Health, gave an overview of the new HIV prevention notice of funding opportunity to the HIPC's Prevention Committee on 07-26-2017.
Opioid Awareness - Report Review: The Mayor's Task Force to Combat the Opioid...Office of HIV Planning
The document summarizes a report by the Mayor's Task Force to Combat the Opioid Epidemic in Philadelphia. It finds that prescription opioid sales doubled from 2000-2012, fueling high rates of opioid use, overdoses, and deaths. The Task Force made recommendations in areas of prevention, treatment, overdose prevention, and criminal justice system involvement. Key recommendations included expanding access to medication-assisted treatment, naloxone distribution, and treatment services in prisons. The report calls for increased monitoring and evaluation to assess progress combating the epidemic.
Planning Council Co-Chair and Prevention Committee member Jen Chapman presented on integrated planning and concurrence at the May 2017 meeting of the HIV Integrated Planning Council.
Ryan White HIV AIDS Program (RWHAP) Services and Policy Clarification Notice ...Office of HIV Planning
At the April meeting of the Comprehensive Planning and Needs Assessment Committees, Jessica Brown of AACO presented on Ryan White service categories. She also reviewed changes enacted by PCN 16-02.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
2. Epidemiology of HCV
• More than 4 million people in the US expected to be
chronically infected with hepatitis C virus (HCV)
• Most people (~70%) are undiagnosed
• Most common reason for liver transplantation
• 50-75% of HCV(+) individuals are unaware of infection
• Worse liver-related outcomes
• Spread of disease
4. Investigated HCV cases by age and risk factor:
Philadelphia, 2013-2014
• Behavioral risk factors (injection drug use and incarceration) account for most of HCV
*Medical includes
blood/organ
transplants, dialysis,
needlesticks,
work in medical/dental
field
20%
35%
21%
8%
16%
<=30 years
Medical
IDU
Incarcerated
Sexual
Tattoo
16%
32%
27%
11%
14%
31-44 years
26%
26%
26%
12%
10%
45-64 years
42%
22%
19%
13%
4%
>=65 years
5. Proportion of HCV-Infected Individuals Reaching Successive Stages
HCV Cascade of Care
0
10000
20000
30000
40000
50000
HCV infected
(estimate)
HCV Ab HCV RNA HCV in
medical care
HCV antiviral
treatment
NumberofIndividuals
47%
22%
6%
3%
HCV-Positive Individuals Are Being Lost At All Stages of Care:
1. HCV Testing Confirmation
2. Referral To Specialist’s Care
3. Treatment
Viner K et al. The Continuum of Hepatitis C Testing and Care. Hepatology. 61: 783-789, 2015.
6. HIV/HCV Coinfection FACTS
• Among HIV-infected individuals, HCV co-
infection
• Is estimated at 25% (CDC)
• Ranges from 10–30% in MSM1
• Up to 80–90% in PWID2
• HIV/HCV coinfection more than triples the risk
for liver disease, liver failure, and liver-related
death
• ART may slow the progression of liver disease by
preserving or restoring immune function and
reducing HIV-related immune activation and
inflammation
1) G.M. Lauer, B.D. Walker. Hepatitis C virus infection. N Engl J Med, 345 (2001), pp. 41–52
2) K.E. Sherman, S.D. Rouster, R.T. Chung, N. Rajicic. Hepatitis C Virus prevalence among patients infected with Human Immunodeficiency
Virus: a cross-sectional analysis of the US adult AIDS Clinical Trials Group. Clin Infect Dis, 34 (2002), pp. 831–837
7. HIV/HCV Coinfection - Philadelphia
• Prevalence
• EMA estimate of 6,200 PLWH coinfected with HCV (18.6%) as of
12/31/2015
• 17.5%* of PLWH in Philadelphia are HCV coinfected as of
12/31/15
• Screening
• Approximately 84% of PLWH screened for HCV in Philadelphia
residents in the Ryan White system
• Two types of HIV/HCV co-infected patients can be distinguished
• Those infected for decades (often have severe fibrosis and several
comorbidities)
• Those recently infected with HCV
• All HIV-infected patients should be screened for HCV
• Patients at high risk of HCV infection should be screened annually
and whenever HCV infection is suspected.
*Source: AACO 2015 Surveillance Report
8. I said that an AIDS-free generation is within reach,
and today, the global community is committed to
ending this epidemic by 2030.
- Former President Barack Obama
9. What does it take to end an epidemic?
Prevention
• Condoms
• PrEP and PEP
• Syringe
Exchange
• STD Testing &
Treatment
• Health
Campaigns
Testing &
Diagnosis
• CDC : Everyone
tested at least
one time, more
freq per risk
• Provider testing
• Walk-In Test
Sites
• STD Clinic
• Partner Services
Linkage to &
Retention in Care
• Case
Management
• SEPTA Tokens
• Co-Located
services
• START Care
• CoRECT
Treatment
• Lifelong
treatment
• Viral Load
Suppression
minimizes
transmission risk
Some Tools in Our Local HIV Infrastructure:
10. HIV: There is still work to be done
HIV Care Continuum, Philadelphia, 2015
11. We have the tools we need to end hepatitis C
in Philly (we just don’t have the $$)!
-Alex Shirreffs
12. What does it take to end an epidemic?
Prevention
• Condoms
• Syringe
Exchange (AND
clean works!)
Testing &
Diagnosis
• CDC: All Baby
Boomers; others
more freq per
risk
• Less than 5 walk
in test sites
• Not all have
confirmatory
• Provider Testing
Linkage to &
Retention in Care
• FOCUS grant
sites have some
linkage support
(ex: C A
Difference,
Prevention
Point)
Treatment
• A
CURE
• Medications
cure most ppl
of HCV in 12
wks or less w
minimal side
effects
Some Tools in Our Local Hep C Infrastructure:
13. Proportion of HCV-Infected Individuals Reaching
Successive Stages
Total HCV Ab+ estimate
Reported HCV Ab+ estimate
Surveillance findings
0
5000
10000
15000
20000
25000
30000
HCV infected
(estimate)
HCV Ab HCV RNA HCV in
medical care
HCV antiviral
treatment
NumberofIndividuals
47%
22%
6% 3%
2010 – 2013
Hep C: There is still a lot of work to be done
14. What if we combined our resources?
Could Philadelphia be the first city to eradicate
hepatitis C among HIV/HCV co-infected people?
Prevention
• Condoms
• Syringe
Exchange (AND
clean works!)
• Integrated
messaging
Testing &
Diagnosis
• Annual hep C
testing for
everyone with
HIV (more with
risk factors)
• Scale up HCV
testing in HIV
care settings
Linkage to &
Retention in Care
• Hep C Linkage
Coordinators
• Train case
managers &
frontline staff on
hepatitis C
Treatment
• A CURE
• Encourage hep
C treatment at
all HIV care
sites
A More Integrated HIV & Hepatitis C Infrastructure:
15. Project Aims:
• Increase Philadelphia’s capacity to provide
comprehensive screening, care and treatment of
hepatitis C among HIV/HCV co-infected people of
color
• Increase number of HIV/HCV co-infected people
of color who are diagnosed, treated and cured of
HCV infection
17. Data & Evaluation
• Match PDPH hepatitis C and HIV data sets to create a
baseline HCV Continuum for PLWH in Philadelphia
• Integrate additional hepatitis C measures into
CAREware
• Develop provider report card tool to measure
progress by HIV care site
• Provide technical assistance to help care sites use
data to track progress moving patients through the
HCV continuum
• Monitor impact of program on Philadelphia’s
HIV/HCV continuum
18. Training & Capacity Building
• Identify gaps in services along the HCV care continuum
using PDPH surveillance data and pre-Implementation
knowledge and needs assessments
• Build hepatitis C curricula into established models of
provider training and capacity building at Health
Federation’s Philadelphia performance site of the Mid-
Atlantic AETC
• Ex: Peer to Peer training, Preceptorships
• Explore other innovative service delivery models:
• Telemedicine
• Directly Observed Therapy
19. Linkage to Care
• Centralized care coordination support under AACO
• Use PDPH data to prioritize lost to care clients and re-
engage in care
• Provide centralized intake to offer sites additional
support with client linkage to hepatitis C services
• Identify opportunities to integrate hepatitis C into
existing patient support activities
• Training Medical Case Managers on hepatitis C
• Create targeted education and awareness materials
• Help publicize existing hepatitis C services offered in
Philadelphia
20. Service Integration
• Identify facilitators and barriers to integration of
hepatitis C into existing Ryan White activities
• What additional resources would be needed to
improve hepatitis C services within Ryan White
programs?
• How can local best practices be shared and replicated?
• Develop a sustainability plan to ensure that any
improvements to hepatitis C services through this
opportunity can be maintained
• Promote and leverage local successes to bring in
additional resources
22. Refining Philadelphia’s Plan
• Pre-Implementation Phase includes Knowledge
Assessments
• Does our strategy begin to meet the needs of
improving HCV services for HIV-infected people?
• How can we refine our strategy to be most useful to
providers and clients in the HIV service system?
• Patient and Provider Knowledge Assessments
23. Patient Focus Groups
• Anonymous and confidential
• Will you help us? Your insight will help us:
• Determine what resources can support clients
• Are there new educational materials that need to be
developed?
• What are barriers and facilitators to hep C treatment?
• If you are interested, provide your contact info and Amy
will follow up!
Editor's Notes
Update
From Kendra’s slides
In care – 2+ RNA tests and/or specialist visits
Alex will discuss HD efforts to move patients through the cascade
Not pictured = more robust surveillance system that other sites have
In care – 2+ RNA tests and/or specialist visits
Alex will discuss HD efforts to move patients through the cascade