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1.
Am J Public Health ; 113(9): 1019-1027, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37410983

RESUMEN

Objectives. To describe HIV testing among clients in the Targeted Highly Effective Interventions to Reverse the HIV Epidemic (THRIVE) demonstration project and evaluate testing frequency. Methods. We identified factors associated with an average testing frequency of 180 days or less compared with more than 180 days using adjusted Poisson regression models. We performed the Kaplan-Meier survival analysis to compare time to diagnosis by testing frequency. Results. Among 5710 clients with 2 or more tests and no preexposure prophylaxis (PrEP) prescription, 42.4% were tested frequently. Black/African American clients were 21% less likely and Hispanic/Latino clients were 18% less likely to be tested frequently than were White clients. Among 71 Black/African American and Hispanic/Latino cisgender men who have sex with men and transgender women with HIV diagnoses, those with frequent testing had a median time to diagnosis of 137 days, with a diagnostic testing yield of 1.5% compared with those tested less frequently, with 559 days and 0.8% yield. Conclusions. HIV testing at least every 6 months resulted in earlier HIV diagnosis and was efficient. Persons in communities with high rates of HIV who are not on PrEP can benefit from frequent testing, and collaborative community approaches may help reduce disparities. (Am J Public Health. 2023;113(9):1019-1027. https://doi.org/10.2105/AJPH.2023.307341).


Asunto(s)
Infecciones por VIH , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Personas Transgénero , Masculino , Humanos , Estados Unidos/epidemiología , Femenino , Homosexualidad Masculina , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Profilaxis Pre-Exposición/métodos , Prueba de VIH
2.
J Public Health Manag Pract ; 28(3): 282-291, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35045008

RESUMEN

CONTEXT: African American and Hispanic adults share a disproportionate burden of HIV infections in the United States but continue to experience suboptimal uptake of HIV pre-exposure prophylaxis (PrEP). Increasing PrEP accessibility in nontraditional care settings is a potential strategy to increase PrEP uptake in these high-risk groups. PrEP implementation in local health departments (LHDs) is not well characterized. OBJECTIVE: To evaluate HIV PrEP implementation for African American and Hispanic adults receiving medical care in Virginia's LHDs. DESIGN: We conducted a retrospective, mixed-methods evaluation of PrEP services implementation at LHDs completing their first PrEP program year between June 1, 2016, and June 30, 2019. Using pharmacy records, we estimated PrEP coverage and adherence using PrEP to need ratios (PnRs) and medication possession ratios (MPRs), respectively. Thematic analysis was used to identify barriers to PrEP delivery in interviews with 6 multidisciplinary LHD workers. RESULTS: Of the 433 PrEP clients receiving an emtricitabine/tenofovir disoproxil fumarate (Truvada) prescription in year 1, 52.0% self-identified as African American and 8.9% self-identified as Hispanic. PnRs were greater for White adults in 50.0% of clinics. The average MPR (0.79) was consistent with protective medication adherence levels; however, 25.0% of clients filled only one prescription in the program year. Qualitative findings suggest incompatibilities between health PrEP services delivery and community preferences for African American and Hispanic adults; however, LHDs in one health region were able to link communities of color to PrEP at similar rates as Whites. CONCLUSIONS: Incorporating a metric sensitive to racial/ethnic differences in the burden of HIV infection improved recognition of PrEP disparities; however, population-specific targets are needed to enhance use of the PnR for program evaluation. Tailoring of PrEP services to communities with the greatest local PrEP burden may be needed to optimize the effectiveness of PrEP programs in LHDs.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Profilaxis Pre-Exposición , Adulto , Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Humanos , Profilaxis Pre-Exposición/métodos , Estudios Retrospectivos , Estados Unidos , Virginia
3.
Materials (Basel) ; 14(4)2021 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-33546176

RESUMEN

The scientific community has made great efforts in advancing magnetic hyperthermia for the last two decades after going through a sizeable research lapse from its establishment. All the progress made in various topics ranging from nanoparticle synthesis to biocompatibilization and in vivo testing have been seeking to push the forefront towards some new clinical trials. As many, they did not go at the expected pace. Today, fruitful international cooperation and the wisdom gain after a careful analysis of the lessons learned from seminal clinical trials allow us to have a future with better guarantees for a more definitive takeoff of this genuine nanotherapy against cancer. Deliberately giving prominence to a number of critical aspects, this opinion review offers a blend of state-of-the-art hints and glimpses into the future of the therapy, considering the expected evolution of science and technology behind magnetic hyperthermia.

4.
Small ; 15(20): e1900224, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30985079

RESUMEN

Interstitially administered iron oxide particles are currently used for interoperative localization of sentinel lymph nodes (LNs) in cancer staging. Several studies have described concerns regarding the cellular accumulation of iron oxide nanoparticles relating them to phenotype and function deregulation of macrophages, impairing their ability to mount an appropriate immune response once an insult is present. This study aims to address what phenotypic and functional changes occur during lymphatic transit and accumulation of these particles. Data show that 60 nm carboxydextran-coated iron nanoparticles use a noncellular mechanism to reach the draining LNs and that their accumulation in macrophages induces transient phenotypic and functional changes. Nevertheless, macrophages recover their baseline levels of response within 7 days, and are still able to mount an appropriate response to bacterially induced inflammation.


Asunto(s)
Dextranos/administración & dosificación , Macrófagos/inmunología , Nanopartículas de Magnetita/administración & dosificación , Animales , Línea Celular , Inflamación/patología , Ratones , Ratones Endogámicos C57BL , Fenotipo , Células RAW 264.7 , Ganglio Linfático Centinela/inmunología
5.
Nanomedicine (Lond) ; 9(9): 1291-4, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25204820

RESUMEN

Nanomedicine 2014 Edinburgh, UK, 26-27 March 2014 The British Society for Nanomedicine (BSNM), in collaboration with SELECTBIO, organized Nanomedicine 2014. BSNM is a registered charity created to allow open access for industry, academia, clinicians and the public to news and details of ongoing nanomedicine research. The Nanomedicine 2014 program provided insight across a number of emerging nanotechnologies spanning treatment to diagnostics. A key objective of the meeting was provision of opportunities to build collaborations and rationalize nanoenabled healthcare solutions.


Asunto(s)
Nanomedicina , Portadores de Fármacos/química , Humanos , Nanopartículas/química , Nanotecnología
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