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Highlights from the
MMWR: Incorporating HIV
Prevention into the Medical Care of Persons Living with HIV:
- Despite major
advances in treatment, an estimated 40,000 new cases of HIV infection occur each year in the United States*.
- Interviews with
people
living with HIV in a variety of settings indicate that more than
70% are sexually active
after receiving their
diagnosis—and many have not
notified their partner of their HIV status.
-
STDs have
been increasing in men and women with HIV
who are
receiving outpatient care, indicating ongoing risky behavior and
opportunities for HIV transmission.
-
Until recently, HIV
prevention in this country has largely focused on preventing infection
in those who do not have the virus. Since
infection rates have
remained steady for the past decade,
the focus is shifting to prevention of
transmission by those living with HIV.
Whenever a patient with HIV visits, health care
providers have the opportunity to:
-
Screen for transmission behaviors.
Reverting to risky sexual behavior might be as important in HIV
transmission as failure to adopt safer practices after diagnosis.
-
Identify and treat STDs. STDs have a
synergistic effect on HIV infectivity and susceptibility, and their
presence indicates risky behavior.
-
Communicate prevention messages.
Patients with HIV can benefit from brief messages on the need for
safer sexual behaviors to protect themselves and their partners.
-
Discuss sexual and drug-use behavior.
Patients need accurate information on factors that increase the risk
of HIV transmission and promote effective prevention strategies.
-
Reinforce changes to safer behavior.
Brief prevention messages can positively reinforce patient actions
to reduce transmission risk.
-
Refer to specialized services. Direct
patients needing additional behavior interventions to social
services (i.e., mental health services, substance abuse care, etc.),
which are available from
the
CDC National
Prevention Information Network (NPIN) or
1-800-458-5231.
-
Facilitate partner notification, counseling,
and testing. Health care providers can help prevent patients’
sexual or needle-sharing partners from becoming infected with HIV and
from infecting others with HIV.
*This information has recently been updated. In 2006, an estimated 56,300 individuals were infected with HIV (Hall HI, Ruiguang S, Rhodes P, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300:520-529).
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