The Serostatus Approach to Fighting the HIV Epidemic: prevention strategies for infected individuals.

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
American Journal of Public Health (Impact Factor: 4.23). 08/2001; 91(7):1019-24. DOI: 10.2105/AJPH.91.7.1019
Source: PubMed

ABSTRACT In the United States, HIV prevention programs have historically tailored activities for specific groups primarily on the basis of behavioral risk factors and demographic characteristics. Through the Serostatus Approach to Fighting the Epidemic (SAFE), the Centers for Disease Control and Prevention is now expanding prevention programs, especially for individuals with HIV, to reduce the risk of transmission as a supplement to current programs that primarily focus on reducing the risk of acquisition of the virus. For individuals with HIV, SAFE comprises action steps that focus on diagnosing all HIV-infected persons, linking them to appropriate high-quality care and prevention services, helping them adhere to treatment regimens, and supporting them in adopting and sustaining HIV risk reduction behavior. SAFE couple a traditional infectious disease control focus on the infected person with behavioral interventions that have been standard for HIV prevention programs.

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    ABSTRACT: Human Immunodeficiency Virus-1 infection is prevalent among injection drug users nationwide, and is espe-cially prevalent here in the Bronx and New York City. Injection drug users are at increased risk for acquiring and transmitting HIV infection primarily because of unsafe injection practices and high-risk sex behaviors, but several studies have tested risk reduction interven-tions for injection drug users and found them to decrease these risk behaviors. The most successful risk reduction interventions mobilize peers, involve commu-nity outreach, and work in conjunction with substance abuse treatment programs. Other successful interven-tions for reducing HIV transmission risk among injec-tion drugs users rely on medical providers to offer individualized risk reduction along with medical treat-ment for HIV. In this article, we review HIV prevention and treatment programs that have helped stem the HIV epidemic among injection drug users in the Bronx.
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    ABSTRACT: Objective: To assess the repercussion of late diagnosis of HIV infection on AIDS incidence in the era of highly active antiretroviral therapy. Design: Analysis of AIDS surveillance data. Setting: Spain. Patients: AIDS cases reported from 1994 though 2000. Main outcome measures: Late testers were defined as persons who had a first positive HIV test in the month of or immediately preceding AIDS diagnosis. Their incidence trend was compared against that for the remaining cases, and the influence of demographic factors evaluated. Results: Of 30 778 AIDS cases, 8499 (28%) were late testers, and of these, 1061 (12%) died within 3 months of diagnosis of HIV infection. From 1995 to 2000, AIDS diagnoses declined by 36% among late testers versus 67% for the remainder (P < 0.001). The percentage of late testers increased from 24% in 1994–1996 to 35% in 1998–2000 (P < 0.001). Among the 7825 AIDS cases diagnosed in 1998–2000, late testing was independently associated (P < 0.01) with male sex, age over 44 years, residence in provinces with a lower AIDS incidence, foreign origin, and no record of injecting drug use or prison stay. Conclusions: A growing proportion of AIDS cases involves late diagnosis of HIV infection. Persons who are unaware of their HIV infection cannot benefit from antiretroviral therapy and, hence, early diagnosis would strengthen the impact of such therapy and so reduce AIDS incidence.
    AIDS 09/2002; 16(14):1945-1951. DOI:10.1097/00002030-200209270-00012 · 6.56 Impact Factor
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David Robert Holtgrave