Abstract:
Background:Maintaining retention in preexposure prophylaxis (PrEP) care among diverse patient populations will be needed to support PrEP's efficacy. We characterized patterns of PrEP care retention in a US municipal primary care health network and examined whether missed visits, a metric of care retention that is easy to evaluate in clinic, are associated with subsequent discontinuation. Methods:We included individuals on PrEP from July 2012 until August 2017 in the San Francisco Primary Care Clinics, a 15-clinic municipal health network. We categorized PrEP usage patterns as follows: early discontinuation (<90 days), later discontinuation (after ≥90 days), and continuing use at the end of follow-up. We first examined early discontinuation using adjusted Poisson regression. In patients who continued PrEP for ≥90 days, we examined factors associated with late discontinuation. Results:Of the 364 individuals who started PrEP, 16% discontinued PrEP before 90 days, 46% discontinued later, and 38% were retained in care over a median 12 months of observation. Transgender women were more likely to discontinue PrEP early (adjusted risk ratio; 2.16; 95% confidence interval, 1.36-3.49), and younger users were more likely to discontinue late (0.82 per 10-year increase in age; .70-.96), as were persons who use illicit drugs (1.59; 1.02-2.47). Missed visits during use of PrEP were associated with future discontinuation (adjusted risk ratio, 1.52; 95% confidence interval, 1.14-2.03). Later year of current PrEP use was associated with both early and late discontinuation. Conclusion:Diverse populations may require differentiated care to continue PrEP. Missed visits should trigger tailored interventions to maximize the impact of PrEP.
journal_name
Open Forum Infect Disjournal_title
Open forum infectious diseasesauthors
Spinelli MA,Scott HM,Vittinghoff E,Liu AY,Gonzalez R,Morehead-Gee A,Gandhi M,Buchbinder SPdoi
10.1093/ofid/ofz101subject
Has Abstractpub_date
2019-02-26 00:00:00pages
ofz101issue
4issn
2328-8957pii
ofz101journal_volume
6pub_type
杂志文章abstract:BACKGROUND:Early diagnosis of human immunodeficiency virus (HIV) is a prerequisite to maximizing individual and societal benefits of antiretroviral therapy. METHODS:Adults ≥18 years of age testing HIV positive at 10 health facilities in Mozambique and Swaziland received point-of-care CD4+ cell count testing immediatel...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx156
更新日期:2017-07-23 00:00:00
abstract:BACKGROUND:Despite the recognized benefit of antiretroviral therapy (ART) for preventing and treating HIV, some studies have reported adverse birth outcomes with in utero ART exposure. We evaluated the effect of infant in utero HIV and ART exposure on preterm delivery (PTD), low birth weight (LBW), small for gestationa...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx187
更新日期:2017-08-30 00:00:00
abstract:Background:Direct acting antiviral hepatitis C virus (HCV) therapies are highly effective but costly. Wider adoption of an 8-week ledipasvir/sofosbuvir treatment regimen could result in significant savings, but may be less efficacious compared with a 12-week regimen. We evaluated outcomes under a constrained budget and...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx267
更新日期:2017-12-08 00:00:00
abstract:BACKGROUND:Amphotericin B is the preferred treatment for cryptococcal meningitis, but it has cumulative severe side effects, including nephrotoxicity, hypokalemia, and hypomagnesemia. Amphotericin-induced severe hypokalemia may predispose the patient to cardiac arrhythmias and death, and there is very little data avail...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofu070
更新日期:2014-08-25 00:00:00
abstract:Background:Concomitant dosing of ledipasvir (LDV) and tenofovir disoproxil fumarate (TDF) results in an increased tenofovir (TFV) area under the curve (AUC). The aim of this study was to examine whether there was a correlation between the renal biomarkers retinol binding protein-4 (RBP-4) and β2 microglobulin (β2M) and...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy273
更新日期:2019-01-24 00:00:00
abstract:BACKGROUND:Antiretroviral therapy (ART) is recommended for all people living with human immunodeficiency virus (HIV), yet physician attitudes and prescribing behaviors toward members of key risk populations may limit ART access and undermine treatment as prevention strategies. METHODS:Physicians in Malaysia (N = 214) ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofw219
更新日期:2017-01-25 00:00:00
abstract::Background. Hepatitis C virus (HCV) treatment access among human immunodeficiency virus (HIV)/HCV-coinfected people who inject drugs is poor, despite a high burden of disease in this population. Understanding barriers and facilitators to HCV treatment uptake is critical to the implementation of new direct-acting anti...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofw065
更新日期:2016-06-24 00:00:00
abstract:Background:This study investigates the association of clinical and demographic predictors with abdominal fat gain, measured using waist circumference (WC) and self-reported abdominal size. Methods:We analyzed data from ACTG A5257, a clinical trial that randomized treatment-naïve HIV-infected participants to 1 of 3 ant...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy201
更新日期:2018-11-16 00:00:00
abstract:Background:The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015-2016 mumps outbreak at the University of Iowa, we estimated the c...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy199
更新日期:2018-10-04 00:00:00
abstract:Background:Antimicrobial stewardship interventions utilizing real-time alerting through the electronic medical record enable timely implementation of the bundle of care (BOC) for patients with severe infections, such as candidemia. Automated alerting for candidemia using the Epic stewardship module has been in place si...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz412
更新日期:2019-10-11 00:00:00
abstract:Background:Recent studies have favored the use of cefazolin over nafcillin for the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. The clinical influence of the cefazolin inoculum effect (CzIE) in the effectiveness of cephalosporins for severe MSSA infections has not been evaluated. Metho...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy123
更新日期:2018-05-23 00:00:00
abstract:Background:Mismanagement of asymptomatic patients with positive urine cultures (referred to as asymptomatic bacteriuria [ASB] in the literature) promotes antimicrobial resistance and results in unnecessary antimicrobial-related adverse events and increased health care costs. Methods:We conducted a systematic review an...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx207
更新日期:2017-11-20 00:00:00
abstract:Background:The use of a "trial of antibiotics" as empiric therapy for bacterial pneumonia as a diagnostic tool for tuberculosis in people with HIV (PWH) was removed from World Health Organization (WHO) recommendations in 2007, based on expert opinion. Current guidelines recommend antibiotics only after 2 Xpert MTB/RIF ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz543
更新日期:2020-01-06 00:00:00
abstract::We report on a case of loiasis revealed during an assisted reproductive technology (ART) cycle. Loa loa could limit implantation outcome. We propose to focus on an ART strategy with frozen embryos to treat the patient before any transfer. ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx208
更新日期:2017-10-06 00:00:00
abstract:BACKGROUND:Invasive aspergillosis (IA) and mucormycosis contribute to substantial mortality, especially among immunocompromised persons, including those with hematopoietic stem cell transplant (HSCT), hematologic malignancy (HM), and solid organ transplant (SOT). METHODS:Using International Classification of Diseases,...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofw268
更新日期:2017-01-13 00:00:00
abstract:Background:We characterized the extent of antiretroviral therapy (ART) experience and postdischarge mortality among hospitalized HIV-infected adults in Zambia. Methods:At a central hospital with an opt-out HIV testing program, we enrolled HIV-infected adults (18+ years) admitted to internal medicine using a population...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz336
更新日期:2019-07-16 00:00:00
abstract:Background:The diagnosis of cellulitis is made clinically without a gold standard diagnostic test, and cellulitis has many disease mimics. There is currently no consensus for optimal antimicrobial treatment duration or method of antimicrobial delivery. Methods:This was a randomized controlled open-label multicenter tr...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz335
更新日期:2019-07-20 00:00:00
abstract::This study evaluated health outcomes among people who inject drugs who are infected with hepatitis C virus using an artificial intelligence platform. Mean (SD) cumulative adherence (visual confirmation of administration) was 91.3% (10.5%). Most subjects (88.2%) achieved ≥80% adherence to treatment, and 88.2% (15 of 17...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa290
更新日期:2020-07-20 00:00:00
abstract:Background:Antibiotic-resistant bacterial infections are a major threat to public health, yet improper use of antibiotics remains high. Infectious Diseases (ID) fellows play a major role in antibiotic stewardship efforts, but there is little research on how they view stewardship activities. We performed a qualitative s...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy102
更新日期:2018-05-03 00:00:00
abstract::Using data from 3 private healthcare claims repositories, we evaluated the incidence of pneumococcal disease among adults with US Advisory Committee on Immunization Practices (ACIP) defined at-risk conditions or rheumatoid arthritis, lupus, Crohn's disease, and neuromuscular disorder/seizures and those with traditiona...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofv020
更新日期:2015-03-20 00:00:00
abstract::We report a family who acquired acute toxoplasmosis after a trip to Central America. One member developed severe clinical manifestations including bilateral chorioretinitis, hepatitis, and myocarditis requiring therapy. Symptomatic acute toxoplasmosis is unusual and possesses a diagnostic challenge. We discuss the cli...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy058
更新日期:2018-03-09 00:00:00
abstract:BACKGROUND:Human immunodeficiency virus controllers (HICs) form a heterogeneous group of patients with regard to formal definitions, immunologic characteristics, and changes over time in viral load. PATIENTS AND METHODS:The HICs with undetectable viral load ([uHICs] ie, for whom a viral load had never been detected wi...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx064
更新日期:2017-04-03 00:00:00
abstract:Background:From an isolated epidemic, coronavirus disease 2019 has now emerged as a global pandemic. The availability of genomes in the public domain after the epidemic provides a unique opportunity to understand the evolution and spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus across the g...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa434
更新日期:2020-09-18 00:00:00
abstract:Background:Needle and syringe sharing among people who inject drugs (PWID) can result in a rapid regional spread of a human immunodeficiency virus (HIV) variant. Such outbreaks have been identified recently in several countries and have raised public health attention because of an association with new psychoactive subs...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa192
更新日期:2020-05-27 00:00:00
abstract:Background:Patients heterozygous for mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene may be more susceptible to respiratory infections than the general population. Methods :We conducted a retrospective case-control study using health insurance claims. We identified patients as either h...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy219
更新日期:2018-11-01 00:00:00
abstract::[This corrects the article DOI: 10.1093/ofid/ofv111.]. ...
journal_title:Open forum infectious diseases
pub_type: 已发布勘误
doi:10.1093/ofid/ofv132
更新日期:2015-09-04 00:00:00
abstract::Cryptococcus gattii infections, especially including those with severe clinical manifestations, may be related to underlying host immunologic factors. We present 2 cases with autoantibodies to granulocyte-macrophage colony-stimulating factor (GM-CSF), a key cytokine in macrophage function. Immunologic evaluation for a...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx211
更新日期:2017-10-05 00:00:00
abstract:BACKGROUND:Disseminated strongyloidiasis in solid organ transplant recipients is a rare but devastating infection. In our center, we implemented a universal screening of all candidates for kidney transplantation. We assessed the seroprevalence and utility of universal screening for strongyloidiasis in our center. METH...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz172
更新日期:2019-07-01 00:00:00
abstract::Invasive aspergillosis (IA) is the most serious mold infection encountered in patients with iatrogenic immunosuppression. IA is also a major cause of mortality and morbidity in individuals with primary immunodeficiency (PID). Although Aspergillus fumigatus is the most common etiologic agent of IA reported in PID patie...
journal_title:Open forum infectious diseases
pub_type: 杂志文章,评审
doi:10.1093/ofid/ofy213
更新日期:2018-09-26 00:00:00
abstract:Background:The objective of this study was to investigate the difference in disease severity between influenza A and B among hospitalized adults using a novel ordinal scale and existing clinical outcome end points. Methods:A prospective, observational study was conducted over the 2016-2018 influenza seasons in a centr...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz053
更新日期:2019-02-15 00:00:00