Abstract:
Background:The Affordable Care Act's (ACA's) major reforms started in 2014. In addition to assessing HIV clinicians' ACA knowledge and attitudes, this study aims to evaluate HIV clinicians' perspectives on whether the ACA has impacted the quality of HIV care and whether it addresses the main barriers to HIV care. Methods:HIV clinicians were emailed a survey weblink in 2018. Descriptive statistics, Mann-Whitney U tests, and binary logistic regression were performed. Results:Of the 211 survey participants, the majority (70%) answered all 4 knowledge questions correctly. About 80% knew correctly whether their state had expanded Medicaid. Participants from Medicaid expansion states were more likely to report an improved ability to provide high-quality care compared with participants from Medicaid nonexpansion states (50% vs 34%; P = .01). The average response to whether the ACA addresses the main barriers to HIV care was neutral and did not differ based on Medicaid status. The top 3 main barriers to HIV care cited were mental health, substance use, and transportation. Conclusions:HIV clinicians in Medicaid expansion states were more likely to report an improved ability to provide high-quality care since ACA implementation compared with those in Medicaid nonexpansion states. However, HIV clinicians across the United States are concerned that the ACA does not address the main barriers to HIV care. To be successful, the "Ending the HIV Epidemic" initiative should address these identified barriers.
journal_name
Open Forum Infect Disjournal_title
Open forum infectious diseasesauthors
McManus KA,Ferey J,Farrell E,Dillingham Rdoi
10.1093/ofid/ofaa225subject
Has Abstractpub_date
2020-06-10 00:00:00pages
ofaa225issue
7issn
2328-8957pii
ofaa225journal_volume
7pub_type
杂志文章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:Avian influenza A/H5N1 has threatened human health for nearly 2 decades. Avian influenza A vaccine without adjuvant is poorly immunogenic. A flexible rapid tactic for mass vaccination will be needed if a pandemic occurs. METHODS:A multicenter, randomized, blinded phase 1 clinical trial evaluated safety and ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofu102
更新日期:2014-11-18 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:Background:Few published studies exist to describe the off-label use of multiple-dose fosfomycin for outpatient treatment of complicated urinary tract infections (UTI). The purpose of this study was to characterize the patients, infections, drug susceptibilities, and outcomes of multiple-dose fosfomycin episodes for ou...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa034
更新日期:2020-01-29 00:00:00
abstract::Background. Sepsis is a serious and common condition with high mortality and morbidity. The public awareness, knowledge, and perception of sepsis in Sweden are unknown. Methods. A survey was performed using an online interview distributed to adults, aged 18-74, between March 6 and 9, 2015. Results. A total of 1001 ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofv161
更新日期:2015-10-26 00:00:00
abstract::Both dengue virus (DENV) and hepatitis C virus (HCV) belong to the Flaviviridae family and could induce hepatitis. We aimed to investigate the interference between them. In total, 515 patients confirmed with dengue fever (DF) were enrolled. Thirty-two patients (6.21%) were seropositive for anti-HCV; 12 of 32 anti-HCV-...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa272
更新日期:2020-07-03 00:00:00
abstract:Background:Delayed pathogen identification and nonspecific clinical findings make definitive decisions regarding antibiotics challenging. The stimuli of bacterial toxins and inflammation make procalcitonin (PCT) unique in its ability to differentiate bacterial infection from other causes of inflammation, and thus it is...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx213
更新日期:2017-10-03 00:00:00
abstract::We describe a case of fetal parvovirus B19 infection resulting in preterm birth and leading to hydrops fetalis requiring multiple in utero transfusions. The infant developed chronic postnatal anemia responsive to intravenous immunoglobulin therapy. Serum viral load decreased after immunoglobulin treatment but remained...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofv049
更新日期:2015-04-15 00:00:00
abstract::Background. Practicing antimicrobial stewardship in the setting of widespread antimicrobial resistance among gram-negative bacilli, particularly in urban areas, is challenging. Methods. We conducted a retrospective cross-sectional study at a tertiary care hospital with an established antimicrobial stewardship progra...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofv009
更新日期:2015-02-19 00:00:00
abstract:BACKGROUND:Intra-abdominal infections (IAI) constitute a common reason for hospitalization. However, there is lack of standardization in empiric management of (1) anaerobes, (2) enterococci, (3) fungi, and (4) multidrug-resistant organisms (MDRO). The recommendation is to institute empiric coverage for some of these or...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofw232
更新日期:2016-12-20 00:00:00
abstract:Background:Recent mumps outbreaks among 2-dose measles mumps rubella (MMR) vaccine recipients have raised questions regarding the potential benefits of a third dose of vaccine (MMR3). If MMR3 provides a sustained elevation in mumps antibody, it may be beneficial for certain at-risk groups or as an outbreak control meas...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx263
更新日期:2017-12-08 00:00:00
abstract::Background. Histoplasmosis causes severe disease in patients with defects of cell-mediated immunity. It is not known whether outcomes vary related to the type of immunodeficiency or class of antifungal treatment. Methods. We reviewed cases of active histoplasmosis that occurred at Vanderbilt University Medical Cente...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofu116
更新日期:2015-02-20 00:00:00
abstract:Background:Oncological patients have several additional risk factors for developing a cardiac implantable electronic device (CIED)-related infection. Therefore, we evaluated the clinical impact of our comprehensive bundle approach that includes the novel minocycline and rifampin antimicrobial mesh (TYRX) for the preven...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa433
更新日期:2020-09-13 00:00:00
abstract:Background:Staphylococcus aureus is the most common cause of native septic arthritis. Few studies have characterized this disease during the US opioid epidemic. The role of methicillin-resistant Staphylococcus aureus (MRSA) nasal screening in this disease has not been elucidated. We sought to identify risk factors and ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa593
更新日期:2020-12-18 00:00:00
abstract:Background:Hepatitis C remains a major cause of liver disease globally and is responsible for approximately 500 000 deaths annually. Newer direct-acting antivirals achieve cure rates at or above 90% with excellent tolerability for most patients. The literature focusing on identification of predictors of efficacy and sa...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz087
更新日期:2019-02-19 00:00:00
abstract::Suspicion of an infection without localizing signs or symptoms is a common problem. A chest x-ray (CXR) is often performed to rule out pneumonia. Our prospective cross-sectional study suggests that a CXR has no diagnostic value in patients without respiratory signs or symptoms, if a reliable medical history can be obt...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa221
更新日期:2020-06-08 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:Whether antibiotic treatment of asymptomatic bacteriuria (AB) can prevent acute graft pyelonephritis (AGP) in kidney transplant (KT) recipients has not been elucidated. Methods:In this multicenter, open-label, nonblinded, prospective, noninferiority, randomized controlled trial, we compared antibiotic treat...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz243
更新日期:2019-05-21 00:00:00
abstract:Background:Hepatitis C virus (HCV), a major cause of morbidity and mortality, is common and rising among young persons who inject drugs (PWID). Reducing the level of viremia may be an intervention, yet the impact of viremia on HCV transmission is unknown. Methods:We conducted a prospective study of injecting partnersh...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz125
更新日期:2019-04-25 00:00:00
abstract::Ebola virus (EBOV) is a highly pathogenic filovirus that causes outbreaks of a severe hemorrhagic fever known as EBOV disease (EVD). Ebola virus disease is characterized in part by a dysregulated immune response and massive production of both pro- and anti-inflammatory cytokines. To better understand the immune respon...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz046
更新日期:2019-02-06 00:00:00
abstract::We developed an open-access, Excel-based model simulating currently recommended and alternative algorithms for adult HIV testing as a preliminary investigation of trade-offs between accuracy and costs. Despite higher costs, simpler HIV testing algorithms incorporating point of care nucleic acid testing may improve out...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy170
更新日期:2018-08-29 00:00:00
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 ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz101
更新日期:2019-02-26 00:00:00
abstract::Background. The majority of Lyme disease cases in the United States are acquired on the east coast between northern Virginia and New England. In recent years the geographic extent of Lyme disease has been expanding, raising the prospect of Lyme disease becoming endemic in the southeast. Methods. We collected confirm...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofv143
更新日期:2015-09-27 00:00:00
abstract:Background:Cryptococcal meningitis is a major cause of death among people with human immunodeficiency virus (PWH). Cryptococcal antigen (CrAg) testing of asymptomatic patients is an important public health measure to reduce mortality in high-incidence areas. However, limited data exist on CrAg prevalence in Central Ame...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa557
更新日期:2020-11-13 00:00:00
abstract:Background:Dengue and Chikungunya viruses can cause large-scale epidemics, with attack rates of up to 80%. In Tanzania, there have been repeated outbreaks of dengue fever, the most recent in 2018 and 2019, mostly affecting the coastal areas. Despite the importance of these viruses, there is limited knowledge on the epi...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa626
更新日期:2020-12-26 00:00:00
abstract::The Democratic Republic of the Congo (DRC) has begun implementing HIV self-testing to boost the first "95" of the UNAIDS 95-95-95 targets by 2025. This study aims to assess the performance and usability of the Exacto Test HIV (Biosynex, Strasbourg, France) self-test in the lab and in the field. The Exacto Test HIV sel...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa554
更新日期:2020-11-29 00:00:00
abstract:Background:Intestinal fatty acid binding protein (I-FABP) has been shown to be a marker of intestinal damage among people living with HIV. We hypothesized that I-FABP would be increased in chronically HIV-infected patents more than elite controllers and would relate to specific nutrient intake and body composition. Me...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy288
更新日期:2018-11-05 00:00:00
abstract::Background. Advanced fibrosis occurs more commonly in human immunodeficiency virus (HIV)-hepatitis B virus (HBV) coinfected individuals; therefore, fibrosis monitoring is important in this population. However, transient elastography (TE) data in HIV-HBV coinfection are lacking. We aimed to assess liver fibrosis using...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofw035
更新日期:2016-02-12 00:00:00
abstract:Background:Residual monocyte activation may contribute to increased risk for endothelial dysfunction and subsequent atherosclerotic cardiovascular diseases (CVDs) among people with HIV (PWH) on antiretroviral therapy (ART). We examined the relationship between monocyte activation and endothelial activation in PWH in Ke...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa425
更新日期:2020-09-12 00:00:00
abstract::Background. Sepsis is a major cause of morbidity and mortality among older adults. The main goals of this study were to assess the association of sepsis at intensive care unit (ICU) admission with mortality and to identify predictors associated with increased mortality in older adults. Methods. We conducted a prospe...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofw010
更新日期:2016-01-21 00:00:00