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Sexual Risk Behavior & Viral Suppression in Patients With HIV

Sexual Risk Behavior & Viral Suppression in Patients With HIV

Research indicates that nearly 90% of new HIV infections in the United States in 2010 were attributed to sexual transmission. However, nationally representative data on sexual risk behaviors have not been available since the late 1990s. Collecting national data on the sexual risk behaviors of people with HIV who are receiving medical care can help clinicians identify those who are at greatest risk of transmitting the virus. It can also help inform prevention efforts to reduce sexual transmission of HIV and the acquisition of other sexually transmitted infections (STIs). Taking a Closer Look For a study published in AIDS, Christine L. Mattson, PhD, and colleagues sought to describe sexual risk behavior in a national sample of HIV-infected adults receiving medical care in the U.S. Some patients were virally suppressed—defined as all viral load measurements during the past 12 months less than 200 copies/ml—and some were not. “Given the increased probability of HIV transmission when individuals are not virally suppressed, we also assessed the association between sexual risk behavior and viral suppression,” says Dr. Mattson. “Using interview and medical record data from 2009, we looked at self-reported sexual behaviors in the past 12 months.” Overall, 56% of participants reported anal or vaginal sex with one or more partners in the past 12 months, 13% reported an STI, and 56% reported not having been tested for STIs. Also, 24% drank alcohol and 11% used drugs before or during sex. Nearly equal percentages of men who have sex with men (MSM), men who have sex with women (MSW), and women who have sex with men (WSM) engaged in vaginal or anal sex...

A 17-Year-Old Boy Impersonates a Doctor

In case you haven’t heard, a 17-year-old boy was discovered impersonating a doctor in a West Palm Beach, Florida hospital last month. According to one report, a patient told some staff at the hospital’s outpatient obstetrics and gynecology office that “a young male who ‘appeared to be a child’ was dressed as a doctor and was inside an exam room.” The lad was wearing a white coat and had a stethoscope around his neck. Some hospital personnel said a real doctor had been conducting an examination while the boy was in the room. From the police report: “The subject was seen on several floors of the hospital by several hospital employees entering patients [sic] rooms and talking to hospital employees.” He had apparently been walking around the hospital for a month. A security guard said the boy was “known around the hospital as a doctor.” After he was apprehended, a search of his car revealed a white coat with the word “Anesthesiology” embroidered on it as well as documents from another hospital in West Palm Beach. An employee of that institution said he had been seen walking around there at least once. Perhaps he was thinking about expanding his practice. The stories said that the boy had some sort of “condition,” and his mother told the police that he had been refusing to take his medication. He was not charged with a crime. Another account published a statement by the hospital that said, “The individual never had contact with any hospital patients and did not gain access to any patient care areas of the hospital at any time. The...
CT-Based Lung Cancer Screening in HIV

CT-Based Lung Cancer Screening in HIV

Studies have found that patients with HIV have a two- to five-fold greater risk of lung cancer when compared with patients from the general population. Other research has suggested that CT-based lung cancer screening can help decrease lung cancer mortality in heavy smokers. Pairing these findings together has led to speculation that patients with HIV, particularly those who smoke, may be a key target for CT-based lung cancer screening. However, approximately 20% of chest CT scans show abnormalities suggestive of lung cancer. This could lead to invasive tests with downstream complications. “Because patients with HIV are more likely than the general population to have a history of lung infections or other pulmonary diseases,” explains Keith Sigel, MD, MPH, “they may have more abnormalities on their CT scans. This can increase their risk of false-positive findings on CT-based lung cancer screening.” New Findings For a study published in AIDS, Dr. Sigel and colleagues analyzed data on patients with and without HIV who were at risk of lung disease. The study aimed to determine whether or not HIV had an effect on the development of lung disease by comparing the frequency of incidental findings—particularly pulmonary nodules—observed on chest CT scans. “We looked at the number of patients who had positive screens in each group and followed those patients to determine the end result of those findings on the CT scans,” says Dr. Sigel. Dr. Sigel and colleagues found that, overall, HIV-infected patients did not have significantly more positive scans (29%) than HIV-uninfected patients (24%). However, HIV-infected patients with CD4 counts lower than 200 had significantly higher odds of positive CT scans...
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