hiv screening, testing and treatment in adolescents january 2012 meera beharry, md division of...
Post on 22-Dec-2015
217 Views
Preview:
TRANSCRIPT
HIV Screening, Testing and Treatment in Adolescents
January 2012
Meera Beharry, MD
Division of Adolescent MedicineUniversity of Rochester Medical Center
ACT for Youth Center of Excellence
Cornell University Bronfenbrenner Center for Translational Research Cornell University Cooperative Extension of New York CityNew York State Center for School SafetyUniversity of Rochester Medical Center Div. of Adolescent Medicine
ObjectivesDescribe current screening methodsUnderstand reasons why repeat testing
would be necessaryDiscuss treatment issues specific to
adolescents
Summary of HIV and AIDS (1 of 2)
HIV is acquired through direct contact with infected body fluids of a person who has HIV.
Untreated, HIV destroys the body’s immune system, leading to AIDS (serious infections, organ failure and death).
High-risk groups: Males who have sex with males at highest
risk. High-risk heterosexual activity is most
rapidly increasing cause.
Summary of HIV and AIDS (2 of 2)
Avoid high-risk behaviors to avoid HIV.Screening is reliable and results can be
obtained quickly; Testing takes longer but is definite.
Treatment with multiple medications (Highly Active Anti-Retroviral Therapy-HAART) is able to stop the progression of HIV replication in the body, but requires compliance with therapy.
Screening HIV screening is
recommended for patients in all health-care settings
Persons at high risk for HIV infection should be screened for HIV at least once a year.
Variety of methods
Uni-Gold FDA approved 2003 Uses small amount
of blood For use by
professionals only Results in 10
minutes Positive result must
be confirmed
Ora-Quick Advance ® Approved in 2002 Uses small amount
of blood or oral fluid For use by
professionals only Results in 20
minutes Positive results must
be confirmed
Home TestsFirst licensed in 1997Only the Home Access HIV-1® test
system is approved by FDA Is actually home collection kitMust call in for resultsExpensive
http://www.cdc.gov/hiv/topics/testing/resources/qa/tests_work.htm#screening
Confirmatory TestingMandatory for positive resultsWestern Blot
Blood draw Oral fluid
Follow-up in 4 weeks if “indeterminate” or negative
Treatment Highly Active Anti-
Retroviral Therapy (HAART)
Early, consistent treatment can prolong life
Can prevent spread to unborn child
PEP: Post Exposure Prophylaxis
“The patient’s need for HAART must be balanced with the ability to adhere to the drug regimen.”
Adolescent Health Care and Practical Guide Belzer and Neinstein
Medication Adherence Assessment Perception of Health Status Social Support Living arrangements/housing stability Psychological concerns Developmental Level Factors that influence ability to take
medication Time orientation and organization Physical abilities Tolerance of side effects Medication Complexity
Myerson, Alice: Adolescent AIDS Program @ Montefiore
Life Skills That an Adolescent Needs for Successful Transition to an Adult Clinic
Knowing when and how to seek medical care Knowing when and how to seek medical care for symptoms or emergenciesfor symptoms or emergencies
Using one’s primary care provider appropriatelyUsing one’s primary care provider appropriately Making, canceling, and rescheduling Making, canceling, and rescheduling
appointmentsappointments Coming to appointments on timeComing to appointments on time Calling ahead of time for urgent visitsCalling ahead of time for urgent visits Refilling of prescriptions on timeRefilling of prescriptions on time Maintenance of one’s health insurance Maintenance of one’s health insurance Negotiating multiple subspecialty providersNegotiating multiple subspecialty providers
Jeffrey M Birnbaum, MD,MPHSUNY Downstate Medical Center
Summary Everyone should be tested for HIV There are many options for HIV testing and
screening---young people may not be aware of these
A positive or indeterminate screening result must be verified with a more specific test
People at high risk for acquiring HIV should be tested at least once a year
SummaryEarly and appropriate treatment with
HAART makes it possible for people who are HIV positive to live healthy and productive lives
HIV positive individuals should be treated by specialists
Being able to adhere to a treatment plan is of utmost importance
Testing
NYS DOH HIV Counseling and Testing Resource Directory (11/10 Update)www.health.ny.gov/publications/9515/index.htm
NYS DOH phone Via the DOH
website below National info by
texting your zip code to KNOWIT (566948) or
www.HIVtest.org
Resources CDC: www.cdc.gov/hiv/ NYS DOH AIDS Institute:
http://www.nyhealth.gov/diseases/aids/ 100 questions and answers about HIV/AIDS
http://www.nyhealth.gov/publications/0213.pdf http://www.nyhealth.gov/publications/0214.pdf (Español)
NYC DOH/MH: www.nyc.gov/html/doh/html/ah/ah.shtml
Or call: 1-800-541-AIDS (English) 1-800-233-SIDA (Español) Complete HIV/AIDS & Young People Series:
http://actforyouth.net/hiv-series
Was this presentation useful? Please give us your feedback:http://www.zoomerang.com/Survey/WEB22AEZWMYJH3
The ACT for Youth Center of Excellence connects positive youth development resources and research to practice in New York State and beyond. The Center provides:
Technical support, training, and evaluation for youth-serving programs funded by the NYS Department of Health.
Youth Development resources: www.actforyouth.net, publications, training and events, and the e-letter ACT for Youth Update. Email act4youth@cornell.edu to subscribe.
A home base for the ACT Youth Network. Visit the network at www.nysyouth.net
act4youth@cornell.edu • 607-255-7736 • http://www.actforyouth.net
ACT for Youth Center of Excellence
top related