A5085929556- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- HIV/AIDS drug development and treatment
- HIV Research and Treatment
- Sex work and related issues
- Reproductive tract infections research
- Syphilis Diagnosis and Treatment
- Adolescent Sexual and Reproductive Health
- Adolescent and Pediatric Healthcare
- Global Maternal and Child Health
- Biomedical Ethics and Regulation
- Genital Health and Disease
- Healthcare Policy and Management
- Healthcare cost, quality, practices
- Pneumocystis jirovecii pneumonia detection and treatment
- Global Health and Epidemiology
- Immune Cell Function and Interaction
- Urologic and reproductive health conditions
- Space Exploration and Technology
- HIV-related health complications and treatments
- Medical Coding and Health Information
- HIV/AIDS Impact and Responses
- Folate and B Vitamins Research
- LGBTQ Health, Identity, and Policy
- Astro and Planetary Science
San Francisco Department of Public Health
2014-2025
University of California, San Francisco
2010-2025
San Francisco General Hospital
2020-2021
Natural History Museum
2020
San Francisco AIDS Foundation
2006
Dana-Farber Cancer Institute
1991
Utrecht University
1991
<h3>Importance</h3> Several randomized clinical trials have demonstrated the efficacy of preexposure prophylaxis (PrEP) in preventing human immunodeficiency virus (HIV) acquisition. Little is known about adherence to regimen, sexual practices, and overall effectiveness when PrEP implemented clinics that treat sexually transmitted infections (STIs) community-based serving men who sex with (MSM). <h3>Objective</h3> To assess adherence, behaviors, incidence STIs HIV infection a cohort MSM...
Background It is unknown if extremely early initiation of antiretroviral therapy (ART) may lead to long-term ART-free HIV remission or cure. As a result, we studied 2 individuals recruited from pre-exposure prophylaxis (PrEP) program who started prophylactic ART an estimated 10 days (Participant A; 54-year-old male) and 12 B; 31-year-old after infection with peak plasma RNA 220 copies/mL 3,343 copies/mL, respectively. Extensive testing blood tissue for persistence was performed, PrEP...
Background: Preexposure prophylaxis (PrEP) is the first biomedical intervention with proven efficacy to reduce HIV acquisition in men who have sex (MSM) and transgender women. Little known about levels of interest characteristics individuals elect take PrEP real-world clinical settings. Methods: The US Demonstration Project a prospective open-label cohort study assessing delivery municipal sexually transmitted disease clinics San Francisco Miami community health center Washington, DC....
Objective: Little is known about long-term viral suppression rates for patients who start antiretroviral therapy (ART) soon after diagnosis. We describe virologic outcomes from the San Francisco-based Ward 86 Rapid ART Program Individuals with an HIV Diagnosis (RAPID) program. Design: Retrospective review of clinic-based cohort. Methods: In 2013, adopted immediate at first visit Patients were referred testing sites, offered same or next-day intakes, and received multidisciplinary evaluation,...
The ability of the human immunodeficiency virus type 1 (HIV-1) to replicate in primary blood dendritic cells was investigated. Dendritic compose less than 1% circulating leukocytes and are nondividing cells. Highly purified preparations were obtained using recent advances cell fractionation. results these experiments show that cells, contrast monocytes T support active replication all strains HIV-1 tested, including T-cell tropic monocyte/macrophage isolates. cultures supported much more...
Pre-exposure prophylaxis (PrEP) for prevention of HIV infection has demonstrated efficacy in randomized controlled trials and demonstration projects. For PrEP implementation to result significant reductions incidence men who have sex with the United States, sufficient access care continued engagement outside projects is required.We report results a follow-up survey 173 former participants from Miami San Francisco sites US Demo Project, administered 4-6 months after study completion.Survey...
Background: Given the strong relation between sexually transmitted diseases (STDs) and spread of HIV infection, recent outbreaks syphilis in United States could lead to increased rates new infection. STD clinics serving persons at risk for would be logical sites monitor acute The detection however, is not routine requires use RNA testing combination with antibody testing. Methods: To determine rate we performed on pooled antibody-negative specimens from seeking care San Francisco City Clinic...
The objective of this study was to investigate the relationship between sex work and HIV infection among young injection drug-using men who have with (MSM-IDU).This a cross-sectional analysis behavioral serologic data collected from 227 street-recruited MSM-IDU in San Francisco, California, January 2000 November 2001.Sixty-eight percent participants reported being paid by another man for sex. prevalence 12% (95% confidence interval, 8-16%); 42% seropositive were unaware their infection....
Many resource-constrained countries now train non-physician clinicians in HIV/AIDS care, a strategy known as 'task-shifting.' There is yet no evidence-based international standard for training these cadres. In 2007, the Mozambican Ministry of Health (MOH) conducted nationwide evaluation quality care delivered by (técnicos de medicina, or TMs), after two-week in-service course emphasizing antiretroviral therapy (ART). Forty-four randomly selected TMs were directly observed expert they cared...
Early virologic suppression (VS) after human immunodeficiency virus (HIV) infection improves individual health outcomes and decreases onward transmission. In San Francisco, immediate antiretroviral therapy (ART) at HIV diagnosis was piloted in 2013-2014 expanded citywide 2015 a rapid start initiative to link all new diagnoses care within 5 days ART the first visit.
A large pool of clinicians are needed to meet the growing demand for HIV preexposure prophylaxis. We surveyed a mixed group specialists and nonspecialists in San Francisco Bay Area determine their attitudes toward training needs regarding prescribing prophylaxis persons at increased risk infection. Willingness prescribe was associated with experience caring HIV-infected patients (adjusted odds ratio 4.76, 95% confidence interval: 1.43 15.76, P = 0.01). Desire further concerns about drug...
HIV preexposure prophylaxis (PrEP) using daily oral tenofovir-disoproxil-fumarate/emtricitabine (TDF/FTC) is effective for preventing acquisition, but concerns remain about its potential kidney toxicity. This study examined function in individuals PrEP real-world clinical settings.
Initiating pre-exposure or post-exposure prophylaxis (PrEP/PEP) in the setting of undiagnosed acute HIV (AHI) could cause antiretroviral resistance. We sought to characterize clinical outcomes and drug resistance mutations among individuals prescribed PrEP/PEP with AHI at a San Francisco sexually transmitted disease clinic.In our program, patients are tested for using point-of-care antibody test. If negative, started on screened pooled RNA (5-10 days turn-around). used 2-drug PEP until...
Clinician-delivered prevention interventions offer an opportunity to integrate risk-reduction counseling as a routine part of medical care. The HIV Intervention for Providers study, randomized controlled trial, developed and tested provider training intervention in 4 northern California care clinics. were assigned either the or control condition (usual care). arm received 4-hour on assessing sexual risk behavior with HIV-positive patients delivering risk-reduction-oriented messages who...
Objective: The optimal screening frequency of sexually transmitted infections (STIs) for MSM and transgender women (TGW) on HIV pre-exposure prophylaxis (PrEP) is unclear, with present guidelines recommending every 3–6 months. We aimed to determine the number STIs which treatment would have been delayed without quarterly screening. Design: US PrEP Demonstration Project was a prospective, open-label cohort study that evaluated delivery in STI clinics San Francisco Miami, community health...
Safe and effective use of pre-exposure prophylaxis (PrEP) depends on retention in care after initial engagement.The United States PrEP Demonstration Project offered daily oral tenofovir/emtricitabine to participants San Francisco, Miami, Washington, D.C. for 48 weeks from 2012 2014.The Demo participants' patterns were assigned 1 3 categories: early loss follow-up (ELTF) within the first 12 study, throughout or intermittent which missed delayed visits resulted gaps medication availability....
Objective adherence metrics for tenofovir (TFV) disoproxil fumarate/emtricitabine (FTC)-based pre-exposure prophylaxis (PrEP) were critical interpretation of efficacy in PrEP clinical trials, and there is increasing interest using drug levels to tailor interventions reengagement adherence. Point-of-care immunoassays TFV, which examine short-term adherence, are development. However, the ability poor long-term predict future nonretention unknown.Secondary data analysis a large, prospective...
Ending the HIV epidemic in U.S. holds rapid antiretroviral therapy as a key strategy to improve health of those with and decrease transmission. In 2015, Getting Zero San Francisco, multisector consortium, expanded citywide.A Francisco Rapid ART Program Initiative for Diagnoses Committee (academic, community, service delivery, department partners) designed program, protocol, dissemination plan, monitoring strategy. Newly diagnosed patients were linked an medical home or initiation hub best...
We found that the odds of return clinic visits for persistent non-gonococcal urethritis (NGU) were significantly lower (odds ratio: .4; 95% confidence interval: .3-.6; P < .0001) after implementing (1) testing Mycoplasma genitalium during initial evaluations NGU and (2) switching from azithromycin to doxycycline as first-line treatment.