RESUMEN
Partner notification services (PNS) offers opportunities to discuss HIV pre-exposure prophylaxis (PrEP) and provide referrals. We evaluated the PrEP care cascade among men who have sex with men (MSM) engaging in PNS within a sexually transmitted infections clinic. Among 121 MSM eligible for PrEP during PNS, 21% subsequently initiated PrEP.
Asunto(s)
Trazado de Contacto , Infecciones por VIH , Homosexualidad Masculina , Profilaxis Pre-Exposición , Humanos , Masculino , Adulto , Infecciones por VIH/prevención & control , Adulto Joven , Parejas Sexuales , Enfermedades de Transmisión Sexual/prevención & control , Persona de Mediana Edad , Instituciones de Atención AmbulatoriaRESUMEN
Objectives. To assess costs of video and traditional in-person directly observed therapy (DOT) for tuberculosis (TB) treatment to health departments and patients in New York City, Rhode Island, and San Francisco, California.Methods. We collected health department costs for video DOT (VDOT; live and recorded), and in-person DOT (field- and clinic-based). Time-motion surveys estimated provider time and cost. A separate survey collected patient costs. We used a regression model to estimate cost by DOT type.Results. Between August 2017 and June 2018, 343 DOT sessions were captured from 225 patients; 87 completed a survey. Patient costs were lowest for VDOT live ($1.01) and highest for clinic DOT ($34.53). The societal (health department + patient) costs of VDOT live and recorded ($6.65 and $12.64, respectively) were less than field and clinic DOT ($21.40 and $46.11, respectively). VDOT recorded health department cost was not statistically different from field DOT cost in Rhode Island.Conclusions. Among the 4 different modalities, both types of VDOT were associated with lower societal costs when compared with traditional forms of DOT.Public Health Implications. VDOT was associated with lower costs from the societal perspective and may reduce public health costs when TB incidence is high.
Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , Antituberculosos/administración & dosificación , Terapia por Observación Directa , Telemedicina/organización & administración , Tuberculosis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Instituciones de Atención Ambulatoria/economía , Antituberculosos/uso terapéutico , Costos y Análisis de Costo , Femenino , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Modelos Económicos , Telemedicina/economía , Estados Unidos , Adulto JovenRESUMEN
The number of people diagnosed with syphilis has increased significantly in the United States over the last decade. In Rhode Island, the number of new diagnoses has increased more than four-fold since 2008. Syphilis disproportionately impacts gay, bisexual, and other men who have sex with men (MSM), with those from African American and Hispanic/Latino communities most affected. Given these trends, physicians need to be aware of current prevention, diagnosis, and treatment practices for syphilis, especially when working with populations who are most at risk. [Full article available at http://rimed.org/rimedicaljournal-2019-02.asp].