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Prevention for Positives

Prevention for Positives. Jordan E. Lake, MD, MSc AAHU August 2013. What is. Prevention for positives?. Prevention for Positives (PWP). PWP means helping HIV+ persons learn how to prevent transmitting HIV to someone else

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Prevention for Positives

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  1. Prevention for Positives Jordan E. Lake, MD, MSc AAHU August 2013

  2. What is Prevention for positives?

  3. Prevention for Positives (PWP) PWP means helping HIV+ persons learn how to prevent transmitting HIV to someone else In addition to educating HIV- partners about risk, optimizing health and behaviors of the HIV+ person is needed to reduce transmission

  4. Prevention for Positives (PWP) • Also a CDC initiative that initially included -increased HIV testing in medical settings -increased use of new testing technologies -prevention of transmission from HIV+ persons to sex and needle sharing partners -perinatal transmission prevention

  5. Prevention for Positives (PWP) • Now a “holistic and system level approach to risk reduction” aimed at High Impact Prevention in the U.S. • 10 components: -linking every person living with HIV to medical care -retaining patients in care -prescribing ART to all patients -helping patients maintain adherence to treatment -providing partner services -screening for HIV risk/referring to risk reduction programs -giving referrals to other supportive services -screening for sexually transmitted infections and supplying related services -delivering appropriate reproductive health care -preventing mother-to-child transmission of HIV

  6. http://www.cdc.gov/hiv/prevention/programs/pwp/index.html

  7. PWP for Developing Countries http://www.who.int/bulletin/volumes/88/8/09-068213/en/

  8. PWP GETTING PATIENTS IN to CARE and Keeping them there

  9. http://www.cdc.gov/hiv/prevention/programs/pwp/linkage.html

  10. http://www.cdc.gov/hiv/prevention/programs/pwp/linkage.html

  11. PWP Preventing HIV with ART

  12. N Engl J Med 2000; 342:921-929

  13. PWP HIV meets the “other” STIs

  14. STIs and HIV Transmission An HIV+ person with and STI is more likely to transmit HIV through sexual contact than other HIV-infected persons Ulcers, inflammation, increased HIV in genital secretions 1. WasserheitJN. 1992. Sexually Transmitted Diseases 9:61-77. 2. http://www.cdc.gov/std/hiv/stdfact-std-hiv.htm

  15. STIs and HIV Transmission: Test Frequently and

  16. PWP OTHER strategies

  17. Risk Reduction as PWP Counseling and education regarding Sexual practices STI history Substance use Domestic violence Food and housing security Fertility desires HIV disclosure Access to services such as needle exchange, substance abuse treatment, shelters, etc. when indicated

  18. Disclosure: Do the Right Thing

  19. Barriers to Risk Reduction Implementation The provider/client environment has to be and feel non-judgemental Providers have to ask! Providers need time to educate and available referral services Clients have to be engaged and want to implement change

  20. Barriers to Risk Reduction Implementation Providers have to ask!

  21. Barriers to Risk Reduction Implementation Clients have to be engaged and want to implement change

  22. PWP: It Takes a Village!

  23. http://www.hivpwp.org/

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