FREDERICK LEWIS ALTICE

..The high prevalence of HIV-seronegative inmates with self-reported high-risk behaviors also suggests the importance of prisons as sites for the introduction of appropriate risk-reduction interventions...

..Alternative methods of facilitating more widespread HIV testing, such as saliva tests, rapid serologic tests, and more routine testing in high HIV-prevalence areas should be considered both for clinical and for public health benefits...

..Dialogue among practitioners and policy makers in the HIV care and substance abuse communities will facilitate an effective expansion of buprenorphine and ensure that these beneficial outcomes are achieved...

..Moreover, DAART should incorporate enhanced elements such as convenience, flexibility, confidentiality, cues and reminders, responsive pharmacy and medical services, and specialized training for staff...

..In addition, it demonstrates that this population can benefit from this therapy with the support of a nontraditional, community-based health intervention...

..Multifaceted, interdisciplinary approaches are urgently needed to achieve parity in health outcomes in HIV-infected drug users...

..Having opioid dependence and HIV infection are associated with poor HIV-related treatment outcomes...

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..Directly administered antiretroviral therapy (DAART) is one approach to improve treatment adherence among human immunodeficiency virus (HIV)-infected drug users...

..The presence of depression and the lack of willingness to travel greater than four blocks to receive DAART predicted time-to-discontinuation...

..More effective community-release programs are needed for incarcerated patients with HIV disease...

..The objective of this study was to evaluate the optimal time to routinely HIV test newly incarcerated jail detainees using an opt-out strategy...

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..Data are lacking on outcomes of treatment with pegylated interferon plus ribavirin (PEG-RBV) in correctional settings...

..Currently, tuberculin skin testing (TST) is recommended for patients enrolling in methadone maintenance treatment (MMT), but not for those enrolling in buprenorphine maintenance treatment (BMT)...

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..Ten million Americans enter jails annually. The objective was to evaluate new CDC guidelines for routine opt-out HIV testing and examine the optimal time to implement routine opt-out HIV testing among newly incarcerated jail detainees...

..These results suggest the potential utility of integrating these services into DAART interventions (DAART-Plus) targeting HIV-infected drug users with problematic adherence...

..The key barriers against effective integration of buprenorphine maintenance therapy and primary HIV services are discussed, and we suggest several mechanisms to overcome such obstacles...

..Previous reports in the literature have suggested hepatotoxicity with buprenorphine tempering initial enthusiasm of the safety of buprenorphine in HCV-infected patients...

..Directly administered antiretroviral therapy (DAART) is an effective intervention that improves clinical outcomes among HIV-infected drug users. Its effects on antiretroviral drug resistance, however, are unknown...

..Prospective cohort studies, rather than hospital-derived samples, are needed to better understand the safety of buprenorphine injection...

..To address this concern, co-formulation of buprenorphine/naloxone (BPN/NLX) replaced buprenorphine alone in Malaysia in December 2006...

..BUP/NLX and TPV/r should therefore be used cautiously to avoid decreased efficacy of TPV in patients taking these agents concomitantly...

..Until buprenorphine maintenance therapy (BMT) was introduced, few effective strategies aimed at achieving reduction in illicit drug use were available as a conduit to anti-retroviral therapy (ARV) among IDUs...

..Future randomized controlled trials are needed to affirm its benefit in this highly vulnerable population...

..Community-based assessments are urgently needed as HAART rollouts continue. Adaptation of this IMB-based survey may better inform efforts to enhance HAART-program implementation in resource-limited settings globally...

..This study was conducted to examine the pharmacokinetic interactions between buprenorphine/naloxone (BUP/NLX) and lopinavir/ritonavir (LPV/r) in HIV-seronegative subjects chronically maintained on BUP/NLX...

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..Buprenorphine/naloxone allows the integration of opioid dependence and HIV treatment...

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..We also examined to what extent negative experiences and stigmatization affected attitudes toward HIV testing...

..Global access to opioid agonist therapy and HIV treatment is expanding but when concurrently used, problematic pharmacokinetic drug interactions can occur...

..Despite the high prevalence of HIV in correctional settings, the duration of therapy and response to various highly active antiretroviral therapy (HAART) regimens in this setting is unknown...

..Jails present added complexities because of their shorter stay with respect to prisons, and testing, treatment, and counseling policies must be adapted to these settings...

..To date, this is the first presentation of symptomatic hyperlactatemia in a patient with HIV infection and HGE...

..Trust engendered by and mutual respect afforded by such programs result in repeated encounters by active IDUs over time...

..In settings where HIV screening policies are not in place, however, the implementation of RPS can be expected to significantly reduce pediatric HIV cases and net health care expenditures...

..We present a review of diagnosis, prevention, and the recently streamlined treatment guidelines for management of HBV infection in correctional settings, and discuss the implications and public health impact of these measures...

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..Innovative mechanisms that harness drug users' peer pressure to promote positive behavioral changes deserve greater study...

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..Evidence points toward the use of behavioral counseling aimed at enhancing patients' motivation during treatment entry followed by an emphasis on improving coping/relapse prevention skills during the primary phase of treatment...

..Objective evidence of reductions in high-risk behavior in these 3 groups, which account for the majority of HIV transmissions in the United States, has critical implications for reducing the overall rate of new HIV infections...

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..Therefore, if allowed the opportunity to decrease my current clinical and administrative responsibilities, I am likely to be able to achieve my short- and long-term career development goals. ..

..It is therefore likely that the stated aim will be successfully accomplished, despite the challenges of working with prisoners and drug-using populations. ..

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..Secondary measures of interest include quality of life measures, health care utilization and entry into drug treatment. ..

..This proposal intends to improve health to the individual and to the community during the crucial period during transition from the prison to the community. ..