Clinical correlate 13 HIV Study questions 1. What are the changes in mortality rate from AIDS in the US and what accounts for that change? 2. How many new cases occur each year and what are the demographics? 3.What are the indications for HIV testing? Should someone who requests testing with no known risk factors be tested? Why? What about patients who repeatedly request testing? 4.What are the US Preventive Services Task Force screening guidelines for HIV? Reference Texts A. Summary from Overcoming the False Dichotomy of Curative vs Palliative Care for Late-Stage HIV/AIDS “Let Me Live the Way I Want to Live, Until I Can’t” Peter A. Selwyn, MD, MPH; Marshall Forstein, MD JAMA. 2003;290:806-814 Following the dramatic decrease in AIDS-related mortality rates that began in 1995, the rate of decline has plateaued at approximately 15 000 deaths per year since 1997. Nevertheless, AIDS remains a leading cause of death among young adults aged 25 to 44 years, especially among African Americans and Hispanics. In addition, with no decrease in HIV incidence and the observed decline in death rates, the prevalence of HIV/AIDS has actually increased, including the subgroup of patients requiring chronic disease management and palliative care interventions.
In 1995, thanks to therapeutic advances, especially through highly active antiretroviral therapy (HAART) death from AIDS began to decrease. Now the death rate is about 15,000 per year. However, incidence of HIV has remained unchanged and AIDS is still one of the major causes of death in the age group 25-44, particularly in minorities. Thus the overall prevalence of HIV disease is increasing, although it is more often now regarded as a chronic disease, at least in the developed world, comprising remissions and exacerbation, and requiring close attention to medications and their side effects, as well as disease related physical and mental conditions . B. Curbside Consultation: Harvey Ann, Golsdschmidt R. HIV Testing on Demand http://www.aafp.org/afp/20050501/curbside.html
C. US Preventive Task Force Recommendation on HIV Screening http://www.ahrq.gov/clinic/uspstf/uspshivi.htm
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