Nurses are on the front-lines of increasing access to health care. As a nurse, my first priority is always the patient. A recent case demonstrates the importance of the role of nursing in providing needed services for patients. In this case, a young person was a victim of sexual assault resulting in HIV exposure. The MidAtlantic AETC had conducted training on post-exposure prophylaxis (PEP) and one of our participants in that training was responsible for making sure that the patient received nPEP.
What is a dental emergency?
I often get this question from non-dental personnel including case managers, physician assistants, nurses, and nurse practitioners. The following is a short list of questions you can ask patients to guide dental referrals for emergency care:
In September 2017, the U.S. Centers for Disease Control and Prevention (CDC) officially recognized that suppressing HIV through antiretroviral therapy (ART) prevents sexual transmission of HIV. In a "Dear Colleague" letter, CDC officials said, "people who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner."
A recent study that was conducted among 1200 HIV patient of whom 600 each belonged to with ART and without ART and the occurrence of oral candidiasis and oral hairy leukoplakia. This study shows that oral candidiasis and leukoplakia was less among patients on ART as well as a decrease in the number of opportunistic infections. This is important as oral manifestations might serve as an important marker for monitoring restoration of immune function and ART failure.
The question I most commonly get asked by oral health providers is...
Do I pre-medicate patients based on a high viral load and low CD4 count?
It is estimated that 1.1 million people in the United States are infected with HIV. Of those, 1 in 7 do not know they are infected. The number of new HIV diagnoses fell 19% from 2005 to 2014. Because HIV testing rates have remained stable or increased in recent years, this decrease in diagnoses suggests a true decline in new infections. The statistics in the Southern United States are not as promising.
The U.S. Department of Health and Human Services currently recommends that every person with HIV begin antiretroviral therapy (ART) as soon as possible after diagnosis.
According to a new study published in the Journal Annals of Internal Medicine, one in nine American men is infected with the oral form of the human papillomavirus (HPV). Nationwide, rates of oral HPV infection are 11.5% of men vs. 3.2% women. HPV 16, the most common type of high-risk HPV and known to contribute to head and neck cancers, was six times higher in men than women.
I had the honor to help develop the first legal syringe access program (SAP) in Atlantic City, NJ, almost 10 years ago. In 2006, the New Jersey legislature passed the Blood-Borne Disease Harm Reduction Act. This allowed for the establishment of up to six pilot SAPs in NJ. However, approval from each selected city’s government was required before opening.
Doravirine (DOR) is an investigational NNRTI that currently is being developed in a coformulation with TDF and FTC. A Phase 3 comparison of DOR + 2 NRTIs (87% of study subjects were given TDF/FTC) and DRV/r + 2 NRTIs in initial therapy was presented at CROI earlier this year (DRIVE-FORWARD); the DOR arm was found to be noninferior to the DRV arm (see CROI 2017: Doravirine Noninferior to Darunavir + Ritonavir in Initial Treatment).