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Prevention for Positives

Prevention for Positives. Jordan E. Lake, MD, MSc AAHU September 2014. What is. Prevention for positives?. Prevention for (with) Positives (PWP). PWP means helping HIV+ persons learn how to P revent transmitting HIV to someone else Optimize health and behaviors.

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Prevention for Positives

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  1. Prevention for Positives Jordan E. Lake, MD, MSc AAHU September 2014

  2. What is Prevention for positives?

  3. Prevention for (with) Positives (PWP) PWP means helping HIV+ persons learn how to • Prevent transmitting HIV to someone else • Optimize health and behaviors

  4. Prevention for Positives (PWP) Also a CDC initiative. Initial Goals: • increased HIV testing in medical settings • increased use of new testing technologies • prevention of transmission from HIV+ persons to sex and needle sharing partners • prevention of perinatal transmission Now: “A holistic and system level approach to risk reduction” aimed at High Impact Prevention in the U.S.

  5. Prevention for Positives (PWP) 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. HPTN 052 Cohen MS et al. N Engl J Med 2011;365:493-505.

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

  14. PWP HIV meets the “other” STIs

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

  16. STIs and HIV Transmission: Test Frequently and

  17. PWP OTHER strategies

  18. 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

  19. Disclosure: Do the Right Thing

  20. 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

  21. Barriers to Risk Reduction Implementation • Providers have to ask!

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

  23. PWP: It Takes a Village!

  24. http://www.hivpwp.org/

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