Christine Potkul

Patients with HIV have a high likelihood of developing depression related to their diagnosis, according to the results of a recent study. Uncertain what actions to take, many of these patients do not seek medical care and go without proper therapy.

, examined the association between the length of time a patient remains depressed and care outcomes among 5927 HIV-positive adult patients. Participants took multiple depressive severity assessments that were translated into a measurement of percent of days with depression. The results showed that patients spend a median of 14% of their days with depression.

According to the study, each 25% increase in the amount of days spent with depression resulted in an 8% increase in the risk of missed appointments, a 5% increase in the risk of treatment failure, and a 19% increase in mortality. Patients experiencing depression for the duration of the follow-up period had a 37% greater risk of missing appointments, a 23% increased risk of treatment failure, and a mortality rate 2 times higher than patients who never spent time depressed.

These study findings show that patients with HIV who develop depression are more susceptible to worse health outcomes than their counterparts without depression. Health care providers need to accurately identify depression in these patients through regular screenings and provide them with an individualized treatment that works for them.

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Patients with HIV have a high likelihood of developing depression related to their diagnosis, according to a recent study, and many of these individuals do not seek medical care.


Patients With HIV at Higher Risk for Developing Depression

Routine HIV screening tests are preventive measures recommended by the CDC for all patients aged 13 to 64 years. Provider-initiated

test offers are an important strategy for increasing HIV screening among heterosexual populations, but improvement is needed, according to a study published in the CDC’s

By offering this service, health care providers remind patients of the importance of HIV testing, especially among heterosexual populations at an increased risk for acquiring the infection. To obtain more information about the prevalence and predictors of provider-initiated HIV test offers in this patient population, the National HIV Behavioral Surveillance (NHBS) used data from Virginia.

The NHBS recruited heterosexual, cis-gendered individuals aged 18 to 60 years, who have an increased risk for acquiring HIV attributed to heterosexual activity and are of low-income status. Patients must not have used injection drugs or had male-to-male sexual contact in the previous 12 months before interviews.

Patients who completed the face-to-face NHBS interviews, but did not meet all criteria were excluded from the study, leaving 333 respondents. To examine the association between HIV test offers and demographic and behavioral characteristics, researchers used univariable log-binomial regression models. All the analysis variables were self-reported by respondents.

According to the findings in this study, 58% of respondents reported not receiving an HIV test offer from their health care provider compared with 42% who did. Among the individuals who did report an HIV test offer, 71% of patients underwent HIV testing during the 12 months following the interview, while only 16% of patients not offered the HIV test went for screenings during that period.

HIV test offer prevalence was lower among patients uninsured than among those with health insurance (PR = 0.78; 95% Cl = 0.59-1.03). The prevalence of HIV test offers in patients aged 31 to 40 years (PR = 1.24; 95% Cl = 0.89-1.72) was higher compared with patients aged 51 to 60 years (PR = 0.71; 95% Cl = 0.49-1.01).

HIV test offer prevalence was lower among men than women (prevalence ratio [PR] = 0.67; 95% cl = 0.50-0.89). Researchers found the relationship between gender and HIV test offer significant (aPR = 0.72; 95% Cl = 0.53-0.97).

When potential confounders were adjusted for in this relationship, prevalence of HIV test offers remained significantly lower in men than in women (aPR = 0.69; 95% Cl = 0.51-0.93). The likelihood of females receiving more HIV test offers could be attributed to their participation in family planning services, fewer sex partners, and more frequent seeking of health care and routine health screens than male patients.

Health care providers who offer HIV tests will encourage patients to integrate preventive HIV screenings into their health care routines. If providers implement this strategy, heterosexual adults at increased risk for acquiring the infection, especially males, will be more inclined to undergo repeat HIV screening.

Karen D, Tina C, Anne R, et al. Prevalence and Predictors of Provider-Initiated HIV Test Offers Among Heterosexual Persons at Increased Risk for Acquiring HIV Infection-Virginia 2016. MMWR Morb Mortal Wkly Rep. 2018; 67(25);714-717.

Routine HIV screening tests are preventive measures recommended by the CDC for all patients aged 13 to 64 years.

Provider-Initiated HIV Test Offers: Important Strategy, Yet Underused

The US Food and Drug Administration (FDA) has granted the US Department of Defense (DoD) an emergency use authorization (EUA) of freeze-dried plasma product (FDP) that is made in France.

Known as French FDP, or Pathogen-Reduced Leukocyte Freeze-Dried Plasma, the product is manufactured by the Centre de Transfusion Sanguine des Armees, and has eliminated a typically long thawing period and made plasma rapidly available for use at the point of injury.

Plasma is typically frozen within 24 hours following donation, to preserve clotting factors. When the frozen plasma is needed, it must be placed in a water bath at 30 to 37 C in an FDA-cleared device. The long thawing period is impractical when treating hemorrhage or coagulopathy in US military personnel during an emergency involving agents of military combat.

The FDA has partnered with the DoD and the Center for Biologics Evaluation and Research (CBER) to see the delivery of safe and effective products to those protecting the nation. An initial work plan was created to address DoD’s medical needs. In this new plan, the FDA will facilitate the development and availability of specific products regulated by the CBER, determined to be important to the health of military service members by the DoD.

In a statement, FDA Commissioner, Scott Gottlieb, MD, explained. “The FDA remains deeply committed to implementing an enduring pathway to ensure that these potentially life-saving medical products are made available in the most expeditious, safe and effective manner possible.”

A Pennsylvania-based company is also developing a freeze-dried plasma product.

FDA takes action to support American Military personnel by granting an authorization for freeze-drived plasma product to enable broader access while the agency works toward approval of the product [news release]. FDA’s website.

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm612893.htm

American Red Cross. Blood Components: How can one donation help multiple people? American Red Cross Website.

https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-donations/blood-components.html

The US Food and Drug Administration (FDA) has granted the US Department of Defense (DoD) an emergency use authorization (EUA) of freeze-dried plasma product (FDP) that is made in France.


Military Personnel Authorized to Receive Freeze-Dried Blood

tedious process that requires careful consideration of every item

packed, especially, when medications are needed. Each country has developed their own distinct guidelines

for those with chronic or serious health conditions.

are permitted to bring with them, and where they can acquire their medication

If travelers violate another country’s rules, they

may face consequences that could present serious setbacks to their health or impose penalti

s for drug trafficking. The CDC is encouraging individuals to be aware of these varying regulations prior to traveling

avoid such consequences. Clinicians can help by counseling patients who are planning vacations or other trips.

When packing, medications should be kept separated from oth

that medications can be easily located, and accessed

. TSA has a specific list of medical supplies that they allow on the plane, so it is important to look at that beforehand. For example, TSA states that diabetes-related supplies, equipment, and medications are allowed

through checkpoint after they have been screened or inspected.

The CDC also recommends bringing a small surplus of medicines in case of delays, and to make sure the containers have their original labels. Travelers should have a copy of all prescriptions in their possession

leave another copy at home with family or relative

. For controlled substances, such as marijuana, and injectable medicines, a note on letterhead stationary from the prescribing doctor should accompany.

A travel health medicine specialist or health care provider should be contacted to obtain

discussions on how to adjust medication schedules when facing time zone changes and the best way to store medicines. Also, be sure to make an appointment, weeks in advance, to get

There is a high likelihood that certain medications will not be accessible for purchase in a different country.

In addition, counterfeit drugs are a major problem amongs

t many developing countries, according to the CDC. Patients should stay

alert, and buy only medicines in original packaging, from a licensed pharmacy.

What the United States may consider common prescriptions, or available over-the-counter drugs, may be illegal somewhere else. Travelers should be

to prevent issues, and to ease the entire traveling process. They should c

country and utilize the International Narcotics Control Board to verify that medicines are permittable.

. It’s important to continue proper management of health issues while in a different country without letting

serious health conditions or chronic diseases get in the way of exciting, new experiences

Traveling Abroad with Medicine. CDC website. https://www.cdc.gov/features/travel-medicine/index.html. Updated July 2, 2018. Accessed July 6, 2018.

Travel preparation can be a tedious process that requires careful consideration of every item being packed, especially, when medications are needed. 

Traveling With Medication Takes Preparation

Today is National HIV Testing Day. The CDC has designated this day out of the year to raise awareness for HIV testing, and early diagnosis. Understanding

status through testing ensures that individuals can keep themselves, and others they encounter, healthy, and guides those who do have the infection to seek services that can improve their quality of life, and length of survival.

Many people with HIV do not always know that they are living with the virus. Some individuals with HIV may not show symptoms at first, which is why periodic testing is necessary. If HIV goes undiagnosed and untreated, patients may experience severe damage to their immune system. Screening tests identify people with the infection early on, so measures can be taken immediately to conduct treatment. Also,

testing reminds people to take precautionary actions to prevent contracting or spreading the virus.

The CDC recommends a screening frequency of at least once a year, however, according to an analysis of national population-based survey data collected during 2006—2016, people with high risk for HIV are not adhering to this recommendation. Test providers can reduce HIV-related adverse health outcomes and risk for transmission by implementing routine, and targeted testing to decrease the amount of time from infection to diagnosis. Health care providers and public health practitioners need to improve efforts to regularly screen all patients for HIV infection, and to keep high risk individuals engaged in annual screenings for the infection.

, often overlooked, continues to be a major health problem. Testing technology and methods have advanced so that HIV can be prevented, and those with the infection can live a long, and healthy life.

This year’s National HIV Testing Day theme, Doing It My Way, reflects on the various reasons people have for getting HIV tested. Additional information for patients and health professionals on National HIV Testing Day, basic testing information, and guidelines for testing can be found on the CDC’s website.

CDC. National HIV Testing Day-June 27, 2018. CDC website.

. Published June 2018. Accessed June 26, 2018.

https://cdc.gov/mmwr/volumes/67/wr/mm6724a1.htm?s_cid=mm6724a1_w

Today is National HIV Testing Day. The CDC has designated this day out of the year to raise awareness for HIV testing, and early diagnosis. 

National HIV Testing Day Raises Awareness, Encouraged Early Diagnoses

The American Diabetes Association (ADA), has announced this year's recipients of the ADA's National Scientific and Health Care Achievement Awards, in a press release. The recognitions were awarded for exemplary leadership, mentorship, and achievements that have advanced the field of diabetes care, and improved health outcomes for people with diabetes.

The ADA's 78th Scientific Sessions will be held June 22-26, 2018 at the Orange County Convention Center in Orlando, Florida. Several leaders will be recognized and will recieve awards for their contribution to diabetes research, prevention, care, and treatment. Some of the award winners will present award lectures.

"All of the recipients of our National Scientific and Health Care Achievement awards have made incredible contributions in their respective fields to increase the vast library of knowledge that has contributed to the many scientific and technological advances that have improved the lives of millions of people living with diabetes," said

, MD, Chief Scientific, Medical and Mission Officer of the ADA, in a press release. "It is an honor for the ADA to recognize these individuals for their extraordinary work."

According to the ADA, Jackie L. Boucher, MS, RDN, will be this year's recipient of the Outstanding Educator in Diabetes Award. Boucher currently serves as the President of Children's Heartlink in Minneapolis, MN, and will be honored for her work in the field of diabetes education. Her lecture,

Outstanding Educator in Diabetes Award Lecture:

Connectedness: How Technology and Social Networks are Advancing Diabetes Nutrition Care, will be presented on June 23.

Other recognitions include the following:

Banting Medal for Scientific Achievement :

Outstanding Scientific Achievement Award:

George R. Cowgill Professor of Medicine and Cellular and Molecular Physiology,

and Co-Director of the Yale Diabetes Research Center,

Professor, Chair in Human Nutrition and Head of the Obesity and Food Choice Division of the Rowett Institute,University of

Jeffrey Keene Family Professor, American Diabetes Association Eminent Scholar for Diabetes Research and Director of the Diabetes Institute,

Outstanding Achievement in Clinical Diabetes Research Award:

Professor of Diabetic Medicine,University of

Diabetes Trial Unit and NIHR Senior Investigator,

Outstanding Physician Clinician in Diabetes Award:

Professor of Medicine, Oregon Health & Science University and Director of the Harold Schnitzer Diabetes Health Center,

Award for Distinguished International Service in the Cause of Diabetes:

Chairman and Chief of Diabetology, Dr. Mohan's Diabetes Specialties Centre and Director of the Madras Diabetes Research Foundation,

Award for Outstanding Achievement in Epidemiology:

Senior Advisor, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Diabetes Epidemiology Program,

The ADA's Scientific Sessions, is the world's largest scientific meeting focused on diabetes research, prevention and care, according to the organization. During the 5-day meeting, more than 16,000 health care professionals from around the world will have exclusive access to more than 3,000 original diabetes research presentations, participate in provocative and engaging exchanges with leading diabetes experts, and can earn Continuing Medical Education or Continuing Education credits for educational sessions.

, PhD, ABPP, President of Health Care and Education, is expected to deliver an address about the ADA in the era of healthcare transformation on J

, MD, President of Medicine and Science, will present her address about living with diabetes on

. In total, the 2018 Scientific Sessions will include 375 oral presentations; 2,117 poster presentations, including 47 moderated poster discussions; and 297 published-only abstracts. On social media, the Scientific Sessions can be followed using #2018ADA.

American Diabetes Association. American Diabetes Association Announces Eight Recipients of 2018 National Scientific and Health Care Achievement Awards [news release]. Arlington, VA: April 26, 2018; ADA website. https://www.prnewswire.com/news-releases/american-diabetes-association-announces-eight-recipients-of-2018-national-scientific-and-health-care-achievement-awards-300636631.html. Accessed June 12, 2018.

Top researchers, clinicians, and educators will be recognized at the 78th Scientific Sessions for their outstanding leadership and work to advance diabetes research, prevention, care, and treatment.

