Also of interest:

• Bradley H, Hall HI, Wolitski RJ: Vital signs: HIV diagnosis, care, and treatment among persons living with HIV—United States, 2011
  MMWR Morb Mortal Wkly Rep 2014; 63(47):1113-7This brief article provides concisely the most recent (2011) data for the HIV care cascade (i.e., how many patients are diagnosed with HIV, how many are linked and retained in care, and how many achieve virological suppression). Out of an estimated 1.2 million people living with HIV in the US, 86% were diagnosed with HIV. Discouragingly, only 4 out of 10 people living with HIV were in care, and only 3 out of 10 were virologically suppressed. Psychiatrists can help patients achieve viral suppression by working on those psychological and psychiatric factors that are obstacles along the full HIV care cascade (e.g., depression leading to poor adherence). The CDC figures are also a reminder that social determinants of health matter as much as the science, even in cases where effective treatments are available.
• Tavakkoli M, Cohen MA, Alfonso CA, Batista SM, Tiamson-Kassab ML, Meyer P: Caring for persons with early childhood trauma, PTSD, and HIV: A curriculum for clinicians
  Acad Psychiatry 2014; 38(6):696-700Childhood adversity and trauma can become major obstacles later in life with regards to HIV risk reduction and HIV care. Clinicians who care for patients with HIV are often unsure about how to elicit a trauma history or make a diagnosis of PTSD and how to use the information obtained for ongoing clinical care, including improving adherence to medical care and antiretroviral medications, and risk reduction. The authors developed a 4-hour curriculum to fill this educational gap. The curriculum’s length lends itself to a workshop for interested providers who feel they need more training in this area. In particular, it is expected that upon completion of the curriculum, participants will be able to:
  1. Integrate the assessment for early childhood and other trauma into routine history taking.
  2. Understand and interpret the signs and symptoms of trauma sequelae.
  3. Diagnose PTSD.
  4. Develop a differential diagnosis of psychiatric disorders associated or concomitant with PTSD.
  5. Formulate treatment approaches for their HIV-positive persons living with a history of trauma.
  6. Improve adherence to risk reduction, medical care, and antiretrovirals.
  7. Enhance the therapeutic alliance with traumatized patients.
• HIV Clinical Resource, New York State Department of Health AIDS Institute: HIV prophylaxis following occupational exposure, 2014
  The guideline on HIV prophylaxis following occupational exposures (post-exposure prophylaxis or PEP) has been updated by the New York State Department of Health AIDS Institute. The initial triple therapy recommendations include tenofovir + emtricitabine (or lamivudine) plus either raltegravir or dolutegravir as the preferred initial PEP regimen because of its excellent tolerability, proven potency in established HIV infection, and ease of administration. AZT is no longer recommended. The recommendations differ from the current CDC guideline on PEP; Appendix B (pp.32-33) of the New York guideline contrasts the recommendations with those by the CDC for psychiatrists who are interested in details about PEP.
• CDC Stacks: Recommendations for HIV prevention with adults and adolescents with HIV in the United States, 2014

  The Centers for Disease Control and Prevention, in collaboration with several other agencies and partner organizations, updated and expanded their 2003 recommendations regarding HIV prevention in the US. This is one of the available documents on the CDC’s website for clinical providers.