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Recommendations for HIV Prevention with Adults and Adolescents Living Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States, 2014 Centers for Disease Control and Prevention Health Resources and Services Administration National Institutes of Health American Academy of HIV Medicine Association of Nurses in AIDS Care International Association of Providers of AIDS Care National Minority AIDS Council Urban Coalition for HIV/AIDS Prevention Services Correspondence Email: [email protected]. Suggested citation Centers for Disease Control and Prevention, Health Resources and Services Administration, National Institutes of Health, American Academy of HIV Medicine, Association of Nurses in AIDS Care, International Association of Providers of AIDS Care, the National Minority AIDS Council, and Urban Coalition for HIV/AIDS Prevention Services. Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States, 2014. http://stacks.cdc.gov/view/cdc/26062. This document is not protected by the Copyright Act, and copyright ownership cannot be transferred. It may be used and reprinted without special permission. Disclosures and disclaimers The contributors to this report (Appendix C) declared no interests regarding the commercial products discussed herein. The report describes the use of certain drugs, tests, and procedures for some indications that do not reflect labeling approved by the U.S. Food and Drug Administration (FDA) at the time of publication. Information about such drugs, tests, or procedures is noted in the relevant sections. What’s New in the Recommendations? The December 11, 2014, version of Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States, 2014, and its companion summaries have been amended in December 2016 to correct errata, outdated or broken hyperlinks, and missing references or footnotes. Page 1 of 238 Contents Contents Navigation tip: To advance to a specific topic, click its link below. In addition, this document contains hyperlinks to related topics in other sections of the document. To navigate to the related topic, click the hyperlink. To return from the topic back to the hyperlink location, press the ALT+left arrow keys on your keyboard. Abbreviations ............................................................................................................................................................... 6 Summary ....................................................................................................................................................................... 8 References ........................................................................................................................................................... 11 Section 1. Introduction .............................................................................................................................................. 13 References ........................................................................................................................................................... 18 Section 2. Methods .................................................................................................................................................... 20 References ........................................................................................................................................................... 23 Section 3. The Context of Prevention with Persons with HIV: Essential Considerations for Providers ............ 24 Background ........................................................................................................................................................... 24 Recommendations ................................................................................................................................................ 25 Methods ................................................................................................................................................................ 28 Individual, Social, and Structural Issues that Influence Access to and Use of HIV Prevention and Care Services ......................................................................................................................................................... 29 The central role of persons with HIV .............................................................................................................. 29 Individual, social, and structural factors ......................................................................................................... 30 Ethical and legal issues that influence access to and use of HIV prevention and care services ................... 34 Laws, Regulations, Policies, and Programs that Promote Delivery of HIV Prevention and Care Services ........... 39 Governmental and nongovernmental policies and programs that provide or fund prevention and care services for persons with HIV ......................................................................................................... 39 Anticipated impact of the ACA on prevention services for persons with HIV ................................................. 42 Strategies to expand the HIV prevention and care workforce ........................................................................ 44 Implementation Resources ................................................................................................................................... 44 References ........................................................................................................................................................... 45 Section 4. Linkage to and Retention in HIV Medical Care ...................................................................................... 49 Background ........................................................................................................................................................... 49 Recommendations ................................................................................................................................................ 51 How These Recommendations Differ from Previous Recommendations ............................................................. 57 Methods ................................................................................................................................................................ 58 Evidence Supporting the Recommendations ........................................................................................................ 58 Linkage to HIV medical care .......................................................................................................................... 58 Retention and reengagement in HIV medical care ........................................................................................ 60 Issues that Influence Implementation of the Recommendations ........................................................................... 63 Implementation progress, challenges, and opportunities ............................................................................... 63 Policy, legal, and ethical considerations ........................................................................................................ 63 Special populations ........................................................................................................................................ 63 Implementation Resources ................................................................................................................................... 64 References ........................................................................................................................................................... 64 Page 2 of 238 Contents Section 5. Antiretroviral Treatment for Care and Prevention ................................................................................. 69 Background ........................................................................................................................................................... 69 Recommendations ................................................................................................................................................ 70 How These Recommendations Differ from Previous Recommendations ............................................................. 73 Methods ................................................................................................................................................................ 74 Evidence Supporting the Recommendations ........................................................................................................ 74 Issues that Influence Implementation of the Recommendations ........................................................................... 76 Implementation progress, challenges, and opportunities ............................................................................... 76 Policy, legal, and ethical considerations ........................................................................................................ 78 Special populations ........................................................................................................................................ 78 Implementation Resources ................................................................................................................................... 79 References ..........................................................................................................................................................
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