Publications by authors named "Jason A Flamm"
Background: Management of hypertension, dyslipidemia, diabetes and other modifiable factors may mitigate the cardiovascular disease (CVD) risk in people with human immunodeficiency virus (HIV, PWH) compared with people without HIV (PWoH).
Methods: This was a retrospective cohort study of 8285 PWH and 170 517 PWoH from an integrated health system. Risk factor control was measured using a novel disease management index (DMI) accounting for amount/duration above treatment goals (0% to 100% [perfect control]), including 2 DMIs for hypertension (diastolic and systolic blood pressure), 3 for dyslipidemia (low-density lipoprotein, total cholesterol, triglycerides), and 1 for diabetes (HbA1c).
We characterized polysubstance use burden and associations with mental health problems across demographic subgroups of PWH. In 2018-2020, as part of a primary care-based intervention study, PWH in care at three medical centers in Kaiser Permanente Northern California were screened for depression (PHQ-9≥10), anxiety (GAD-2≥3), and substance use (Tobacco, Alcohol, Prescription medication, and other Substance use [TAPS]≥1 per substance). We used Poisson regression to estimate prevalence ratios (PRs) comparing polysubstance use prevalence (TAPS≥1 for ≥2 substances) between PWH with positive screens for depression or anxiety vs.
View Article and Find Full Text PDFOutcomes of PWH with unhealthy alcohol use, such as alcohol use reduction or progression to AUD, are not well-known and may differ by baseline patterns of unhealthy alcohol use. Among 1299 PWH screening positive for NIAAA-defined unhealthy alcohol use in Kaiser Permanente Northern California, 2013-2017, we compared 2-year probabilities of reduction to low-risk/no alcohol use and rates of new AUD diagnoses by baseline use patterns, categorized as exceeding: only daily limits (72% of included PWH), only weekly limits (17%), or both (11%), based on NIAAA recommendations. Overall, 73.
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- The CUSTOMIZE study evaluated the effectiveness of monthly long-acting injections of cabotegravir and rilpivirine for people living with HIV-1 across diverse clinics in the US.
- After 12 months, the majority of participants maintained suppressed viral loads and reported high levels of acceptability for the treatment, with scores increasing from baseline.
- Most participants preferred the long-acting injections over daily oral medications, and many felt that the COVID-19 pandemic did not significantly interfere with their treatment.
Article Synopsis
- CUSTOMIZE was a 12-month study that evaluated a new injectable HIV treatment regimen (cabotegravir + rilpivirine) across various US healthcare settings to understand its implementation outcomes.
- Conducted at eight different types of clinics, the study gathered data through surveys and interviews from healthcare staff to assess the treatment's acceptability, appropriateness, and feasibility.
- Results showed high satisfaction among staff regarding the treatment's implementation, with notable improvements in concerns about patient attendance at appointments over time, though issues like injection pain remained consistent.
Article Synopsis
- - The study aimed to compare the occurrence of dementia in individuals over 50 with and without HIV, using data from healthcare systems between 2000 and 2016.
- - Researchers found that the incidence and prevalence of dementia were higher among people with HIV (PWH) compared to those without HIV (PWoH), despite a general decline in dementia cases over time.
- - The findings suggest that while improvements in antiretroviral therapy (ART) have led to some reductions in dementia incidence, individuals with HIV still face a greater risk of developing dementia as they age.
We implemented self-collected gonorrhea/chlamydia testing in 17 medical centers in California serving men who have sex with men living with HIV. From 2012 to 2018, gonorrhea/chlamydia testing increased from 45.2% to 63.
View Article and Find Full Text PDFBackground: Unhealthy alcohol use among persons living with HIV (PLWH) is linked to significant morbidity, and use of alcohol services may differ by HIV status. Our objective was to compare unhealthy alcohol use screening and treatment by HIV status in primary care.
Methods: Cohort study of adult (≥18 years) PLWH and HIV-uninfected participants frequency matched 20:1 to PLWH by age, sex, and race/ethnicity who were enrolled in a large integrated healthcare system in the United States, with information ascertained from an electronic health record.
Article Synopsis
- In a study analyzing the effectiveness and safety of two HIV treatment regimens over 144 weeks, a combination of bictegravir, emtricitabine, and tenofovir alafenamide was found to be as effective as a dolutegravir-based regimen for treatment-naive patients.
- *The studies included 1,274 participants who were randomly assigned to receive either the bictegravir regimen or various dolutegravir regimens, with the primary endpoint showing non-inferiority at week 48.
- *By week 144, the efficacy results showed that a high percentage of participants in both treatment groups maintained low plasma HIV-1 RNA levels, indicating continued effectiveness of the bictegravir regimen.*
Objectives: To evaluate the safety and efficacy of the novel tenofovir prodrug, tenofovir alafenamide (TAF), as part of the first protease inhibitor-based single-tablet regimen (STR) for initial treatment of HIV-1 infection.
Methods: Antiretroviral therapy (ART)-naive adults with estimated glomerular filtration rate ≥ 70 mL/min were randomized 2:1 to receive the darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) STR (TAF: N = 103) or darunavir + cobicistat + emtricitabine/tenofovir disoproxil fumarate (TDF: N = 50) once daily with matched placebos for 48 weeks.
Results: At week 24, viral suppression (HIV-1 RNA <50 copies/mL) rates were similar (TAF 74.
Increased rates of appendicitis in HIV-infected men: 1991-2005.
J Acquir Immune Defic Syndr
September 2009
Article Synopsis
- The study aimed to compare surgical outcomes between HIV-infected and matched non-infected patients, focusing on complication rates and mortality after various surgeries over a 12-month period.
- Conducted at Kaiser Permanente in Northern California, the research involved 332 pairs of patients matched by demographics and surgical procedures, ensuring a comprehensive analysis of their postoperative results.
- Results showed that both groups had similar hospital stays and follow-up visits, indicating that HIV infection did not significantly impact surgical outcomes in the studied cohort.