Treatment of HIV in outpatients with schizophrenia, schizoaffective disorder and bipolar disease at two county clinics.

Despite a high prevalence of HIV in patients with serious mental health disorders, there is little information in the literature regarding details of their HIV treatment. The objective of this paper is to assess factors associated with the success of HIV therapy in people with schizophrenia, schizoaffective, and bipolar disease. The methods used are retrospective, post-study chart review, and clinician questionnaire at two HIV county clinics.

Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings.

Background: Reducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide "prevention with positives" in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve clinic-based assessment and counseling for risky behaviors.

Reframing "prevention with positives": incorporating counseling techniques that improve the health of HIV-positive patients.

Federal HIV prevention strategy seeks to increase efforts by health care providers to identify and reduce their HIV-positive patients' transmission-related behaviors. Implementation of these recommendations will be hindered if providers perceive these efforts have the potential to harm their relationships with patients. Because transmission-related behaviors (unsafe sex and sharing needles) and the related issues of drug and alcohol use also jeopardize the health of HIV-positive patients, providers can use patient-centered counseling when addressing those behaviors.

Integrating treatment for hepatitis C virus infection into an HIV clinic.

In the United States, one-third of human immunodeficiency virus (HIV)-infected patients are also coinfected with hepatitis C virus (HCV). Of 228 coinfected patients whose charts were reviewed in our 2000 study, only 2 had received therapy with interferon. To address low rates of treatment, in 2001 we implemented a program to shift the primary responsibility for oversight of care for HCV-infected patients from the liver clinic to HIV primary care clinicians and to provide education and support regarding adherence to patients.

Strategies for managing hepatitis C virus infection in HIV-infected patients.

Liver disease associated with hepatitis C virus (HCV) is a significant and increasing cause of death for HIV-infected patients, but limited data exist to guide treatment of coinfection. Increased knowledge of HCV disease and its treatment among HIV care practitioners and adoption of routine care procedures can improve management of coinfected patients. This article discusses HCV screening and diagnosis, counseling and health care maintenance, and evaluation for and supervision of treatment in HIV-seropositive patients who are coinfected with HCV.