Publications by authors named "Miao-Jung Chen"
Article Synopsis
- The study investigated cases of undiagnosed acute HIV (AHI) in individuals who were prescribed pre-exposure (PrEP) or post-exposure prophylaxis (PEP) at a San Francisco clinic from 2011 to 2018.
- Out of a total of 4,000 PrEP and PEP initiations, there were only 13 cases of AHI, with a small percentage developing drug resistance mutations within days of starting treatment.
- Rapid initiation of HIV care led to successful viral suppression in all affected patients, highlighting the need for AHI screening before starting PrEP/PEP.
Background: Pre-exposure prophylaxis (PrEP) with emtricitabine and tenofovir disoproxil fumarate is highly protective against HIV infection. We report a case of tenofovir-susceptible, emtricitabine-resistant HIV acquisition despite high adherence to daily PrEP.
Methods: Adherence to PrEP was assessed by measuring concentrations of emtricitabine and tenofovir disoproxil fumarate or their metabolites in plasma, dried blood spots, and hair.
Article Synopsis
- Early syphilis, gonorrhea, and chlamydia infections have increased notably in San Francisco, with a significant focus on the male population, whereas HIV infections have not shown the same trend.
- Between 2007 and 2014, a considerable percentage of individuals diagnosed with STDs were also coinfected with HIV: 66% for early syphilis, 28% for gonorrhea, and 15% for chlamydia, with specific demographics outlined, particularly among men who have sex with men (MSM).
- The study indicates a critical need for integrated prevention strategies for HIV and STDs due to the concerning rates of coinfection, with particular attention to high-risk groups like Latino MSM and transgender
Background: In the United States, an estimated two-thirds of persons with human immunodeficiency virus (HIV) infection do not achieve viral suppression, including those who have never engaged in HIV care and others who do not stay engaged in care. Persons with an unsuppressed HIV viral load might experience poor clinical outcomes and transmit HIV.
Objective: The goal of the Re-engaging Surveillance-identified Viremic Persons (RSVP) project in San Francisco, CA, was to use routine HIV surveillance databases to identify, contact, interview, and reengage in HIV care persons who appeared to be out of care because their last HIV viral load was unsuppressed.
Objective: To examine whether improved human immunodeficiency virus (HIV) treatment was associated with better survival after diagnosis of AIDS-defining opportunistic illnesses (AIDS-OIs) and how survival differed by AIDS-OI.
Design: We used HIV surveillance data to conduct a survival analysis.
Methods: We estimated survival probabilities after first AIDS-OI diagnosis among adult patients with AIDS in San Francisco during 3 treatment eras: 1981-1986; 1987-1996; and 1997-2012.
Background: Persons with unsuppressed HIV viral load (VL) who disengage from care may experience poor clinical outcomes and potentially transmit HIV. We assessed the feasibility and yield of using the San Francisco Department of Public Health (SFDPH) enhanced HIV surveillance system (eHARS) to identify and re-engage such persons in care.
Methods: Using SFDPH eHARS data as of 4/20/2012 (index date), we selected HIV-infected adults who were alive, had no reported VL or CD4 cell count results in the past nine months (proxy for "out-of-care") and a VL >200 copies/mL drawn nine to 15 months earlier.
We use HIV testing history of persons newly diagnosed with HIV through HIV partner services to identify persons who might not otherwise have tested. Seventeen percent had never been tested, 44% had not been tested in the previous 2 years, and none had been tested routinely. These data demonstrate that HIV partner services were successful in reaching persons who may not have initiated testing without this service.
View Article and Find Full Text PDFPeople aged 50 and older are an increasing proportion of the population of persons living with AIDS (PLWA) in the USA. We used San Francisco's population-based HIV/AIDS surveillance registry to examine trends in the age distribution of people diagnosed and living with AIDS in San Francisco, California. AIDS case reporting is highly complete.
View Article and Find Full Text PDFObjective: To measure the incidence and risk factors of AIDS-defining opportunistic illnesses (AOIs) in the pre-highly active antiretroviral therapy (HAART) (1993-1995), early-HAART (1996-2000), and late-HAART (2001-2008) periods.
Design: Prospective cohort analysis of AIDS surveillance data.
Methods: Individuals living with, or diagnosed with AIDS from 1993 through 2008 were included.