Publications by authors named "Sheila R Enders"

Reducing HIV transmission is a critical goal worldwide, prompting new strategies to slow the spread of the virus. This paper describes the theoretical underpinnings of the Comprehensive Harm Reduction Protocol (CHRP) and the process of its implementation in one large urban HIV clinic and two smaller rural primary care clinics. Patients enrolled in CHRP complete the Risk Diagnostic Questionnaire (RDQ), self-reporting HIV transmission risk behavior at most clinic visits.

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Background: Decision making about medical treatment, advance care planning and end-of-life care often is limited or influenced by a patient's capacity to read or comprehend crucial information. Ineffective communication between patient and physician, and the complex nature of serious illness and dying also affect these decisions. America's incarcerated have virtually no autonomy in decision making, especially with regard to medical care and treatment.

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Hospice at the California Medical Facility (CMF) Vacaville dates back to the mid-1980s, when the acquired immune deficiency syndrome (AIDS) epidemic began to be felt throughout California's Department of Corrections. Vacaville has served for decades as the principal location for delivering health services to California's incarcerated men. Informal hospice-like services were inspired by Elisabeth Kubler-Ross and through inmate and community calls for more humane care for dying inmates.

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Prison populations throughout the Unites States are growing; the 1990s saw an average 6.5% per year increase. Average inmate age is increasing, as are both the number and rate of inmate deaths.

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