Transgender (trans) communities worldwide, particularly those on the trans feminine spectrum, are disproportionately burdened by HIV infection and at risk for HIV acquisition/transmission. Trans individuals represent an underserved, highly stigmatized, and under-resourced population not only in HIV prevention efforts but also in delivery of general primary medical and clinical care that is gender affirming. We offer a model of gender-affirmative integrated clinical care and community research to address and intervene on disparities in HIV infection for transgender people. We define trans terminology, briefly review the social epidemiology of HIV infection among trans individuals, highlight gender affirmation as a key social determinant of health, describe exemplar models of gender-affirmative clinical care in Boston MA, New York, NY, and San Francisco, CA, and offer suggested "best practices" for how to integrate clinical care and research for the field of HIV prevention. Holistic and culturally responsive HIV prevention interventions must be grounded in the lived realities the trans community faces to reduce disparities in HIV infection. HIV prevention interventions will be most effective if they use a structural approach and integrate primary concerns of transgender people (eg, gender-affirmative care and management of gender transition) alongside delivery of HIV-related services (eg, biobehavioral prevention, HIV testing, linkage to care, and treatment).
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http://dx.doi.org/10.1097/QAI.0000000000001088 | DOI Listing |
JAMA
January 2025
Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT, Washington, DC.
Importance: Health information technology, such as electronic health records (EHRs), has been widely adopted, yet accessing and exchanging data in the fragmented US health care system remains challenging. To unlock the potential of EHR data to improve patient health, public health, and health care, it is essential to streamline the exchange of health data. As leaders across the US Department of Health and Human Services (DHHS), we describe how DHHS has implemented fundamental building blocks to achieve this vision.
View Article and Find Full Text PDFDig Dis Sci
January 2025
Department of Internal Medicine and Center for Recovery Medicine, Allegheny General Hospital, 1307 Federal St Suite B300, Pittsburgh, PA, 15212, USA.
Background: Alcohol use disorder and alcohol-associated liver disease is increasing in the US, with subsequent and expected increases in morbidity and mortality due to these conditions.
Aims: To determine the impact of an educational intervention regarding alcohol use disorder on gastroenterology fellows.
Methods: A before-after survey study was carried out.
Dig Dis Sci
January 2025
Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70401, Taiwan.
Aim: Sarcopenic obesity (SO) is associated with adverse outcomes in diseased patients. This study aimed to examine the prevalence and risks associated with SO, with a focus on the impact of SO on cardiovascular risk in patients with MASLD.
Materials And Methods: In this cross-sectional study, patients with MASLD were prospectively enrolled.
Curr Cardiol Rep
January 2025
Section of Pediatric Nephrology, Department of Pediatrics, Yale University School of Medicine, New Haven, USA.
Purpose Of Review: To review the benefits of ambulatory blood pressure monitoring and home blood pressure monitoring in children and to discuss implementation of guideline-recommended ambulatory blood pressure monitoring.
Recent Findings: Compared with office blood pressure, ambulatory blood pressure monitoring and home blood pressure monitoring provide superior accuracy, reproducibility, and stronger associations with target organ damage although future work is needed to determine the utility of home blood pressure monitoring to predict hypertension status on ambulatory blood pressure monitoring. Due to the benefits of out-of-office blood pressure measurement, ambulatory blood pressure monitoring has been recommended to confirm the diagnosis of hypertension in children and adolescents since publication of the 2017 American Academy of Pediatrics clinical practice guidelines on hypertension.
Drugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
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