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Biomedical subjects

B M Branson

Publications and source records attributed to B M Branson.

12 recordsLinked to original sources
PubMed1999

Rates of receiving HIV test results: data from the U.S. National Health Interview Survey for 1994 and 1995.

OBJECTIVE: To determine the frequency and predictors of receipt of HIV test results. METHODS: Analysis of responses from 19,127 adults in 1994 and 16,848 in 1995 surveyed for the U.S. National Health Interview Survey, using logit models to determine factors independently associated with decreased likelihood of receiving HIV test results. RESULTS: Overall, 12.5% (+/-1.0%) of persons tested in 1994 and 13.3% (+/-0.9%) in 1995 had not received their test results. Those whose test was not self-initiated were significantly less likely (p<.05) to receive their test results. The proportion who did not receive results was lowest among persons who had sought testing (6.1% in 1994 and 4.3% in 1995) and highest among persons whose tests were required for hospitalization or surgery (24.2% in 1994 and 22.9% in 1995). CONCLUSIONS: An estimated 2.3 million of the 17.5 million people tested annually for HIV infection did not receive their test results. Alternative measures to increase the number of persons who receive their results need to be evaluated. These may include enhancing prevention counseling about the importance of receiving test results, telephone notification, or using rapid HIV-screening tests that provide results at the time of testing.

AIDS Serodiagnosis↗
PubMed1998

Home sample collection tests for HIV infection.

CONTEXT: Home sample collection (HSC) tests allow persons to test themselves for human immunodeficiency virus (HIV) infection at home without medical supervision. Characterizing the use of such tests can help assess their potential effect on public health efforts to prevent and control HIV. OBJECTIVE: To describe use of HIV HSC tests. DESIGN: Retrospective descriptive analysis from data collected by test manufacturers during 1996 and 1997. SETTING: United States. PARTICIPANTS: Volunteer sample of consumers who used either of 2 HSC tests. MAIN OUTCOME MEASURES: Demographic and behavioral aspects of users. RESULTS: During the first year of availability, 174316 HIV HSC tests were submitted to the manufacturers for analysis; 0.9% of the results were positive for HIV, and 97% of all users called to learn test results. Survey responses from 70620 HIV-negative and 865 HIV-positive users revealed that most were men, white, and aged 25 to 34 years; HIV prevalence was highest among nonwhites, aged 35 to 44 years, men who have sex with men, and injection drug users. Bisexual men accounted for a large proportion of HIV-positive users. Nearly 60% of all users and 49% of those who tested HIV positive had never been tested before. Telephone counselors found that 23% of HIV-positive users already had a source of follow-up care, 65% accepted referrals, and 12% had tested themselves to evaluate the effects of antiretroviral therapy. CONCLUSIONS: Home sample collection tests for HIV were used by persons who were at risk for HIV and by persons who did not use other testing. Most HIV-positive users either had a source of medical care or received referrals.

AIDS Serodiagnosis↗
PubMed1998

Group counseling to prevent sexually transmitted disease and HIV: a randomized controlled trial.

OBJECTIVE: To compare prevention effectiveness of multisession group counseling with standard HIV prevention counseling for reducing risk behaviors and new sexually transmitted diseases (STDs). METHODS: Small groups of consenting STD clinic patients were randomized to four 1-hour small group counseling interventions based on the information-motivation-behavioral skills (IMB) model with a booster session at 2 months or to the standard two 20-minute individual counseling sessions. Follow-up interviews and examinations were 2, 6, 9, and 12 months after enrollment. RESULTS: From March 1992 through June 1993, 996 (59%) of 1,681 eligible persons were enrolled; 32 (3%) tested HIV-positive and were excluded. Intervention attendance was 98% for one session, and 47% attended four or five counseling sessions. Follow-up was similar for both groups: 72% attended at least once; 47% returned at 12 months. Both groups had similar increases in condom use and decreases in number of partners, and similar number of new infections with gonorrhea (14%), chlamydia (10%), or syphilis (2%). CONCLUSIONS: Two 20-minute counseling sessions were as effective as four 1-hour group sessions for reducing risk behavior and STD incidence in an STD clinic patient population.

Adolescent↗
PubMed1997

Home collection kits for HIV testing: evaluation of three strategies for dealing with insufficient dried blood specimens.

Home collection kits allow individuals to obtain a blood specimen at home and send it to a laboratory for HIV testing. In preliminary studies, 15% of kit users submitted specimens considered to be insufficient for analysis. The current Public Health Service policy requires the laboratory to reject all such specimens entirely and request a second specimen, even though some specimens are sufficient to perform an enzyme immunoassay (EIA) but not a Western blot (WB) test. Using decision analysis, we evaluated three strategies to handle specimens sufficient to perform an EIA but insufficient to perform a WB analysis: current recommendation, or baseline, for which no test is preformed and "quantity not sufficient" is reported; alternative 1 , for which an EIA is done and reported as "negative" or "quantity not sufficient" (if initially reactive); and alternative 2, for which an EIA is done and reported as "negative" or "a reactive screening test" (if initially reactive). Baseline strategy requires all consumers with an initial specimen sufficient for EIA only to submit a second specimen, but either alternative requires fewer than 3% to submit a second specimen. Although 80% of consumers with an initial specimen sufficient for EIA learn their test results only with the baseline strategy, more than 99% learn their test results with either alternative. With the scenario of high (2%) HIV prevalence, 91% of consumers who would be told "reactive screening test" are truly infected. At a low (0.1%) HIV prevalence, 33% of consumers who would be told "reactive screening test" are truly infected. When a specimen is sufficient for EIA only, it is preferable to perform the EIA instead of rejecting the specimen, because many persons can get results from the initial specimen and because many fewer are required to submit a second specimen. Current policy should be reexamined in light of these findings.

Blood Specimen Collection↗
PubMed1995

Early intervention for persons infected with human immunodeficiency virus.

Early intervention for persons infected with human immunodeficiency virus (HIV) involves characterization of the stage of HIV disease, institution of therapy to prevent associated infections and postpone deterioration of immune function, and assistance in preventing transmission of the virus. This review examines the available data on the efficacy of current recommendations regarding the evaluation and management of persons with early HIV infection. Existing evidence supports the efficacy of physical examination, monitoring of the CD4+ cell count, tuberculin testing (with chemotherapy for persons who test positive), anergy testing, Papanicolaou testing and screening for gonorrhea and chlamydial infection (for high-risk women), screening for syphilis, antiretroviral therapy (for symptomatic patients), and guidance in reducing the transmission of HIV. Recommended measures for which evidence of clinical efficacy is less certain include immunization against infections due to influenza virus, Streptococcus pneumoniae, Haemophilus influenzae, and hepatitis B virus as well as antiretroviral therapy for asymptomatic persons. Quantitative measurement of viral titers appears promising for the monitoring of HIV disease and antiretroviral therapy; the correlations of these titers with clinical end points need to be confirmed.

HIV Infections↗