Public policy for health care workers infected with the human immunodeficiency virus.
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Biomedical subjects
Publications and source records attributed to T Summers.
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Programs for voluntary counseling and testing (VCT) for HIV play an increasingly important role in comprehensive prevention and care strategies. New technological advancements and behavioral interventions can improve the effectiveness of VCT as a tool for preventing new HIV infections and helping HIV-positive individuals access appropriate care. With growing consensus that early access to HIV therapy increases its effectiveness, and that individuals diagnosed with HIV reduce risk behavior, VCT has become integral to the continuum of HIV primary care. However, federal funding of VCT has declined, with concomitant decreases in numbers of people being tested. An estimated 200,000 people in the United States remain unaware that they are HIV positive, and many at-risk individuals do not seek out standard HIV counseling and testing services. To increase the acceptability and effectiveness of VCT, the authors recommend that VCT programs employ outreach programs offering anonymous testing to reach those at heightened risk of HIV infection, and to make rapid use of new technologies and counseling strategies to improve the reach and efficacy. Given the important role that VCT can play in both prevention and early treatment, the authors recommend significant increases in federal support.
Ten patients underwent 50-70 percent plasma exchanges using the continuous flow cell separator. The exchange material consisted of Plasma Protein Fraction (PPF) and Lactated Ringer's Solution (LRS) instead of fresh frozen, modified or lyophilized plasma. No bleeding or other complications were encountered. The coagulation factor activity after exchange was above that required for hemostasis. The procedure is safe, expeditious and efficient.
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Hydroxyethyl starch (HES) was used as sedimenting agent in the course of granulocyte collection on seventeen normal donors, using the continuous flow cell separator (CFCS). No clinical bleeding was noted in any of the donors. In spite of a 21 per cent mean reduction in postcollection platelet count, all donors had platelet counts within normal limits precollection and postcollection. Postcollection platelet adhesiveness increased in five donors, remained the same in one donor and declined in ten donors. Except in one donor there was no change in previously normal platelet aggregation to adenosine diphosphate or collagen. In the dose used, 500 ml, the infusion of 6% hydroxyethyl starch as an adjunct to granulocyte separation using the continuous flow cell separator does not appear to adversely affect platelet number and function.