Know the New HIV Testing Guidelines?

To the Editor: Human immunodeficiency virus (HIV) testing identifies people infected with HIV.1 A positive assay confirms the diagnosis and provides an opportunity for lifesaving treatment. Accurate detection in an early stage of illness allows pharmacotherapy that could decrease disease severity and reduce viral...

Commentary on “Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015”

In response to the sentinel Institute of Medicine report on emerging infectious diseases,1 the Centers for Disease Control and Prevention (CDC) published a national strategy for infectious disease prevention in 19942 and created the Emerging Infection Program (EIP) in 1995. As part of the Emerging Infection Program, the Epidemiology and...

OPEN: Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015

Because clinicians may be the first to encounter cases of emerging infectious diseases, they need to be able to work together with public health departments to quickly identify and respond to infectious disease outbreaks. Infectious diseases are a constant threat in many parts of the United States, including rural...

Healthcare Disparities in People with Disabilities: Is There a Cure?

The National Prevention Council, formed under the Patient Protection and Affordable Care Act of 2010 (PL 111–148), identifies a health disparity as a difference in health outcomes across subgroups of the population that often is linked to social, economic, or environmental...

The Importance of Health and Social Services Spending to Health Outcomes in Texas, 2010–2016

Objectives: Public health and social services spending have been shown to improve health outcomes at the county level, although there are significant state and regional variations in such spending. Texas offers an important opportunity for examining nuances in the patterns of association between local government health and social services...

Commentary on “Evaluation of Patients for Zika Virus Infection in a Travel Clinic in the Southeast United States, 2016”

In 2016, the World Health Organization declared the ongoing Zika virus outbreak in the Americas, the Caribbean, and the Pacific a public health emergency of international concern after identifying a causal association between Zika virus infection and microcephaly in newborns, among other central nervous system abnormalities, and adverse pregnancy...

Evaluation of Patients for Zika Virus Infection in a Travel Clinic in the Southeast United States, 2016

Objectives: Zika virus is an emerging infection that has posed vexing challenges to the US public health system. Improved characterization of patients with possible and confirmed infection is needed to better understand risks for infection in US travelers and to inform evolving evaluation guidelines. Methods: We performed a retrospective...

Ebola 101

To the Editor: Ebola virus (EBOV) is a zoonotic filovirus, with fruit bats being the animal reservoir. In recent years, there has been an Ebola epidemic in western Africa, yielding a public health crisis.1 Transmission of the virus to humans requires the direct contact of mucous membranes with the...

Potential Provider Oversupply and Underserved Areas: The Future of Alabama Medicine

Alabama must turn around its primary care provider deficit in its rural areas or risk its population’s health, finances, and well-being. Recent data show that a large portion of Alabama’s population is moving from rural areas to urban areas of the state, seeking jobs, whereas others are leaving Alabama...

Blood Pressure, HIV, and Cocaine Use Among Ethnically and Racially Diverse Individuals

Objectives: Racial minorities are at greater risk of cardiovascular disease (CVD), and CVD is the primary cause of mortality among human immunodeficiency virus (HIV)–infected individuals. Cocaine use also has been associated with hypertension. This study examined the contribution of lifestyle factors to systolic, diastolic, and mean arterial pressure (MAP)...

A Social-Ecological Review of Cancer Disparities in Kentucky

Cancer continuously ranks among the top 10 leading causes of death in the United States. The burden of cancer is particularly elevated in the Commonwealth of Kentucky and its 54-county Appalachian region, where cancer is the leading cause of death. Kentucky’s high rates of cancer have been attributed to...

Standardized Hypertension Management to Reduce Cardiovascular Disease Morbidity and Mortality Worldwide

Cardiovascular diseases (CVDs) are the leading cause of death globally. In 2013, CVDs were responsible for approximately 17 million deaths worldwide (32%), with >75% occurring in low- and middle-income countries...

Treatment-Naïve HIV-Infected Patients Have Fewer Gut-Homing β7 Memory CD4 T Cells than Healthy Controls

Objectives: The integrin α4β7 is the gut-homing receptor for lymphocytes. It also is an important co-receptor for human immunodeficiency virus (HIV) via glycoprotein (gp)120 binding. Depletion of gut cluster of differentiation (CD)4 T cells is linked to chronic inflammation in patients with HIV; however, measuring CD4 cells in the...

Conjoint Treatment: A Novel Approach to Target the Syndemic Conditions of Trauma, Substance Abuse, and HIV in Women Living with HIV

The Centers for Disease Control and Prevention estimates that in the United States, 1.2 million adults and adolescents are living with human immunodeficiency virus (HIV).1 In a span of 15 years, from 1985 to 2000, the proportion of women living with HIV more than tripled.2 The Centers for Disease...

Rural Religious Leaders’ Perspectives on their Communities’ Health Priorities and Health

Objectives: In traditionally underserved communities, faith-based interventions have been shown to be effective for health promotion. Religious leaders—generally the major partner in such interventions—however, are seldom are consulted about community health priorities and health promotion preferences. These insights are critical to ensure productive partnerships, effective programming, and sustainability. Methods:...

Commentary on “Factors Influencing Injury Severity of Bicyclists Involved in Crashes with Motor Vehicles: Bike Lanes, Alcohol, Lighting, Speed, and Helmet Use”

Many of us can remember receiving our first bicycle as a young child. This is the first sense of freedom that many children experience—having basic transportation. Whether it was used to ride across the street, around the block, or across town, at a young age this concept was...

Factors Influencing Injury Severity of Bicyclists Involved in Crashes with Motor Vehicles: Bike Lanes, Alcohol, Lighting, Speed, and Helmet Use

Objectives: In 2014, 726 bicyclists were killed and an additional 50,000 were injured in crashes with motor vehicles. The number of cyclists in the United States is increasing, and as a result there has been a call for more bike lanes. We examined the difference in the severity of...

Free Lung Cancer Screening Trends Toward a Twofold Increase in Lung Cancer Prevalence in the Underserved Southeastern United States

Objectives: The National Lung Screening Trial (NLST) reported that the prevalence of lung cancer in individuals at high risk for the disease is 1%, and that screening these individuals using low-dose helical computed tomography of the chest saves lives. To increase screening accessibility in the underserved southeastern United States,...

Disparities in Cancer Survivorship Indicators in the Deep South Based on BRFSS Data: Recommendations for Survivorship Care Plans

Objectives: The purpose of this investigation was to describe cancer survivorship based on the Behavioral Risk Factor Surveillance System (BRFSS) cancer survivorship modules in Alabama, Georgia, and Mississippi, conducted in 2012 and 2014, and to investigate disparities across the US Deep South region. Methods: The optional BRFSS cancer survivorship...

Planning for the Next Epidemic

Recent American public health concerns have included two emerging viral infection threats, zika and Ebola, and the recrudescence of the measles virus. Zika confirms the opinion that even when a disease vector, such as a mosquito, for a viral disease is well defined, it may be difficult to eliminate...