PrEP, HIV, and Continuing Barriers to Access

As a gay man navigating the complex landscape of health care, I never expected to encounter judgment, stigma, and discrimination in my pursuit of preventative measures against HIV. In a world that’s constantly evolving, it’s disheartening to see how outdated attitudes still hinder access to essential services like pre-exposure prophylaxis (PrEP). My personal experience may shed light on the urgent need for an update on PrEP for HIV prevention.

The human cost of judgment and stigma.

Like many in the LGBTQIA+ community, I faced the harsh reality of being told not to have sex, to pursue monogamy and marriage as the only path to a healthy life. These societal expectations, fueled by ignorance and prejudice, led me to suppress my desires, inadvertently putting my health at risk. Denial of access to prevention services like PrEP left me feeling isolated, vulnerable, and frustrated.

My wake-up call came through a close friend who, unfortunately, lived out the consequences of societal judgment. Despite being vulnerable and at risk, he was denied access to PrEP because of the same archaic beliefs that I had encountered. The result was a diagnosis of HIV that forever altered his life and left me grappling with the reality that I […]

2023-12-18T09:33:20-05:00December 18th, 2023|equity, infectious diseases, Nursing|0 Comments

RSV Prophylaxis for Infants and Children: Now Available, But Is it Accessible?

July, a month typically characterized by the relative hibernation of communicable respiratory illnesses, brought with it the U.S. Food and Drug Administration’s (FDA’s) approval of nirsevimab-alip (brand name: Beyfortus) and thus a reminder of the gearing up necessary for the respiratory disease season ahead. Nirsevimab, approved for the prevention of respiratory syncytial virus (RSV), is poised to mitigate the staggering effects of this lower respiratory tract disease. Since significant barriers remain related to distribution, accessibility, and insurance reimbursement for this drug, it is especially important for primary care RNs and nurse practitioners in clinics and medical homes to be well informed on this topic.

RSV: a significant public health burden.

Transmission electron microscopic image revealing morphologic traits exhibited by a human respiratory syncytial virus (RSV)/ CDC

RSV is primarily of concern in the youngest and most vulnerable of the pediatric population, such as those born prematurely, with chronic lung or congenital heart disease. As many of us know all too well, RSV carries significant public health burden, causing more hospitalizations than any other illness in U.S. infants and accounting for 100 to 300 deaths each year in children under five […]

2023-09-21T11:10:58-04:00September 21st, 2023|infectious diseases, Nursing, pediatrics, pediatrics|0 Comments

Updated FDA Guidance on Blood Donation Screening: Where Are We Now?

Blood donation at Red Cross blood drive Photo by LuAnn Hunt on Unsplash

In July 2022, Velasco et al. brought attention to ongoing and systemic discriminatory policies regarding blood donation in the United States. The Food and Drug Administration (FDA) guidelines specifically targeted individuals who identify as men who have sex with men (MSM). The screening questions specifically asked men if they had sex with other men. A “yes” answer disqualified potential donors from donating blood even if they were in monogamous relationships where both partners were HIV-negative.

In December 2022, the FDA’s commissioned study (ADVANCE) wrapped, and news emerged that the study’s results prompted potential changes in the FDA-required screening policies. In a post on this blog titled Potential Changes to Blood Donation Policies for MSM in the United States, I reported the possible changes.

At the time, although we knew there would be potential change, we did not have full transparency or a final answer. Then in May 2023, the FDA updated the guidance for screening blood donors based on the results of the ADVANCE study. You can review those changes here. However, until August 7, some major blood donation centers, such as the American […]

2023-08-21T10:45:35-04:00August 21st, 2023|Nursing, Public health|0 Comments

Why Should You Care About Malaria?

malaria parasite Colorized electron micrograph showing malaria parasite (right, blue) attaching to a human red blood cell. The inset shows a detail of the attachment point.

In June and July, eight locally acquired cases of malaria were diagnosed in the U.S.—seven in Florida and one at the southern tip of Texas. Cases in the two states appear to be unrelated, and all patients are recovering. In both geographic areas, it’s likely that malaria in people with travel-related cases was transmitted by local (U.S.) mosquitoes to the people who developed the locally acquired cases.

Malaria was endemic in this country until the early 1950s, when mosquito control programs and public health campaigns brought the disease under control. Since that time, virtually all cases in the U.S—now at almost 2000 per year—have been travel related.

Malaria transmission.

Malaria is caused by several species of the Plasmodium parasite, transmitted by the bite of a female Anopheles mosquito infected by the parasite. In less than one percent of cases, transmission occurs congenitally or via transfusion, organ transplant, or unsafe needle sharing.

Why it matters.

If you’re […]

Resources for Staying Safe as Wildfires and Poor Air Quality Events Increase

Orange sky from wildfire smoke in San Francisco Photo by Tegan Miele/Unsplash

Find out what you need to know about the health risks of wildfire smoke and the best ways to keep you and your family or patients informed and safe—whether through use of a smartphone app, limiting outdoor activities, buying an air filtration device, or other means.

As we enter summer, wildfire season is upon us and will extend into the early fall. Wildfires in the United States have increased in frequency and severity over the past several decades. The states with the most wildfires are California, Georgia, Texas, North Carolina, Florida, Arizona, and Oklahoma. This year, as the season ramps up, Canada has experienced record-setting wildfires, with smoke causing air quality alerts and evacuations in Canada, the northeastern United States, and Europe.

The health risks of wildfire smoke.

With these fires comes poor air quality, with the main culprit being a pollutant known as particulate matter (PM) 2.5. These tiny particles or droplets in the air are 2.5 microns or less in width and are able to travel deep into the respiratory tract. Exposure to fine particles can cause short-term health effects such as eye, nose, throat and lung irritation, coughing, sneezing, runny nose, and shortness of breath. It […]

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