Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-19 (of 19 Records) |
Query Trace: Fenton KA [original query] |
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A strategic approach to public health workforce development and capacity building
Dean HD , Myles RL , Spears-Jones C , Bishop-Cline A , Fenton KA . Am J Prev Med 2014 47 S288-296 In February 2010, CDC's National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease (STD), and Tuberculosis (TB) Prevention (NCHHSTP) formally institutionalized workforce development and capacity building (WDCB) as one of six overarching goals in its 2010-2015 Strategic Plan. Annually, workforce team members finalize an action plan that lays the foundation for programs to be implemented for NCHHSTP's workforce that year. This paper describes selected WDCB programs implemented by NCHHSTP during the last 4 years in the three strategic goal areas: (1) attracting, recruiting, and retaining a diverse and sustainable workforce; (2) providing staff with development opportunities to ensure the effective and innovative delivery of NCHHSTP programs; and (3) continuously recognizing performance and achievements of staff and creating an atmosphere that promotes a healthy work-life balance. Programs have included but are not limited to an Ambassador Program for new hires, career development training for all staff, leadership and coaching for mid-level managers, and a Laboratory Workforce Development Initiative for laboratory scientists. Additionally, the paper discusses three overarching areas-employee communication, evaluation and continuous review to guide program development, and the implementation of key organizational and leadership structures to ensure accountability and continuity of programs. Since 2010, many lessons have been learned regarding strategic approaches to scaling up organization-wide public health workforce development and capacity building. Perhaps the most important is the value of ensuring the high-level strategic prioritization of this issue, demonstrating to staff and partners the importance of this imperative in achieving NCHHSTP's mission. |
Program collaboration and service integration in the prevention and control of HIV infection, viral hepatitis, STDs, and tuberculosis in the U.S.: lessons learned from the field
Fenton KA , Aquino GA , Dean HD . Public Health Rep 2014 129 1-4 his supplemental issue of Public Health Reports (PHR) presents a selection of innovative approaches, studies, and lessons learned from efforts to implement program collaboration and service integration (PCSI) in the prevention and control of human immunodeficiency virus (HIV) infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB) in the United States. Promotion of a comprehensive approach for these diseases is an important cross-cutting goal for the Centers for Disease Control and Prevention's (CDC's) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).1 | NCHHSTP's PCSI efforts are intended to strengthen collaborative work across disease areas and to integrate services that are provided by related programs at the client level. The catalyst for this systems change stems from the enhanced understanding of how these diseases synergistically relate with one another.2 With the rise of infectious disease syndemics (e.g., HIV and TB3) and the resultant increase in burden of disease,4 guidance has been produced to help state and local health departments better integrate service delivery.2,5–7 PCSI aims to organize and blend interrelated prevention strategies in an effort to provide more comprehensive delivery of services.2 |
Program collaboration and service integration: implementation successes and challenges
Fenton KA , Steiner RJ . Sex Transm Dis 2013 40 (8) 675-7 Health sector responses to address the overlapping epidemics of HIV and other sexually transmitted diseases (STDs), viral hepatitis, and tuberculosis (TB) have traditionally relied on the provision of highly specialized, disease-specific programs.1 Such programs have helped deliver high-quality and effective services that have been the mainstay for the management of these conditions in many Western industrialized settings over the past half century. This infrastructure has undoubtedly played an important role in providing a base for the delivery and scale-up of prevention and control programs; accelerating the awareness, diagnosis, and treatment of these conditions; and driving significant scientific and technological advances.1 | Nevertheless, the high population prevalence of these conditions and ongoing need for prevention, treatment, and care often outstrip the capacity of existing specialist services.2 It is increasingly clear that these highly specialized categorical programs, although necessary, are insufficient to manage the complex, interconnected realities of today’s health challenges—characterized by rapidly evolving transmission networks, multiple concurrent morbidities, population mobility, and complex social and structural contexts.2 At the same time, changes within the health sector have made new approaches feasible. Other players including private providers, community-based organizations, and primary care providers are increasingly involved in the diagnosis and management of these conditions. Technological advances including new diagnostic tests and the emergence of the Internet as a tool to quickly and effectively link clients with services are now poised to completely change the landscape for the management of sexual and reproductive health and related coinfections. Thus, the 2 articles in this issue focusing on program collaboration and service integration are both timely and relevant. |
Enhancing HIV/AIDS, viral hepatitis, sexually transmitted disease, and tuberculosis prevention in the United States through program collaboration and service integration: the case for broader implementation
Steiner RJ , Aquino G , Fenton KA . Sex Transm Dis 2013 40 (8) 663-8 HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis in the United States remain major public health concerns. The current disease-specific prevention approach oftentimes has led to narrow success and missed opportunities for increasing program capacity, leveraging resources, addressing social and structural determinants, and accelerating health impact-suggesting a need for greater innovation to prevent related diseases. The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's Program Collaboration and Service Integration (PCSI) strategic priority aims to strengthen collaborative engagement across these disease areas and to integrate services at the client level. In this review, we articulate the 5 principles of PCSI-appropriateness, effectiveness, flexibility, accountability, and acceptability. Drawing upon these principles and published literature, we discuss the case for change that underlies PCSI, summarize advances in the field since 2007, and articulate key next steps. Although formal evaluation is needed to fully assess the health impact of PCSI, available evidence suggests that this approach is a promising tool to advance prevention goals. |
Considerations for national public health leadership in advancing sexual health
Ivankovich MB , Fenton KA , Douglas JM Jr . Public Health Rep 2013 128 Suppl 1 102-10 Nations across the globe face significant public heath challenges in optimizing sexual health, including reducing human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), sexually transmitted infections (STIs), unintended pregnancies, and sexual violence, and mitigating the associated adverse social and economic impacts. In response, some countries have implemented national strategies and other efforts focused on promoting more holistic and integrated approaches for addressing these syndemics. This article describes opportunities for national leadership to use a more holistic approach to improve the sexual health of individuals and communities. |
Understanding sexual health and its role in more effective prevention programs
Douglas JM Jr , Fenton KA . Public Health Rep 2013 128 Suppl 1 1-4 This supplemental issue of Public Health Reports (PHR) presents a variety of articles addressing the science and practical applications of sexual health, an important health promotion concept with the potential for improving population health in a broad range of areas related to sexual behavior, including human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), sexually transmitted diseases (STDs), viral hepatitis, teen and unintended pregnancy, and sexual violence. The focus of these articles is especially timely given the population burden of these conditions in the United States and other nations, and the growing recognition that, despite the sensitive nature of the topic, addressing the broad construct of sexual health can enhance the national dialogue in this area and increase the effectiveness of public health programs.1–4 | The concept of sexual health has evolved since its initial articulation by the World Health Organization (WHO) in 1975,5 but it has generally emphasized well-being across a range of life domains (e.g., physical, mental, and emotional) rather than simply the absence of disease or other adverse outcomes.6 The definition of sexual health currently in most widespread use is that developed by WHO in 2002: | Sexual health is a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence.7 | More recently, the Centers for Disease Control and Prevention(CDC)/Health Resources and Services Administration Advisory Committee on HIV, Viral Hepatitis, and STD Prevention and Treatment (CHAC) has developed the following revised definition of sexual health recommended for use in the U.S.: | Sexual health is a state of well-being in relation to sexuality across the life span that involves physical, emotional, mental, social, and spiritual dimensions. Sexual health is an intrinsic element of human health and is based on a positive, equitable, and respectful approach to sexuality, relationships, and reproduction, that is free of coercion, fear, discrimination, stigma, shame, and violence. It includes: the ability to understand the benefits, risks, and responsibilities of sexual behavior; the prevention and care of disease and other adverse outcomes; and the possibility of fulfilling sexual relationships. Sexual health is impacted by socioeconomic and cultural contexts—including policies, practices, and services—that support healthy outcomes for individuals, families, and their communities.8 | Similar to the WHO definition, this newer definition is health-focused, emphasizing well-being related to sexuality that is beyond the absence of specific health problems, in multiple dimensions of life, as well as positive and respectful approaches to sexuality and relationships. Moving beyond the WHO definition, the CHAC definition also specifically emphasizes attributes of sexual health at both the individual level (e.g., individual understanding of benefits, risks and responsibilities, and prevention and care of health outcomes) and the social level (e.g., impact by socioeconomic and cultural contexts and healthy outcomes for families and communities as well as individuals). |
The future of HIV prevention in the United States
Mermin J , Fenton KA . JAMA 2012 308 (4) 347-8 In the United States, 1.1 million people live with human immunodeficiency virus (HIV), a 60% increase from 15 years ago. The increasing number of people who can potentially transmit HIV makes prevention more difficult. Yet federal domestic HIV prevention funding, after adjustment for inflation, has not increased since 1991, necessitating a different approach to HIV prevention. | The CDC's new strategy, “High Impact Prevention,” involves prioritizing and implementing the optimal combination of cost-effective, scalable interventions based on current science.1 This strategy focuses on the goal of the National HIV/AIDS Strategy (NHAS) of reducing the current annual HIV incidence of about 50 000 infections by 25% in 5 years. If the NHAS goals are realized, it is possible that an estimated 163 000 infections could be prevented along with a corresponding potential projected savings of $48 billion in health expenditures by 2020.2 |
Common roots: a contextual review of HIV epidemics in black men who have sex with men across the African diaspora
Millett GA , Jeffries WL4th , Peterson JL , Malebranche DJ , Lane T , Flores SA , Fenton KA , Wilson PA , Steiner R , Heilig CM . Lancet 2012 380 (9839) 411-23 Pooled estimates from across the African diaspora show that black men who have sex with men (MSM) are 15 times more likely to be HIV positive compared with general populations and 8.5 times more likely compared with black populations. Disparities in the prevalence of HIV infection are greater in African and Caribbean countries that criminalise homosexual activity than in those that do not criminalise such behaviour. With the exception of US and African epidemiological studies, most studies of black MSM mainly focus on outcomes associated with HIV behavioural risk rather than on prevalence, incidence, or undiagnosed infection. Nevertheless, black MSM across the African diaspora share common experiences such as discrimination, cultural norms valuing masculinity, concerns about confidentiality during HIV testing or treatment, low access to HIV drugs, threats of violence or incarceration, and few targeted HIV prevention resources. |
Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis
Millett GA , Peterson JL , Flores SA , Hart TA , Jeffries WL4th , Wilson PA , Rourke SB , Heilig CM , Elford J , Fenton KA , Remis RS . Lancet 2012 380 (9839) 341-8 BACKGROUND: We did a meta-analysis to assess factors associated with disparities in HIV infection in black men who have sex with men (MSM) in Canada, the UK, and the USA. METHODS: We searched Embase, Medline, Google Scholar, and online conference proceedings from Jan 1, 1981, to Dec 31, 2011, for racial comparative studies with quantitative outcomes associated with HIV risk or HIV infection. Key words and Medical Subject Headings (US National Library of Medicine) relevant to race were cross-referenced with citations pertinent to homosexuality in Canada, the UK, and the USA. Data were aggregated across studies for every outcome of interest to estimate overall effect sizes, which were converted into summary ORs for 106 148 black MSM relative to 581 577 other MSM. FINDINGS: We analysed seven studies from Canada, 13 from the UK, and 174 from the USA. In every country, black MSM were as likely to engage similarly in serodiscordant unprotected sex as other MSM. Black MSM in Canada and the USA were less likely than other MSM to have a history of substance use (odds ratio, OR, 0.53, 95% CI 0.38-0.75, for Canada and 0.67, 0.50-0.92, for the USA). Black MSM in the UK (1.86, 1.58-2.18) and the USA (3.00, 2.06-4.40) were more likely to be HIV positive than were other MSM, but HIV-positive black MSM in each country were less likely (22% in the UK and 60% in the USA) to initiate combination antiretroviral therapy (cART) than other HIV-positive MSM. US HIV-positive black MSM were also less likely to have health insurance, have a high CD4 count, adhere to cART, or be virally suppressed than were other US HIV-positive MSM. Notably, despite a two-fold greater odds of having any structural barrier that increases HIV risk (eg, unemployment, low income, previous incarceration, or less education) compared with other US MSM, US black MSM were more likely to report any preventive behaviour against HIV infection (1.39, 1.23-1.57). For outcomes associated with HIV infection, disparities were greatest for US black MSM versus other MSM for structural barriers, sex partner demographics (eg, age, race), and HIV care outcomes, whereas disparities were least for sexual risk outcomes. INTERPRETATION: Similar racial disparities in HIV and sexually transmitted infections and cART initiation are seen in MSM in the UK and the USA. Elimination of disparities in HIV infection in black MSM cannot be accomplished without addressing structural barriers or differences in HIV clinical care access and outcomes. FUNDING: None. |
HIV Infection - United States, 2005 and 2008
Hall HI , Hughes D , Dean HD , Mermin JH , Fenton KA . MMWR Suppl 2011 60 (1) 87-9 Approximately 1.1 million adults and adolescents are living with human immunodeficiency virus (HIV) infection in the United States, with 48,200--64,500 persons newly infected each year (1,2). At the beginning of the HIV epidemic in the United States in the early 1980s, the majority of persons with an HIV diagnosis were white men who have sex with men (MSM) (3,4). MSM continue to comprise a substantial proportion of persons newly infected with HIV, and the proportion of HIV infections among racial/ethnic minorities and women has increased (5). (These categories are not mutually exclusive.) Monitoring the burden of the epidemic among specific population groups provides guidance for targeting prevention and treatment efforts and allows assessment of intervention success. | | HIV infection is a notifiable disease in all states and the District of Columbia (DC). Since 1982, all 50 U.S. states and DC have reported stage 3-HIV infection, acquired immunodeficiency syndrome (AIDS), to CDC in a uniform format. In 1994, CDC implemented data management for national surveillance of early-stage HIV infection integrated with AIDS case surveillance, at which time 25 states with confidential, name-based HIV surveillance began submitting de-identified case reports to CDC. Eventually, additional states implemented name-based HIV surveillance, and all states had implemented such surveillance by April 2008. CDC regards data from states with confidential, name-based, HIV surveillance systems as sufficient to monitor trends for HIV infection after 4 continuous years of reporting (5). |
Attitudes and first heterosexual experiences among Indians and Pakistanis in Britain: evidence from a national probability survey
Griffiths C , Johnson AM , Fenton KA , Erens B , Hart GJ , Wellings K , Mercer CH . Int J STD AIDS 2011 22 (3) 131-9 We compare attitudes, experiences of learning about sex and first intercourse among Indians (n = 393) and Pakistanis (n = 365) using a probability survey of Britain's general population aged 16-44 years conducted during 1999-2001 (n = 12,110). Higher proportions of Pakistanis (64.6%) and Indians (28.1%) reported religion as 'very important' versus 6.2% of other ethnicities. Pakistanis were more conservative in their attitudes, e.g. reporting premarital sex as wrong (adjusted odds ratios [AORs] for sociodemographic differences, 4.71 [men] and 6.59 [women]). Pakistanis were more likely to be married at first sex (AORs 6.2 [men] and 9.53 [women]), yet men were more likely than women to be in non-marital relationships at this time (69.4% versus 25.2%). Pakistani men and women and Indian women were more likely to report not using reliable contraception at first sex relative to others (AORs 2.33, 3.16 and 1.90, respectively). Pakistani and Indian women were more likely than others to report school lessons as their main source of sex education (AORs 2.23 and 1.77) and not discussing sex with their parents during adolescence (AORs 2.04 and 2.62). These unique data have implications for ensuring that sex and relationship education and health promotion messages are appropriately planned, targeted and delivered to benefit Pakistanis and Indians. |
Towards a more coordinated federal response to improving HIV prevention and sexual health among men who have sex with men
Rausch D , Dieffenbach C , Cheever L , Fenton KA . AIDS Behav 2011 15 Suppl 1 S107-11 Nearly 30 years into the HIV/AIDS pandemic, the disease continues to exact a heavy toll in the United States. More than 1.1 million people are currently living with HIV in the US, and each year more than 56,000 new HIV infections occur, with nearly 18,000 people with AIDS dying annually [1]. Men who have sex with men (MSM) continue to be the group most severely impacted by HIV/AIDS, a disparity that has remained unchanged since the beginning of the epidemic, although the demographic characteristics of MSM who are impacted by HIV has changed dramatically [2]. Today, HIV affects MSM of all racial and ethnic backgrounds, with a particularly devastating impact on black and Hispanic/Latino MSM [3], and especially young MSM within these groups [4]. In this paper, we review current strategic efforts being considered or implemented by three United States government agencies (the Centers for Disease Control and Prevention, the National Institutes of Health, and the Health Resources and Services Administration) to accelerate reductions in HIV and improve sexual health among MSM. We also discuss the need for improved collaboration among federal agencies in order to achieve these goals. |
Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States
Wolitski RJ , Fenton KA . AIDS Behav 2011 15 Suppl 1 S9-17 The sexual health of gay, bisexual, and other men who have sex with men (MSM) in the United States is not getting better despite considerable social, political and human rights advances. Instead of improving, HIV and sexually transmitted infections (STIs) remain disproportionately high among MSM and have been increasing for almost two decades. The disproportionate and worsening burden of HIV and other STIs among MSM requires an urgent re-assessment of what we have been doing as a nation to reduce these infections, how we have been doing it, and the scale of our efforts. A sexual health approach has the potential to improve our understanding of MSM's sexual behavior and relationships, reduce HIV and STI incidence, and improve the health and well-being of MSM. |
A way forward: the National HIV/AIDS Strategy and reducing HIV incidence in the United States
Millett GA , Crowley JS , Koh H , Valdiserri RO , Frieden T , Dieffenbach CW , Fenton KA , Benjamin R , Whitescarver J , Mermin J , Parham-Hopson D , Fauci AS . J Acquir Immune Defic Syndr 2010 55 S144-S147 In July 2010, the Obama Administration released a National HIV/AIDS Strategy for the United States to refocus national attention on responding to the domestic HIV epidemic. The goals of the strategy are to reduce HIV incidence; to increase access to care and optimize health outcomes among people living with HIV; and to reduce HIV-related disparities. The strategy identifies a small number of action steps that will align efforts across federal, state, local, and tribal levels of government, and maximally impact the domestic HIV epidemic. In this article, we outline key programmatic and research issues that must be addressed to accomplish the prevention goals of the National HIV/AIDS Strategy. |
Time for change: rethinking and reframing sexual health in the United States
Fenton KA . J Sex Med 2010 7 250-252 The data are both compelling and concerning. Each year more than 19 million sexually transmitted infections (STIs) are estimated to occur in the United States, with almost half of these infections occurring among young persons aged 15 to 24 years [1]. One in four women aged 14–19 years is infected with at least one STI [2], and there are an estimated 1.1 million Americans living with HIV, with over 55,000 new infections per year [3]. The annual direct and indirect costs associated with managing STIs, including HIV, are estimated at $15.9 billion per year [4,5]. One-half of all pregnancies in the United States are unintended [6], and rates of teenage pregnancies are again on the rise after a decade of relative stabilization [7]. There is growing concentration of adverse sexual and reproductive health outcomes among the economically disadvantaged or socially marginalized [8–9], challenging our work to achieve sustained improvements in health for all persons in the United States. Today, men who have sex with men (MSM) of all races, young people, African Americans, and Hispanic/Latinos bear a severe, pervasive, and disproportionate burden of many of these and other adverse health outcomes [10]. The enormity of the challenges appears daunting—it’s time for change. | It is time for us to question whether this status quo is either acceptable or just. While individual-level sexual risk behaviors are among the strongest predictors of STI acquisition, there is now a greater appreciation of the role of interpersonal, network, community, and societal level influences on the sexual health of individuals and communities [11]. As our understanding of the complex and dynamic interactions between these multi-layered determinants evolve, they challenge communities, practitioners, and policymakers to question long-held beliefs regarding the role and responsibilities of individuals, clinical, and public health services. Similarly, generational changes resulting from major demographic shifts in sexual attitudes and behaviors, combined with the global expansion of the internet; mobile technology; social networking; novel patterns of sexual mixing; globalization of sex work; and technological advances in preventive, diagnostic, and clinical services, suggest that simultaneous evolutions in our practice are required to remain relevant and effective in today’s society [12]. |
Estimated future HIV prevalence, incidence, and potential infections averted in the United States: a multiple scenario analysis
Hall HI , Green TA , Wolitski RJ , Holtgrave DR , Rhodes P , Lehman JS , Durden T , Fenton KA , Mermin JH . J Acquir Immune Defic Syndr 2010 55 (2) 271-6 OBJECTIVES: To estimate the potential future burden of HIV in the United States under different intervention scenarios. METHODS: We modeled future HIV incidence, prevalence, and infections averted using 2006 estimates of HIV incidence (55,400 new infections per year), prevalence (1,107,000 persons living with HIV), and transmission rate (5.0 per 100 persons living with HIV). We modeled 10-year trends for 3 base-case scenarios (steady incidence, steady transmission rate, declining transmission rate based on the 2000-2006 trend) and 2 intensified HIV intervention scenarios (50% reduction in transmission rate within 10 and 5 years). RESULTS: Base-case scenarios predicted HIV prevalence increases of 24%-38% in 10 years. Reducing the transmission rate by 50% within 10 years reduces incidence by 40%; prevalence increases 20% to an estimated 1,329,000 persons living with HIV. Halving the transmission rate within 5 years reduces incidence by 46%; prevalence increases 13%, to 1,247,000. Although in year 10 incidence is similar regardless of the intervention time frame, more infections are averted when halving the transmission rate within 5 years. CONCLUSIONS: HIV prevalence will likely increase creating additional demands for health care services. These analyses are instructive for setting HIV prevention goals for the nation and assessing potential cost savings of intensified HIV prevention efforts. |
Prevention with HIV-positive men who have sex with men: regaining lost ground
Fenton KA . Sex Transm Infect 2010 86 (1) 2-4 The data are clear: the sexual health of gay, bisexual and other men who have sex with men (MSM) continues to deteriorate in many western industrialised countries.1 2 The epidemiological trends appear consistent: a resurgence of bacterial and viral sexually transmitted infections (STI); rising or stable HIV incidence; recent outbreaks of lymphogranuloma venerum and hepatitis C, especially among HIV-positive MSM;3 4 accompanied by a stable or increasing prevalence of risky sexual behaviours including unprotected anal intercourse, serodiscordant unprotected anal intercourse and high rates of partner change.5 These individual level changes are occurring within a wider context of evolving social, cultural and risk environments and norms and at a time when MSM in many developed country settings are enjoying unparalleled social acceptance and freedoms.6 Concomitant changes in the availability, use and abuse of recreational drugs, including alcohol, continue to fuel risk behaviour and drive disease incidence.1 Similarly, the growing population of HIV-infected MSM, many of whom are unaware of their HIV infection, may be increasing the burden of infection at a time when more men are reporting homosexual sexual behaviours and partnerships.7 8 |
Toward integration of STD, HIV, TB, and viral hepatitis surveillance
Weinstock H , Douglas JM , Fenton KA . Public Health Rep 2009 124 5-6 Public health surveillance is “the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation, and evaluation of public health practice.”1 While the fundamental activities of surveillance include data collection, analysis, and dissemination, the value of surveillance is measured through its impact on public health practice. The integration of surveillance data on sexually transmitted diseases (STDs), human immunodeficiency virus (HIV), tuberculosis (TB), and viral hepatitis is important insofar as an understanding of the intersection of these diseases geographically, in different populations, and by risk behaviors impacts the ability of public health programs to operate more efficiently and effectively. As Jennings et al.2 recommend in this special supplement of Public Health Reports, surveillance systems should be patient-based rather than case-based because program services themselves are most effective when they are patient-based. As many of the articles in this supplement illustrate, it is at the local and state levels where duplication and inefficiencies are felt most. These inefficiencies are felt by the patients who do not get the care they need in a timely fashion or who get fragmented care, by the programs that are being asked to accomplish more with diminished resources, and by the public, who are often provided fragmented rather than comprehensive summaries of problems of importance to their communities. | This special supplement highlights approaches to the integrated use of data by STD epidemiologists in the Outcome Assessment through Systems of Integrated Surveillance (OASIS) workgroup. OASIS was originally funded in 1998 by the Centers for Disease Control and Prevention's (CDC's) National Center for HIV, STD, and TB Prevention (the name was changed to the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention [NCHHSTP] in 2007) to promote the integrated interpretation and use of surveillance data across disease programs. The work of OASIS, only partially reflected in this supplement, demonstrates that state and local health departments, which have the most to gain from program integration, truly are the laboratories for creatively engineering more integrated surveillance and information systems. A system such as the Patient Reporting Investigation Surveillance Manager (PRISM), developed by the Florida Bureau of STD Prevention and Control and supported by OASIS, is one such example, as Shiver et al. describe in this issue.3 Groups like OASIS, consisting of local and state STD epidemiologists, can provide the energy and ideas to develop these efforts locally, but CDC must facilitate this work through leadership, coordination, funding, and dissemination of best practices. |
A review of the Centers for Disease Control and Prevention's response to the HIV/AIDS crisis among blacks in the United States, 1981-2009
Sutton MY , Jones RL , Wolitski RJ , Cleveland JC , Dean HD , Fenton KA . Am J Public Health 2009 99 S351-9 Among US racial/ethnic groups, Blacks are at the highest risk of acquiring HIV/AIDS. In response, the Centers for Disease Control and Prevention (CDC) has launched the Heightened National Response to Address the HIV/AIDS Crisis Among African Americans, which seeks to engage public and nonpublic partners in a synergistic effort to prevent HIV among Blacks. The CDC also recently launched Act Against AIDS, a campaign to refocus attention on the domestic HIV/AIDS crisis. Although the CDC's efforts to combat HIV/AIDS among Blacks have achieved some success, more must be done to address this crisis. New initiatives include President Obama's goal of developing a National HIV/AIDS Strategy to reduce HIV incidence, decrease HIV-related health disparities, and increase access to care, especially among Blacks and other disproportionately affected populations. |
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