HIV and ID Observations

November 20th, 2009

Ties Tied to Bugs

Are doctors’ neckties causing infections?  That’s the implication of this Wall Street Journal piece: The list of things to avoid during flu season includes crowded buses, hospitals and handshakes. Consider adding this: your doctor’s necktie. … A 2004 analysis of neckties worn by 42 doctors and medical staffers at the New York Hospital Medical Center of […]

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October 31st, 2009

Would Changing Restrictive HIV Testing Laws Improve Survival?

Emphatically yes — to the tune of >600,000* years of life gained nationwide.  So says a nifty paper being presented at the annual IDSA meeting today by Mike April, under the direction of Rochelle Walensky. (*Original abstract said 549,437, cited in the link; number at the actual presentation, though, was 609,656.) Bottom line is that laws that […]

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October 20th, 2009

Well That Was Fast! HIV Vaccine Trial Published

Remember the HIV vaccine trial press release?  The one announcing the first-ever positive result? Then the backlash, with people questioning how the analyses were done, and reported? Now, less than a month later, we have the scientific presentation and the paper appear on the same day. Read all about it here and here. If you want the view […]

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October 5th, 2009

No Baseball Tonight

“Are you writing another funny blog post because there’s no baseball?” asks my son J. As “funny” is very much in the eye of the beholder, that remains to be seen.  But here are a few things on my mind the last few days: No data supporting N95 over surgical masks for flu.  One huge logistical issue […]

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September 24th, 2009

HIV Vaccine Study Shows Promise …

So says this press release by the US Military HIV Research Program: A Phase III clinical trial involving more than 16,000 adult volunteers in Thailand has demonstrated that an investigational HIV vaccine regimen was safe and modestly effective in preventing HIV infection. According to final results released by the trial sponsor, the U.S. Army Surgeon General, […]

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September 4th, 2009

For Suspected H1N1, Get Out the N95 Masks?

So says the Institute of Medicine’s recommendations for protection of health care workers: Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators … Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance with […]

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August 20th, 2009

The V.A. Opts Out

Read all about it here: As of August 17, 2009, written (signature) consent is no longer required for HIV testing in the VHA. Instead, patients will provide verbal informed consent prior to HIV testing. Furthermore, scripted pre-test and post-test counseling are no longer mandated. Since the VA is the largest HIV provider in the nation — […]

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June 24th, 2009

An Irrational Fear of IRIS?

One of the most important recent studies in HIV has just been “published” in (on?) PLoS ONE.  It’s ACTG 5164, led by Andrew Zolopa, which compared “early” versus “deferred” antiretroviral therapy in 282 patients presenting with acute opportunistic infections. (Full disclosure: I am on the protocol study team — but am not an author on this paper.) […]

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June 20th, 2009

More HIV in the Adult Film Industry (Maybe)

From the New York Times last week: Health officials in Los Angeles said Friday that 22 actors in adult sex movies had contracted HIV since 2004, when a previous outbreak led to efforts to protect pornography industry employees. (snip) Occupational health officials have long argued that failing to require that performers wear condoms during intercourse and other […]

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June 16th, 2009

Q: What is the Purpose of a Note in the Patient Chart?

A:  Depends who you’re asking. The best guidance I ever received on how to write a good note came from my residency program director, who told us that a note needn’t be encyclopedic to be excellent; in fact, he urged us to get away from the “second-year medical student” style, which typically includes absolutely everything. Instead, he […]

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