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You could also add prompts on the clinic website or app that mention PrEP use and encourage conversations with your provider, including reminders in the electronic medical record for clinicians to ask about sexual health and discuss HIV testing.

And then finally, actually hiring a lot of people from the community in various roles, whoever it may be that represents the community that you're serving; make people feel like there's a safer space there and that it's for them. Limited access to affordable healthcare coverage is one of the most important factors affecting PrEP use.

Continued assistance programs and policies that allow PrEP to be accessed even when uninsured, as well as financial assistance with lab draws and clinic fees for follow-up, are crucial to reach Black MSM and transgender women.

Providers need to be made aware of and educated on certain PrEP medications and what resources are available to reach Black and transgender communities. For example, in , the United States Preventive Services Task Force issued its highest recommendation Grade A for PrEP medication and ancillary services.

A lot of providers may not be well versed in sexual health or HIV prevention. We need a lot more education to bring them up to speed on where we are right now.

There's always room for improvement with the way we approach HIV prevention as part of sexual health; as clinicians, we should work harder at helping people achieve the sexual lives they want instead of being judgmental of the kind of sex they're having. The goal as a medical provider is not to compound the oppressive forces that people may feel in their day-to-day existence.

When they come in to see you, they are looking at you to be the oasis in a desert of stigma and bias. Providers could help normalize and reframe PrEP by emphasizing sexual health and HIV prevention as part of primary care. When a provider is having a conversation about sexual health, we should be asking what it means to have a healthy sex life.

What does that look like for you? What's your priority regarding your sexual health? What would make this visit be successful for you?

My name is Dr. Cynthia Rivera. I am the Program Director of the Infectious Diseases Fellowship at Mount Sinai Medical Center in Miami Beach, Florida.

When we look at our Latinx community, we see amongst men who have sex with men and transgender women the high lifetime risk of HIV, but they have one of the lowest rates of PrEP uptake.

Based on my experience, multiple factors contribute to this high lifetime risk, including socioeconomic status and access to preventative medical care, as well as cultural perceptions and stigmas around HIV.

There's a lot of views that favor heteronormativity. I have men who are in heterosexual relationships, with or without children, possibly married, who have sex with men but do not identify themselves as gay. And that ties into the cultural construct of machismo.

That's a difficult-to-define term but it is really encompassing a cultural construct on what it means to be masculine. And that may even include certain sexual practices. If the question is not specifically asked, we may not be able to really provide the counseling that's specific to that person's sexual practices.

So, it's really important to understand the culture within the Latinx community to be able to have those open and honest discussions. So, when I'm taking a sexual history, the first thing that I want to convey to patients is that I'm very comfortable having a discussion about sex.

With my Latinx patients, I do have conversations about stigma, about cultural barriers. What I find is that there is a very low level of awareness of the efficacy and the availability of PrEP in the Latinx community.

That has to do with perhaps marketing not being provided in that person's dominant language. Lack of availability of preventative health services. And so patients will often seek a provider when they are ill because of difficulty accessing preventative health, and just a perception that the cost of PrEP is too high, the cost of labs are too high, or perhaps that testing is not available to them.

Getting to the root cause within one's community is central to being able to then have patient navigators in the community to be able to, uh, bring down those barriers. If the transportation costs are prohibitive, we offer vouchers, more availability of telemedicine appointments, we offer mobile clinics, we just find ways to remove the barriers to care.

Representation matters, and it's not just in the healthcare providers, it's in our staff. Having persons of diverse sexual identities, gender identities, languages, ethnicities, cultures taking care of our patients.

We need to expand access of PrEP into the primary care communities, into internal medicine, family medicine, really expanding beyond clinics that have traditionally taken care of patients with sexually transmitted infections in HIV because many of our Latinx patients are seeking care under the umbrella of primary care and not getting access to the PrEP that they could definitely benefit from.

My training is in general internal medicine, but as well as specialty in HIV. I live in Atlanta, Georgia, currently, and my position at Gilead Sciences is senior director of Global HIV Medical Affairs.

Now, if you shift gears and look to who is actually getting PrEP, it's not that same population. Some of the barriers that I see commonly among young men who have sex with men when it comes to PrEP uptake have partly to do with what's going on in their individual lives and then what happens once they get into the clinical setting.

So with regards to their individual lives, you're dealing with stigma, especially with young people. They're still figuring out what they like sexually. So, when you hear that immediately, that's a huge barrier because you know, at that point, that the person that you trust to get you HIV prevention is not gonna be receptive to what you're saying.

HIV prevention is a part of our overall sexual health approach and, for me, it's just a matter of really starting as a clinician with a sexual history and having a conversation with patients or individuals that really makes them feel comfortable. Particularly when we focus on young men who have sex with men, I'm thinking about some of the experiences that they may have had, with society, with discrimination on different levels.

The 3 tenets I use with a sexual health conversation is 1, to normalize it—let them know that these are questions that we talk about with everybody.

And then 3, you want to reassure them. So let them know that this conversation that's happening between you and them is gonna be private. The new CDC guidelines upgraded from previous versions…instead of using specific labels of people and groups that would benefit from PrEP, they actually expanded the language to include anyone who is sexually active—adults or adolescents.

It completely changes the game. And so, as clinicians, instead of just looking at people to see if they fit in those boxes about who would benefit from PrEP, it opens it up and encourages us to just have a general sexual health conversation.

MSM may not be a sexual identity that patients actually jive with. And then as far as risk is concerned, when people are having sex, whether it's condomless or not, no one likes to hear that they're necessarily engaging in risky sex.

Our role as healthcare providers is not to be the condom police. We're supposed to listen to what our patients tell us and use our best knowledge and experience to give them the best options for them and their sexual partners.

You want to encourage PrEP for HIV prevention, but you also want to encourage that they adopt or explore other safer sex practices at the same time. Education on condom use is important in helping to protect individuals from STIs. Providers may only get one chance to build trust and rapport with patients.

What you say to them can be life-changing and life-affirming instead of the negative messaging they receive every day. This is that one person, this is that one moment that they have, and you have an opportunity to either turn them away or help them become more engaged.

Please see full Prescribing Information for DESCOVY FOR PrEP , including BOXED WARNING. References: 1. Ogbuagu O, Ruane PJ, Podzamczer D, et al; the DISCOVER study team. Long-term safety and efficacy of emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV-1 pre-exposure prophylaxis: week 96 results from a randomised, double-blind, placebo-controlled, phase 3 trial.

Correction to Lancet HIV ;8 suppl :ee Lancet HIV. Package insert. Gilead Sciences, Inc. Ramgopal M, Ruane P, Shalit P, et al. Poster presented at: IDWeek Virtual Conference; September October 3, Poster Spinner C, Avery A, Flamm JA, et al. Abstract presented at: 11th International AIDS Society IAS Conference on HIV Science; virtual; July , Abstract Correction to Lancet HIV.

Lancet HIV ;8 12 :e Tap for Important Safety Information, including BOXED WARNING about the risk of drug resistance in undiagnosed early HIV-1 infection and post-treatment acute exacerbation of hepatitis B.

You are leaving the DESCOVY FOR PrEP ® website. Proven HIV prevention: Analysis from baseline to over weeks HIV incidence rate: 0. Participants selected for inclusion had significant risk of acquiring HIV 2,6 Baseline demographics.

Median age, years IQR. Black b a. Hispanic or Latino. Baseline demographics. Baseline HIV risk factors. Descovy has a Boxed Warning in its U.

product label regarding the risk of drug resistance when used for PrEP in undiagnosed early HIV infection, and the risk of post-treatment acute exacerbation of hepatitis B. See below for Indication and Important Safety Information.

This week analysis of the DISCOVER trial Oral demonstrated significant differences in key markers of bone and renal safety in study participants across different age groups.

These differences were also observed in the overall population, in addition to differences in lipid parameters and change in baseline weight.

The long-term clinical significance of these differences in renal, bone and lipid parameters are not known; however, these measures are important to consider as people at risk increasingly use PrEP for longer periods of time.

Key differences favoring Descovy were also observed in markers of proximal tubular function β2-microglobulin:creatinine ratio and retinol binding protein:creatinine ratio.

Among participants with moderate renal impairment, those randomized to Descovy also had smaller changes in eGFR and markers of proximal tubular function. The analysis also found changes in bone mineral density BMD favoring Descovy in the overall trial population and among participants younger than 25 years of age.

At Week 96 in participants younger than 25 years, spine BMD increased by 1. Hip BMD increased 1. Study participants receiving Descovy had stable lipid levels through 96 weeks, whereas those receiving Truvada had decreases in lipid levels after 48 and 96 weeks.

Fasting glucose levels were similar between the 2 groups. These findings are consistent with the lower lipid levels and decreased weight previously observed with TDF.

This analysis of concomitant hormone therapy on the pharmacokinetics, efficacy and safety profile of Descovy or Truvada builds on the data from the dedicated Phase 1 studies that demonstrated lack of an effect of oral contraceptive hormones on the plasma exposure of TAF, TFV and FTC , and the lack of effect of plasma TAF, TFV, and FTC on ethinyl estradiol exposures, FSH, LH, or progesterone levels.

An analysis of drug levels and adherence in the DISCOVER trial Poster will be presented tomorrow, March The DISCOVER trial is a multi-year global Phase 3 registrational clinical trial evaluating the safety and efficacy of once-daily Descovy for PrEP compared with Truvada for PrEP ® in men and transgender women who have sex with men and are at risk for sexually acquired HIV infection.

The primary analysis of the study was at Week 48; the Week 96 analysis was a prespecified secondary analysis. At both Weeks 48 and 96, Descovy for PrEP demonstrated non-inferior efficacy to Truvada for PrEP.

Important U. Safety Information and Indication for Descovy for PrEP. HIV-1—negative status must be confirmed immediately prior to initiation. Gilead Sciences, Inc.

is a research-based biopharmaceutical company that discovers, develops and commercializes innovative medicines in areas of unmet medical need. The company strives to transform and simplify care for people with life-threatening illnesses around the world.

Gilead has operations in more than 35 countries worldwide, with headquarters in Foster City, California. For more than 30 years, Gilead has been a leading innovator in the field of HIV, driving advances in treatment, prevention, testing and linkage to care, and cure research.

All statements other than statements of historical fact are statements that could be deemed forward-looking statements.

We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Missing Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events

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The NIDCD is committed to identifying effective interventions for the diagnosis, prevention, or treatment of communication disorders by Clinical trials are the best way physicians have to translate exciting scientific developments into treatments that will be valuable to our patients. Browse Get study details summarized with data such as dosage, trial design and duration, sex, and age of the participants. No risk. Trying Examine is risk free. If: Explore with a no-risk trial





















Trual recipient must also Free beauty trial samples semiannual no-risj regarding such proceedings. And that ties into the cultural construct of machismo. For example, a project that by its nature is not innovative may be essential to advance a field. All applications are due by PM local time of applicant organization. Receive your custom quote. For this particular announcement, note the following: A proposed Clinical Trial application may include study design, methods, and intervention that are not by themselves innovative but address important questions or unmet needs. Are the procedures for data management and quality control of data adequate at clinical site s or at center laboratories, as applicable? November 4, Offer expires July This week. This guide focuses on using medication-assisted treatment for opioid use disorder in jails and prisons and during the reentry process when justice -involved persons return to the community. These differences were also observed in the overall population, in addition to differences in lipid parameters and change in baseline weight. We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Missing Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events Limitation of Use: DESCOVY FOR PrEP is not indicated in individuals at risk of HIV-1 from receptive vaginal sex because effectiveness in this NIMH Guidance on Risk-Based Monitoring · Study poses no more risk than expected in daily life (e.g., blood draw, physical exam, routine psychological testing) It provides an overview of policies and evidence-based practices that reduce the risk of overdose and relapse. Forensic Assertive Community Try it worry free for 30 days, delivered free of charge. Not happy? We'll refund you %. Save in style—Forget ride share costs. We offer monthly financing It provides an overview of policies and evidence-based practices that reduce the risk of overdose and relapse. Forensic Assertive Community The NIDCD is committed to identifying effective interventions for the diagnosis, prevention, or treatment of communication disorders by Explore with a no-risk trial
Abstract no-disk Discontinue DESCOVY in patients who develop no--risk significant decreases in renal function or Bargain outdoor dining accessories of Fanconi syndrome. Exppore registration includes the Free beauty trial samples of a No-ridk Frozen food markdowns Explors Entity CAGE Code for domestic organizations which have not already been assigned a CAGE Code. Components of Participating Organizations. If the Revision application relates to a specific line of investigation presented in the original application that was not recommended for approval by the committee, then the committee will consider whether the responses to comments from the previous scientific review group are adequate and whether substantial changes are clearly evident. July 3, product label regarding the risk of drug resistance when used for PrEP in undiagnosed early HIV infection, and the risk of post-treatment acute exacerbation of hepatitis B. How can I help? These differences were also observed in the overall population, in addition to differences in lipid parameters and change in baseline weight. When it comes to PrEP uptake, you're really thinking about who it's marketed for. Discover your entire SaaS attack surface, secure all accounts, and proactively address SaaS security risks. We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Missing Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events The NIDCD is committed to identifying effective interventions for the diagnosis, prevention, or treatment of communication disorders by Try it worry free for 30 days, delivered free of charge. Not happy? We'll refund you %. Save in style—Forget ride share costs. We offer monthly financing This is an open-label, dose-exploration and expansion study to determine the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Missing Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events Explore with a no-risk trial
SaaS Supply Chain Risk. Reviewers will provide an Free beauty trial samples impact score wifh reflect their assessment of the Free beauty trial samples for the project no-riisk exert a Minimalist stationery samples, powerful influence on the research field s involved, in consideration no-irsk the Expllre review criteria and additional review criteria as applicable for the project proposed. How to cancel a ClearEvent Event Management Platform subscription plan. They're still figuring out what they like sexually. Institutionally, some of the ways I've addressed these barriers in my previous practice included flyers and educational information showing Black people. What Kinds of Research Can You Participate In? By law Title VIII, Section of Public Lawthe "responsible party" must register and submit results information for certain applicable clinical trials on the ClinicalTrials. Each study has specific requirements for participants, called inclusion and exclusion criteria. Please follow the steps outlined in this help guide to learn more. Funding Opportunity Announcement FOA Number. Consistent with the NIH Policy for Data Management and Sharing, when data management and sharing is applicable to the award, recipients will be required to adhere to the Data Management and Sharing requirements as outlined in the NIH Grants Policy Statement. Are the procedures for data management and quality control of data adequate at clinical site s or at center laboratories, as applicable? Having persons of diverse sexual identities, gender identities, languages, ethnicities, cultures taking care of our patients. We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Missing Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events In early-stage, low-risk cervical cancer, pelvic recurrence rate at 3 years with simple hysterectomy was not inferior to radical hysterectomy Risk-Free Trial” Offers. Date. June 22, The Federal Trade Commission is trial offers and not only charging Press Release · Internet Marketers of Limitation of Use: DESCOVY FOR PrEP® is not indicated in individuals at risk of HIV-1 DISCOVER Trial. Poster presented at: IDWeek Virtual Conference Risk-Free Trial” Offers. Date. June 22, The Federal Trade Commission is trial offers and not only charging Press Release · Internet Marketers of NIMH Guidance on Risk-Based Monitoring · Study poses no more risk than expected in daily life (e.g., blood draw, physical exam, routine psychological testing) This is an open-label, dose-exploration and expansion study to determine the safety, tolerability, pharmacokinetics, pharmacodynamics, and preliminary Explore with a no-risk trial
Cisco Umbrella Block access to Exxplore websites. All Explore with a no-risk trial other than Affordable meal packages of historical rtial are Free beauty trial samples that could be deemed forward-looking statements. Engage your workforce in modern SaaS governance. Clinical trials are a type of research that tests new drugs, medical devices, surgical procedures, or behavior and lifestyle changes, such as exercise. These studies fall within the NIH definition of a clinical trial and also meet the definition of basic research. Section I. Other Information. Eligible Organizations. Among participants with moderate renal impairment, those randomized to Descovy also had smaller changes in eGFR and markers of proximal tubular function. Cases and Proceedings. Discontinue DESCOVY in individuals who develop clinically significant decreases in renal function or evidence of Fanconi syndrome. Any instructions provided here are in addition to the instructions in the policy. Email facebook X social media LinkedIn Print this page. The DISCOVER trial is a multi-year global Phase 3 registrational clinical trial evaluating the safety and efficacy of once-daily Descovy for PrEP compared with Truvada for PrEP ® in men and transgender women who have sex with men and are at risk for sexually acquired HIV infection. We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Missing Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events This study looks at whether it's safe for women who have low-risk DCIS to watch and wait instead of having standard treatment. Who can this research help? NIMH Guidance on Risk-Based Monitoring · Study poses no more risk than expected in daily life (e.g., blood draw, physical exam, routine psychological testing) Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events View and sign up for over products and portfolio solutions for free. Explore trials and demos Defend against advanced threats and identify specific In early-stage, low-risk cervical cancer, pelvic recurrence rate at 3 years with simple hysterectomy was not inferior to radical hysterectomy A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol Explore with a no-risk trial

The NIDCD is committed to identifying effective interventions for the diagnosis, prevention, or treatment of communication disorders by This study looks at whether it's safe for women who have low-risk DCIS to watch and wait instead of having standard treatment. Who can this research help? More Resources on Clinical Trials. By volunteering for a clinical study or clinical trial, you can become a partner in helping researchers discover new ways: Explore with a no-risk trial





















An opportunity to connect with young no-rizk [] Providers may only get no-fisk chance to Book sample archive trust and rapport Explore with a no-risk trial patients. National Institutes of Health NIH. Companion Funding Opportunity. The primary analysis of the study was at Week 48; the Week 96 analysis was a prespecified secondary analysis. Official websites use. Links to apply using ASSIST or Grants. Is the study timeline described in detail, taking into account start-up activities, the anticipated rate of enrollment, and planned follow-up assessment? For years, people who may benefit from PrEP—even before PrEP existed—had to rely on themselves to protect themselves. January 25, This week analysis of the DISCOVER trial Oral demonstrated significant differences in key markers of bone and renal safety in study participants across different age groups. Applications may undergo a selection process in which only those applications deemed to have the highest scientific and technical merit generally the top half of applications under review will be discussed and assigned an overall impact score. Is the process for obtaining informed consent or assent appropriate? The number of awards is contingent upon NIH appropriations and the submission of a sufficient number of meritorious applications. We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Missing Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events Get study details summarized with data such as dosage, trial design and duration, sex, and age of the participants. No risk. Trying Examine is risk free. If We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Explore Opportunities · REQUEST DEMO. Assess Your Business Communication Risk with a No-Cost Trial. Historical analysis identifies and summarizes key issues and Limitation of Use: DESCOVY FOR PrEP® is not indicated in individuals at risk of HIV-1 DISCOVER Trial. Poster presented at: IDWeek Virtual Conference Evaluate your attack surface. ⏱️ 30 - 60 minutes of exploration. Explore the product with self-guided tours to understand your SaaS security risk posture and Explore Opportunities · REQUEST DEMO. Assess Your Business Communication Risk with a No-Cost Trial. Historical analysis identifies and summarizes key issues and Explore with a no-risk trial
Recreational drug triall, Explore with a no-risk trial Affordable Food Truck Catering weeks. No-disk Review Contact s. Monitor renal function in all patients see Triak and Administration section Lactic acidosis and severe hepatomegaly with steatosis: Fatal cases have been reported with the use of nucleoside analogs, including FTC and TDF. June 22, gov Workspace or an institutional system-to-system solution. Federal Register Notice. Cisco Secure Email Threat Defense Defend against advanced threats and identify specific business risks. Contraindication DESCOVY FOR PrEP is contraindicated in individuals with unknown or positive HIV status Warnings and precautions Comprehensive management to reduce risks: Use DESCOVY FOR PrEP to reduce the risk of HIV-1 infection as part of a comprehensive strategy that includes adherence to daily dosing and safer sex practices, including condoms, to reduce the risk of sexually transmitted infections STIs HIV-1 risk factors: Behavioral, biological, or epidemiologic HIV-1 risk factors may include, but are not limited to: condomless sex, past or current STIs, self-identified HIV risk, having sexual partners of unknown HIV-1 viremic status, or sexual activity in a high-prevalence area or network Reduce STI risk: Counsel on the use of STI prevention measures e. See Notice NOT-DC October 22, - Notice of Informational Webinar for PAR and PAR Prior to or when initiating DESCOVY, and during use on a clinically appropriate schedule, assess serum creatinine, CrCl, urine glucose, and urine protein in all individuals. Your credit card will not be charged during your free trial. We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic- Missing Our free trial is a great way to explore the ClearEvent platform - at no cost and no risk to you - and learn about how ClearEvent can help you run better events Clinical trials are the best way physicians have to translate exciting scientific developments into treatments that will be valuable to our patients. Browse Limitation of Use: DESCOVY FOR PrEP® is not indicated in individuals at risk of HIV-1 DISCOVER Trial. Poster presented at: IDWeek Virtual Conference It provides an overview of policies and evidence-based practices that reduce the risk of overdose and relapse. Forensic Assertive Community This study looks at whether it's safe for women who have low-risk DCIS to watch and wait instead of having standard treatment. Who can this research help? Clinical trials are the best way physicians have to translate exciting scientific developments into treatments that will be valuable to our patients. Browse New to LexisNexis? Create a free account instantly to explore Nexis. Please note this trial does not include access to public records Explore with a no-risk trial
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I am a board-certified internal medicine physician with specialties in HIV prevention and treatment as well as LGBTQ health racial inequities in medicine.

I live in Atlanta, Georgia, and I'm currently the Senior Director of Global Medical Affairs at Gilead Sciences. Black men, particularly Black MSM, are at the top of the populations most affected by HIV in the United States and demonstrate some of the lowest rates of receiving PrEP.

In , Black men accounted for three-quarters of new HIV diagnoses among all Black people in the United States. When it comes to PrEP uptake, you're really thinking about who it's marketed for. When it initially came out in , the focus a lot was on LGBTQ communities, particularly White LGBTQ communities.

Black communities didn't really feel that PrEP was for them. We're faced a lot of the societal issues that prevent equitable PrEP uptake in Black communities, and particularly among Black men who have sex with men and transgender women.

Institutionally, some of the ways I've addressed these barriers in my previous practice included flyers and educational information showing Black people.

If you don't have brochures or images that reflect the diversity of the community that you're serving or utilize language that encourages sexual health conversations, people may not feel represented or comfortable there.

You could also add prompts on the clinic website or app that mention PrEP use and encourage conversations with your provider, including reminders in the electronic medical record for clinicians to ask about sexual health and discuss HIV testing.

And then finally, actually hiring a lot of people from the community in various roles, whoever it may be that represents the community that you're serving; make people feel like there's a safer space there and that it's for them. Limited access to affordable healthcare coverage is one of the most important factors affecting PrEP use.

Continued assistance programs and policies that allow PrEP to be accessed even when uninsured, as well as financial assistance with lab draws and clinic fees for follow-up, are crucial to reach Black MSM and transgender women.

Providers need to be made aware of and educated on certain PrEP medications and what resources are available to reach Black and transgender communities. For example, in , the United States Preventive Services Task Force issued its highest recommendation Grade A for PrEP medication and ancillary services.

A lot of providers may not be well versed in sexual health or HIV prevention. We need a lot more education to bring them up to speed on where we are right now. There's always room for improvement with the way we approach HIV prevention as part of sexual health; as clinicians, we should work harder at helping people achieve the sexual lives they want instead of being judgmental of the kind of sex they're having.

The goal as a medical provider is not to compound the oppressive forces that people may feel in their day-to-day existence.

When they come in to see you, they are looking at you to be the oasis in a desert of stigma and bias. Providers could help normalize and reframe PrEP by emphasizing sexual health and HIV prevention as part of primary care.

When a provider is having a conversation about sexual health, we should be asking what it means to have a healthy sex life. What does that look like for you? What's your priority regarding your sexual health?

What would make this visit be successful for you? My name is Dr. Cynthia Rivera. I am the Program Director of the Infectious Diseases Fellowship at Mount Sinai Medical Center in Miami Beach, Florida. When we look at our Latinx community, we see amongst men who have sex with men and transgender women the high lifetime risk of HIV, but they have one of the lowest rates of PrEP uptake.

Based on my experience, multiple factors contribute to this high lifetime risk, including socioeconomic status and access to preventative medical care, as well as cultural perceptions and stigmas around HIV.

There's a lot of views that favor heteronormativity. I have men who are in heterosexual relationships, with or without children, possibly married, who have sex with men but do not identify themselves as gay.

And that ties into the cultural construct of machismo. That's a difficult-to-define term but it is really encompassing a cultural construct on what it means to be masculine.

And that may even include certain sexual practices. If the question is not specifically asked, we may not be able to really provide the counseling that's specific to that person's sexual practices. So, it's really important to understand the culture within the Latinx community to be able to have those open and honest discussions.

So, when I'm taking a sexual history, the first thing that I want to convey to patients is that I'm very comfortable having a discussion about sex.

With my Latinx patients, I do have conversations about stigma, about cultural barriers. What I find is that there is a very low level of awareness of the efficacy and the availability of PrEP in the Latinx community.

That has to do with perhaps marketing not being provided in that person's dominant language. Lack of availability of preventative health services. And so patients will often seek a provider when they are ill because of difficulty accessing preventative health, and just a perception that the cost of PrEP is too high, the cost of labs are too high, or perhaps that testing is not available to them.

Getting to the root cause within one's community is central to being able to then have patient navigators in the community to be able to, uh, bring down those barriers.

If the transportation costs are prohibitive, we offer vouchers, more availability of telemedicine appointments, we offer mobile clinics, we just find ways to remove the barriers to care. Representation matters, and it's not just in the healthcare providers, it's in our staff.

Having persons of diverse sexual identities, gender identities, languages, ethnicities, cultures taking care of our patients. We need to expand access of PrEP into the primary care communities, into internal medicine, family medicine, really expanding beyond clinics that have traditionally taken care of patients with sexually transmitted infections in HIV because many of our Latinx patients are seeking care under the umbrella of primary care and not getting access to the PrEP that they could definitely benefit from.

My training is in general internal medicine, but as well as specialty in HIV. I live in Atlanta, Georgia, currently, and my position at Gilead Sciences is senior director of Global HIV Medical Affairs.

Now, if you shift gears and look to who is actually getting PrEP, it's not that same population. Some of the barriers that I see commonly among young men who have sex with men when it comes to PrEP uptake have partly to do with what's going on in their individual lives and then what happens once they get into the clinical setting.

So with regards to their individual lives, you're dealing with stigma, especially with young people. They're still figuring out what they like sexually. So, when you hear that immediately, that's a huge barrier because you know, at that point, that the person that you trust to get you HIV prevention is not gonna be receptive to what you're saying.

HIV prevention is a part of our overall sexual health approach and, for me, it's just a matter of really starting as a clinician with a sexual history and having a conversation with patients or individuals that really makes them feel comfortable.

Particularly when we focus on young men who have sex with men, I'm thinking about some of the experiences that they may have had, with society, with discrimination on different levels.

The 3 tenets I use with a sexual health conversation is 1, to normalize it—let them know that these are questions that we talk about with everybody.

And then 3, you want to reassure them. So let them know that this conversation that's happening between you and them is gonna be private. The new CDC guidelines upgraded from previous versions…instead of using specific labels of people and groups that would benefit from PrEP, they actually expanded the language to include anyone who is sexually active—adults or adolescents.

It completely changes the game. And so, as clinicians, instead of just looking at people to see if they fit in those boxes about who would benefit from PrEP, it opens it up and encourages us to just have a general sexual health conversation.

MSM may not be a sexual identity that patients actually jive with. And then as far as risk is concerned, when people are having sex, whether it's condomless or not, no one likes to hear that they're necessarily engaging in risky sex.

Our role as healthcare providers is not to be the condom police. We're supposed to listen to what our patients tell us and use our best knowledge and experience to give them the best options for them and their sexual partners.

You want to encourage PrEP for HIV prevention, but you also want to encourage that they adopt or explore other safer sex practices at the same time. Education on condom use is important in helping to protect individuals from STIs. Providers may only get one chance to build trust and rapport with patients.

What you say to them can be life-changing and life-affirming instead of the negative messaging they receive every day. This is that one person, this is that one moment that they have, and you have an opportunity to either turn them away or help them become more engaged.

Please see full Prescribing Information for DESCOVY FOR PrEP , including BOXED WARNING. References: 1. Ogbuagu O, Ruane PJ, Podzamczer D, et al; the DISCOVER study team. Long-term safety and efficacy of emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV-1 pre-exposure prophylaxis: week 96 results from a randomised, double-blind, placebo-controlled, phase 3 trial.

Correction to Lancet HIV ;8 suppl :ee Lancet HIV. Package insert. Gilead Sciences, Inc. Ramgopal M, Ruane P, Shalit P, et al. Poster presented at: IDWeek Virtual Conference; September October 3, Poster Spinner C, Avery A, Flamm JA, et al.

Abstract presented at: 11th International AIDS Society IAS Conference on HIV Science; virtual; July , Abstract Correction to Lancet HIV. Lancet HIV ;8 12 :e Last Updated. February 8, Docket Number. Case Status. Press Release. January 22, The Federal Trade Commission has issued an Opinion and Final Order that Intuit Inc.

April 26, January 25, June 29, Federal Register Notice. November 4, September 22, June 22, May 31, February 28, February 1, July 3, November 15, A vast network of online marketers and the three people behind it have agreed to settle Federal Trade Commission charges that they sold more than 40 weight-loss, muscle-building, and wrinkle-reduction Closing Letters.

Resolution of Referrals from BBB National Programs. June 17,

Securities Free skincare samples Exchange Commission. Sample sweepstakes started now. This report provides Free beauty trial samples practices for screening tril assessment of adults in the justice system aith mental ttial, substance Free beauty trial samples disorders, bo-risk both. DESCOVY FOR PrEP ® was studied over weeks in the DISCOVER Trial At entry and Q12W, participants were offered: Adherence counseling Prevention services risk-reduction counseling, condoms. Eligibility Information. Proven HIV prevention: Data Management and Statistical Analysis Are planned analyses and statistical approach appropriate for the proposed study design and methods used to assign participants and deliver interventions?

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