National Academies Press: OpenBook
« Previous: Appendix G: Biographies
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

Index

A

Abstinence education programs, components of, 119n

“Abstinence-plus” programs, 117

Access

to drug abuse treatment, 106-116

to sterile drug injection equipment, 114-116

ACHSP. See Advisory Committee for HIV and STD Prevention

Acquired immunodeficiency syndrome. See AIDS

ACSUS. See AIDS Cost and Services Utilization Survey

ADAMHA Reorganization Act of 1992, 167

ADAP. See AIDS Drug Assistance Program

Adolescent AIDS cases, by exposure category, 141

Adolescent Family Life Act (AFLA), 118-119

Adolescent sex workers, 189

Adult AIDS cases, by exposure category, 141

Adult correctional systems, HIV/AIDS education, harm reduction, and discharge planning programs in U.S., 122

Advisory Committee for HIV and STD Prevention (ACHSP), 74

AFLA. See Adolescent Family Life Act

Africa, HIV incidence in, 105, 140

African Americans

Medicaid services provided to, 57

rates of AIDS infection among, 143-145

Agency for Health Care Quality and Research, spending on HIV/AIDS, 172

Aggregate HIV incidence, estimating, 173

AIDS cases

adult/adolescent, by exposure category, 141

and co-occurring conditions, 147-148, 152

geographic distribution of, 145-146

inadequacy of reporting based on, 15

increases in, 1

lag in diagnosis time for, 4, 81n

perinatally acquired, 144-145

providers caring for, 55-56

“public health” responses to, 22

in racial and ethnic minorities, 144-145

rates per 100,000 population, 146

and sexual orientation, 2

in women, 142-143

in youth, 143-144

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

AIDS Cost and Services Utilization Survey (ACSUS), 56

AIDS Drug Assistance Program (ADAP), 169

AIDS Education Training Centers, established under the Ryan White CARE Act of 1990, 170

AIDS incidence

versus allocation of HIV prevention funds, 32

CDC-allocation of HIV prevention funds versus, 32

estimates of, 141

by state, 32

AIDS pandemic

global, 140

projecting, 15

AIDS Research Program Evaluation Working Group, 76-77

AIDS service organizations (ASOs), 68

improving organizational capacity of, 72-73

Alaskan Natives, HIV prevention programs for, 171

Alcohol use, 107n

Alliance for Microbicide Development, 85-86, 90

Alliances, for health departments, 193

Allocating resources for HIV prevention, 5-6, 26-49.

See also HIV prevention investments

versus AIDS incidence by state, 32

assessing the cost-effectiveness of, 32-35

calculations for, 175-177

at the community level, 39

current allocation of federal, 28-32

at the national level, 39-46

optimizing, 44-46

state and local, 3, 46-47

a strategic vision for, 37

using epidemic impact as a measure of success, 35-37

Alternative barrier methods, 83-86

the female condom, 83-84

microbicides, 84-86

“America Responds to AIDS” (ARTA), 158

American Academy of Pediatrics, 118

American Foundation for AIDS Research, 90

American Indians, HIV prevention programs for, 171

American Journal of Public Health, 173

Anal intercourse, male condom use during, 36

Annual infections prevented

cost-effectiveness versus proportional allocation, 43

impact of investing in better, more expensive programs, 45

percentage improvement, 44

Antimicrobial therapies, advances in, 7

Antiretroviral therapies, 86-87

advances in, 2, 7, 14

HIV-infected persons receiving, 51

nevirapine, 34, 156

optimizing patient adherence to, 53-54

Public Health Service Task Force recommendations for use of, 34

zidovudine, 34, 142, 156

ARTA. See “America Responds to AIDS”

ASOs. See AIDS service organizations

Assessing the cost-effectiveness of HIV prevention interventions, in allocating resources, 32-35

At-risk populations, 2, 12, 99-100

B

“Back calculations,” 148

Balanced Budget Act of 1997, 119

Barrier methods, alternative, 83-86

Barrier products, 171

Barriers to HIV care, 98-128

access to drug abuse treatment, 106-116

access to sterile drug injection equipment, 114-116

comprehensive sex education and condom availability in schools, 116-120

HIV prevention in correctional settings, 120-128

lack of leadership, 104-105

misperceptions, 103-104

poverty, racism, and gender inequality, 98-100

requests for public comment on, 189-190

the sexual “code of silence,” 100-101

stigma of HIV/AIDS, 101-103

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

Base scenario, at the national level of resource allocation, 42

Baseline rate of new infections, 33

Behavioral interventions to prevent HIV infection, 155-156

new infections, 153-155

Behavioral surveillance, 17

Bill and Melinda Gates Foundation, 90

Biomedical interventions, to prevent HIV infection, 156-157

Biomedical strategies, used in preventing new HIV infections, 153-155

Bleach, used for HIV disinfection, 125

Blood samples, procedures for taking, 20

Blood supply

in assessing the cost-effectiveness of HIV prevention interventions, 33-34

protecting, 33-34

Buprenorphine, 110

C

Capitation payments, 60

CAPS. See Center for AIDS Prevention Studies model

CARE Act. See Ryan White Comprehensive AIDS Resources Emergency Act of 1990

Case finding approach, 16-19

alternative to surveillance, 16

Case reporting, in tracking the HIV epidemic, 16-19

CBOs. See Community-based organizations

CDC. See Centers for Disease Control and Prevention

CDC Behavioral and Social Science Volunteer Project, 69, 72

Center for AIDS Prevention Studies, 193

Center for AIDS Prevention Studies (CAPS) model, 75-76

Center for Mental Health Services (CMHS), 167

Center for Substance Abuse Prevention (CSAP), 167

Center for Substance Abuse Treatment (CSAT), 167

Centers for AIDS Research (CFARs), 76

Centers for Disease Control and Prevention (CDC), 2, 11, 34

allocation of HIV prevention funds versus AIDS incidence by state, 32

intervention/program implementation, 164-165

leading role played in HIV prevention, 26, 47

policy, 165

position on HIV testing, 55

program evaluation, 165

publicly funded sites of, 55n

recommendations to, 59

research under, 68, 165

spending on HIV/AIDS, 164-165

studies by, 52-53

surveillance by, 15, 165

syphilis elimination plan, 62

technical assistance, 165, 186

Changes in Medicaid and Ryan White Care Act programs needed to encourage HIV prevention, 58-63

Changes in the epidemic, 139-151

AIDS trends in the United States, 139-148

demographics of, 142-146

HIV incidence and prevalence, 148-149

Changes needed to encourage HIV prevention, 58-63

encouraging HIV prevention in CARE Act programs, 61-63

financing options for Medicaid coverage, 58-61

Characteristics of Reputationally Strong Programs Project, 69

Children

health care settings utilized by, 56

programs for under the Ryan White CARE Act of 1990, 170

Clinical care for HIV-infected persons financing, 56-58

programs that provide, 55-58

Clinical settings, 50-67

changes in Medicaid and Ryan White Care Act programs needed to encourage HIV prevention, 58-63

DHHS-wide policies to encourage integration of prevention into clinical care, 63

programs that provide clinical care to HIV-infected persons, 55-58

using for prevention, 6, 51-55

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

Clinton Administration, 29

CMHS. See Center for Mental Health Services

Co-occurring conditions, 152

trends in the United States, 98, 147-148

Cocaine use, 107n

“Code of silence,” as a social barrier, 100-101

Commission on Health Research for Development, 90

Community and Migrant Health Center (CHCs) program, 57-58

Community-based organizations (CBOs), 68, 193

improving organizational capacity of, 72-73

Community Health Centers (CHCs)

HIV tests performed at, 55n

programs of, 57

Community-level resource allocation for HIV prevention, 39

Community Planning Groups (CPGs), 28, 29, 165, 191

Community Planning Leadership Summit, 180-185

Compendium of HIV Prevention Interventions with Evidence of Effectiveness, 69, 70, 152

Comprehensive sex education, in schools, 116-120

Condom availability, 157

in correctional facilities, 125-126

in schools, 116-120

Condom use

female, 83-84

male, 36

Confidentiality issues, 18-19.

See also Reporting issues

in testing, 29

Connecticut, drug paraphernalia laws in, 115

Consensus Panel on Interventions to Prevent HIV Risk Behaviors, 119

Consortium for Industrial Collaboration in Contraceptive Research, 90

Coordination of programs

lack of, 3, 188

requests for public comment on, 188-189

Correctional systems

condom availability in, 125-126

HIV/AIDS education, harm reduction, and discharge planning programs in U.S. adult, 122

HIV prevention in, 120-128

needle exchange programs in, 126

Cost-effectiveness of HIV prevention interventions, 32-35, 107n

assessing in the allocation of resources, 32-35

implementing needle exchange programs, 34-35

preventing perinatal transmission of HIV, 34

versus proportional allocation in preventing annual infections, 43

protecting the blood supply, 33-34

Costs of HIV interventions, 40-42, 174-175

Costs of HIV testing, 83

Costs of HIV treatment, 42

Counseling, 106

by race and ethnicity, 30

CPGs. See Community Planning Groups

CSAP. See Center for Substance Abuse Prevention

CSAT. See Center for Substance Abuse Treatment

Current allocation of federal HIV prevention funds, in allocating resources, 28-32

Current national AIDS surveillance system, 15

D

Data gathering activities, 180-193

Community Planning Leadership Summit, 180-185

problems with expanding, 186

requests for public comment, 185-190

site visits to state health departments, 190-193

Data needs, requests for public comment on, 185-186

Deaths, estimates of, 141

Demographics of the AIDS epidemic, 14, 142-146

cases in racial and ethnic minorities, 144-145

cases in women, 142-143

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

cases in youth, 143-144

geographic distribution, 145-146

Dental Reimbursement Program, established under the Ryan White CARE Act of 1990, 170

Department of Defense Health Care Systems, 56

Department of Health and Human Services (DHHS)

Agency for Health Care Quality and Research, 172

categorization of those needing treatment, 108

Centers for Disease Control and Prevention, 28, 164-165, 186

Food and Drug Administration, 170-171

Health Care Financing Administration, 171

Health Resources and Services Administration, 168-170, 182, 186

Indian Health Service, 171

National Institutes of Health, 28, 165-167, 182

need for strong leadership from, 4

policies to encourage integration of prevention into clinical care, 63

regulatory role of, 111

spending on HIV/AIDS, 28, 164-172, 182

Substance Abuse and Mental Health Administration, 28, 167-168

Department of Justice, 56

Department of Veterans Affairs Health Care System (VA), 56

Description and mathematical statement of the HIV prevention resource allocation model, 173-179

allocating resources for HIV prevention, 175-177

the costs of HIV prevention programs, 174-175

estimating aggregate HIV incidence, 173

estimating the efficacy and reach of HIV prevention programs, 174

Detecting HIV antibodies, rapid testing methods for, 80-83

DHHS. See Department of Health and Human Services

Diabetes, 190

Diagnosis time for AIDS cases, lag in, 4, 81n

Discharge planning in correctional settings, 121-123

for U.S. adults, 122

Disease progression, advances in antiretroviral therapies to prevent, 2, 7, 14

Disinfection, use of bleach for, 125

Domestic federal HIV/AIDS spending, fiscal year 1995-1999, 163

Drug abuse, link to spread of AIDS, 106

Drug abuse treatment

access to, 106-116

in correctional settings, 124-125

Drug control spending, federal, 111

Drug Enforcement Agency, regulatory role of, 111

Drug injection equipment, access to sterile, 114-116

Drug paraphernalia laws, in Connecticut, 115

Drug-resistant HIV, re-infection with, 52

E

Early and Periodic Screening, Diagnostic, and Treatment program, 58

Early intervention grants, under the Ryan White CARE Act of 1990, 170

Education

components of abstinence programs, 119n

in U.S. adult correctional systems, 122

Efficacy of HIV interventions, 40, 174-175

measured in quality adjusted life years, 38n

EIA test. See Enzyme-linked immunoassay test

Eligible Metropolitan Areas (EMAs), 169

Enzyme-linked immunoassay (EIA) test, 33, 81

Epidemic impact, allocation of resources as a measure of success, 35-37

Estimates

of aggregate HIV incidence, 173

of AIDS incidence, deaths, and prevalence in adults, 141

of efficacy and reach of HIV prevention programs, 174

Ethnic minorities, AIDS cases in, 144-145

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

Ethnicity

counseling, testing, referral, and partner notification by, 30

health education and risk reduction by, 30-31

proportion of AIDS cases by, 145

Evaluations

of Centers for Disease Control and Prevention programs, 165

of HIV prevention programs for workability, 192

Expenditures for HIV prevention. See Allocating resources for HIV prevention

Expensive programs, impact on preventing annual infections of investing in, 45

Exposure categories, 140-141

adult/adolescent AIDS cases by, 141

F

FDA. See Food and Drug Administration

Federal Bureau of Justice, studies by, 124

Federal drug control spending, 111

Federal HIV prevention funds, current allocation of, 28-32

Federal Regulation of Methadone, 111n

Federal spending on HIV/AIDS, 162-172

additional technical assistance needed in HIV prevention activities, 192

Agency for Health Care Quality and Research, 172

Centers for Disease Control and Prevention, 164-165

Department of Health and Human Services, 164-172

for fiscal year 1995-1999, domestic, 163

Food and Drug Administration, 170-171

Health Care Financing Administration, 171

Health Resources and Services Administration, 168-170

Indian Health Service, 171

National Institutes of Health, 165-167

overview of, 162-164

Substance Abuse and Mental Health Administration, 167-168

Fee-for-service, Medicaid coverage for, 59-60

Female condom use, 83-84

Financing options for Medicaid coverage, 58-61

Medicaid fee-for-service, 59-60

Medicaid managed care organizations, 60-61

Food and Drug Administration (FDA)

recommendations concerning tests, 34, 81-82

regulatory role of, 110-111, 170

spending on HIV/AIDS, 170-171

Funding HIV prevention. See Allocating resources for HIV prevention

G

GAO. See U.S. General Accounting Office

Gates Foundation, 90

Gender inequality, as a social barrier, 98-100

Geographic distribution, of AIDS cases, 145-146

Global HIV/AIDS pandemic, 140

Grants.

under the Ryan White CARE Act of 1990, 169-170

under the Substance Abuse and Mental Health Administration, 167-168

H

Hampden County Correctional Center (in Massachusetts), HIV prevention in, 123

Harm reduction programs, in correctional settings, 122, 125-128

HCFA. See Health Care Financing Administration

HCSUS. See HIV Cost and Services Utilization Study

Health Care Financing Administration (HCFA), 57, 171

Medicaid services under, 59, 171

Medicare services under, 171

recommendations to, 59

spending on HIV/AIDS, 59n, 171

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

Health departments, potential new partnerships or alliances for, 193

Health education, by race and ethnicity, 31

Health professionals’ training, integrating HIV prevention early in, 54

Health Resources and Services Administration (HRSA), 28, 77, 168-170, 182

Ryan White Comprehensive AIDS Resources Emergency Act of 1990, 168-170

spending on HIV/AIDS, 168-170, 186

studies by, 52-53

Heart disease, 190

Hewlett Foundation, 90

The Hidden Epidemic, recommendations from, 101

Hierarchical surveillance, 141n

Hispanics

Medicaid services provided to, 57

rates of AIDS infection among, 143-145

HIV/AIDS High Risk Behavior Prevention/ Intervention Model for Youth Adult/Adolescent and Women Program, 168

HIV antibodies, rapid testing methods for detecting, 80-83

HIV case reporting, in tracking the epidemic, 16-19

HIV Cost and Services Utilization Study (HCSUS), 56

HIV Cost Study, 168

HIV disinfection, use of bleach for, 125

HIV education, harm reduction, and discharge planning programs, in U.S. adult correctional systems, 122

HIV incidence estimation

changes in, 148-149

population-based, in tracking the epidemic, 19-23

HIV-infected persons

categorization of by DHHS, 108

complacency among, 1

extending prevention efforts to, 50

programs that provide clinical care to, 55-58

receiving antiretroviral therapy, 51

HIV infections, allocating resources for prevention of new, 5-6, 11

HIV interventions, cost, reach, and efficacy of, 40

HIV outreach grants, under the Substance Abuse and Mental Health Administration, 168

HIV pandemic, global, 140

HIV prevalence, changes in, 148-149

HIV prevention

changes needed to encourage, 58-63

defining, 27n

encouraging in CARE Act programs, 61-63

estimating the efficacy and reach of, 174

integrating early in health professionals’ training, 54

leading role played by the Centers for Disease Control and Prevention in, 26

programs for Native Americans, 171

resource allocation for, 38-46

rethinking, 11-13

unrealized opportunities for improving, 193

HIV Prevention Community Planning Process, 76

HIV Prevention Evaluation initiative, 75n

HIV prevention funds, CDC allocation of, versus AIDS incidence by state, 32

HIV prevention in correctional settings, 120-128

discharge planning, 121, 123

drug abuse treatment, 124-125

harm reduction programs, 125-128

HIV prevention education, 123

HIV Prevention Initiative for Youth and Women of Color, 168

HIV prevention investments, 33

development of new tools and technologies for, 7-8

strategic vision in allocating resources, 26, 37

HIV prevention research dissemination, examples of, 70-71

HIV Prevention Science Initiative, 166

HIV prevention strategies

description and mathematical statement of resource allocation model for, 173-179

examples of research dissemination, 70-71

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

prioritizing and selecting for implementation, 191

HIV risk assessments, guides for conducting, 54

HIV status

emphasis on people learning, 81

outreach to those of unknown, 61

HIV surveillance approaches, comparison of, 22

Homicide, 190

HRSA. See Health Resources and Services Administration

Human immunodeficiency virus. See HIV

I

IDUs. See Injection drug users

Immunofluorescence assay, 81n

Impact of investing in better, more expensive programs, on preventing annual infections, 45

Implementation

of Centers for Disease Control and Prevention programs, 164-165

of HIV prevention programs, 192-193

of needle exchange programs, 34-35

removing obstacles to, 13

requests for public comment on, 188-189

Improving HIV prevention, unrealized opportunities for, 193

Incidence estimation, 141

changes in HIV, 4, 148-149

declines in, 14

population-based, in tracking the HIV epidemic, 19-23

Indian Health Service, spending on HIV/ AIDS, 171

Infants, programs for under the Ryan White CARE Act of 1990, 170

Infected persons

complacency among, 1

extending prevention efforts to, 50-51

programs that provide clinical care to, 55-58

Infections. See HIV infections;

New HIV infections;

Re-infection

Injection drug users (IDUs), 34.

See also Sterile drug injection equipment

programs targeting, 46n, 102, 189

providers caring for, 51

Institute of Medicine (IOM), 2, 111-112

defining drug addiction, 112-113n

International AIDS Vaccine Initiative, 90

“Interventions in a box,” 73

Interventions to prevent HIV infection, 152-161.

See also Early intervention grants

behavioral interventions, 155-156

biomedical and technological interventions, 156-157

in Centers for Disease Control and Prevention programs, 164-165

interventions associated with the treatment of co-occurring conditions, 156

societal interventions, 157-158

used in preventing new HIV infections, 153-155

Investment-based approach. See HIV prevention investments

K

Knowledge Development and Application (KDA) programs, under the Substance Abuse and Mental Health Administration, 168

L

LAAM. See Levo-alpha-acetylmethadol (LAAM)

Leadership, 185

lack of as a social barrier, 3-4, 104-105

Levo-alpha-acetylmethadol (LAAM), 110n

Lifesaving Vaccine Technology Act of 1999, 91

Local resource allocation, support for, 46-47

M

Mail Order Drug Paraphernalia Act, 115

Male condom use, 36

Managed care organizations (MCOs), Medicaid coverage for, 59-61

Maryland, coded system of HIV case reporting, 19

Massachusetts, coded system of HIV case reporting, 19

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

Massachusetts correctional system, HIV prevention in, 123

Mathematical statement, of the HIV prevention resource allocation model, 41, 173-179

Measurement techniques, changes in, 20

Medicaid services

Early and Periodic Screening, Diagnostic, and Treatment program, 58

fee-for-service, 59-60

financing options for coverage, 58-61

managed care organizations, 59-61

provided to African Americans and Hispanics, 57

provided under the Health Care Financing Administration, 171

Medical Research Council, 89

Medicare services, provided under the Health Care Financing Administration, 171

Men who have sex with men (MSM), 140, 183

Mental illness, link to spread of AIDS, 147, 152

Methadone, regulation of, 110-111

Metropolitan areas, grants to under the Ryan White CARE Act of 1990, 169

Microbicides, 84-86

advances in, 7

workings of, 84-85

Military health care options. See Department of Defense Health Care Systems

Misperceptions, as a social barrier, 103-104

Modeling, statistical, 19

Modes of transmission. See Transmission

Monitoring HIV prevention programs, additional information needed for, 192

Moriah Fund, 90

MSM. See Men who have sex with men

N

N-9. See Nonoxynol-9

Naltrexone, 110

NAT test. See Nucleic Acid Amplification Technology test

National AIDS Control Programme (in Uganda), 105

National AIDS surveillance system, in tracking the epidemic, 15

National Cancer Institute, 165, 167

National Center for Research Resources, 165

National Health Interview Survey, 20

National Heart, Lung and Blood Institute, 165

National Institute for Drug Abuse, 165

National Institute of Allergy and Infectious Diseases, 165, 167

National Institute of Child Health and Human Development, 165

National Institute of Justice, studies by, 125

National Institute of Mental Health (NIMH), 75, 165

National Institutes of Health (NIH), 28, 165-167, 182

Consensus Panel on Interventions to Prevent HIV Risk Behaviors, 119, 152

nonvaccine prevention research under, 166-167

spending on HIV/AIDS, 165-167

vaccine research under, 68, 167

National level resource allocation for HIV prevention, 39-46

base scenario, 42

optimistic scenario, 42

pessimistic scenario, 42

National Research Council (NRC), 20, 34

Native Americans, HIV prevention programs for, 171

Needle exchange programs

in assessing the cost-effectiveness of HIV prevention interventions, 34-35

in correctional facilities, 126

implementing, 34-35

programs targeting, 46

Nevirapine, 34, 156

New HIV infections

baseline rate of, 33

developing an accurate surveillance system for, 4-5

populations growing in, 2

NIH. See National Institutes of Health

NIMH. See National Institute of Mental Health

Nonoxynol-9 (N-9), 85

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

Nonvaccine prevention research, under the National Institutes of Health, 166-167

Nucleic Acid Amplification Technology (NAT) test, 34

O

OAR. See Office of AIDS Research

Office of AIDS Research Advisory Council, AIDS Research Program Evaluation Working Group, 76-77

Office of AIDS Research (OAR), 165

Office of National Drug Control Policy, 107

Opportunistic infections, tuberculosis, 52

Opportunities

requests for public comment on, 189-190

unrealized, for overcoming social barriers, 106-128

Optimistic scenario, at the national level of resource allocation, 42

Outreach to those of unknown HIV status, CARE Act Title III support for, 61

Overcoming social barriers, 97-135

social barriers described, 98-105

unrealized opportunities for, 106-128

P

PACHA. See Presidential Advisory Council on HIV/AIDS

Partner notification, by race and ethnicity, 30

“Partnership for Health” studies, 53

Partnerships for health departments, 75, 193

Patients. See HIV-infected persons

“Payer of last resort,” CARE Act programs as, 57, 169

Pediatric HIV surveillance, 18

Percentage improvement, in preventing annual infections, 44

Perinatal transmission

in acquired AIDS cases, 141-142

assessing the cost-effectiveness of HIV prevention interventions, 34

preventing, 7

Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), 119

Pessimistic scenario, at the national level of resource allocation, 42

“Physician Delivered Intervention for HIV+ Individuals,” 53

Planning effective HIV prevention programs

additional information needed for, 192

barriers encountered, 193

Policy issues

in Centers for Disease Control and Prevention programs, 165

explicit goals of, 11-12

Population-based HIV incidence estimation, in tracking the epidemic, 19-23

Poverty, as a social barrier, 98-100

Presidential Advisory Council on HIV/ AIDS (PACHA), 69, 74

Prevalence

in adults, estimates of, 141

changes in HIV, 148-149

Prevention, 6, 51-55

effectiveness of, 11

“missing link” in, 187

of new HIV infections, 5-6, 153-155

of perinatal transmission of HIV, 34

Prevention budgets, 38-39

Prevention education, in correctional settings, 123

Prevention Marketing Initiative, 158

Prevention portfolio, 152-161

behavioral interventions, 155-156

biomedical and technological interventions, 156-157

interventions associated with the treatment of co-occurring conditions, 156

societal interventions, 157-158

Prevention research, requests for public comment on translating into practice, 187

Prevention Research Synthesis (PRS) project, 69

Prevention Science Working Group, 166

Prevention technology transfer

current efforts in, 68-72

opportunities for improving, 74-77

Prioritizing, HIV prevention strategies for implementation, 191

Privacy issues, 18-19

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

Program evaluation, requests for public comment on, 187-188

Proportion of AIDS cases, by race and ethnicity, 145

Proportionality

in allocation, versus cost-effectiveness, 5, 31-32

in preventing annual infections, 43

Protecting the blood supply, 33-34

Providers

caring for AIDS cases, 56

caring for injection drug users (IDUs), 51

PRWORA. See Personal Responsibility and Work Opportunity Reconciliation Act

Psychotherapy, 106

Public comment, requests for, 185-190

“Public health” responses to AIDS, 22

Public Health Service Act, Title XX, 119

Public Health Service Task Force, recommendations for use of antiretroviral drugs, 34

Publicly funded sites, of the Centers for Disease Control and Prevention, 55n

Q

Quality adjusted life years (QALYs), measure of effectiveness, 38n

R

Race

counseling, testing, referral, and partner notification by, 30

health education and risk reduction by, 30-31

proportion of AIDS cases by, 145

Racial minorities, AIDS cases in, 144-145

Racism, as a social barrier, 98-100

Rapid testing methods, for detecting HIV antibodies, 80-83

Rates of AIDS cases, per 100,000 population, 146

Rationale for a national system of HIV surveillance, in tracking the epidemic, 16

Re-infection, with drug-resistant HIV, 52

Reach of HIV intervention programs, 40, 174-175

Receptive anal intercourse, male condom use during, 36

Recommendations

for allocating prevention resources, 5-6, 37

for a CDC-created, population-based surveillance system, 4-5

to the Centers for Disease Control and Prevention, 59

for collaboration among federal agencies, 114

for congressional policy making, 120

for creating a surveillance system, 17-18, 22

general, 191-193

to the Health Care Financing Administration, 59

from The Hidden Epidemic, 101

for HIV prevention in correctional facilities, 126-127

for investing in local-level research and interventions, 6-7, 77

for investing in products and technologies linked to HIV prevention, 7-8, 91

for legalizing injection equipment, 116

for overcoming social barriers to HIV prevention, 8

for providing prevention services as standard for all HIV-infected persons, 6, 63

of Public Health Service Task Force for use of antiretroviral drugs, 34

Referrals, by race and ethnicity, 30

1990 Report of the Commission on Health Research for Development, 90

Reporting issues, 148

Requests for public comment, 185-190

on coordination and implementation of programs, 188-189

on data needs, 185-186

on opportunities and barriers, 189-190

on program evaluation, 187-188

on technical assistance, 186

on translation of prevention research into practice, 187

Research

barriers to effective technology transfer at the community level, 72-74

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

in Centers for Disease Control and Prevention programs, 165

current efforts in prevention technology transfer, 68-72

under the National Institutes of Health, 166-167

opportunities for improving prevention technology transfer, 74-77

translating into action, 6-7, 68-79

Research dissemination, examples of HIV prevention, 70-71

Resource allocation for HIV prevention, 38-46.

See also Allocating resources for HIV prevention

Risk assessments, guides for conducting, 54

Risk reduction, by race and ethnicity, 31

Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990, 29, 57, 168-170

AIDS Education Training Centers, 170

Dental Reimbursement Program, 170

early intervention grants, 170

encouraging HIV prevention in programs of, 61-63

grants to eligible metropolitan areas, 169

grants to states and territories, 169

as “payer of last resort,” 57, 169

Special Projects of National Significance, 123, 170

Title III support for outreach to those of unknown HIV status, 61

women, infants, children, and youth, 170

S

SAMHSA. See Substance Abuse and Mental Health Administration

SAPT. See Substance Abuse Prevention and Treatment block grants

Scenarios, at the national level of resource allocation, 42

Schools, comprehensive sex education and condom availability in, 116-120

Secondary infections, 52

Senegal, HIV incidence in, 105

Sentinel surveillance, 19-22

Serosurveys, 20

Sexual “code of silence,” as a social barrier, 100-101

Sexually transmitted diseases (STDs). See AIDS;

HIV

Shalala, DHHS Secretary Donna E., 115

Single Use Diagnostic System (SUDS) test, 81-82

Site visits to state health departments, 190-193

additional information needed for planning, implementing, or monitoring HIV prevention programs, 192

additional technical assistance needed from the federal government to support HIV prevention activities, 192

barriers encountered to planning or implementing effective HIV prevention programs, 193

evaluating HIV prevention programs for workability, 192

potential new partnerships or alliances health departments should pursue, 193

prioritizing and selecting HIV prevention strategies for implementation, 191

unrealized opportunities for improving HIV prevention, 193

Social barriers, 3, 12, 98-128

access to drug abuse treatment, 106-116

access to sterile drug injection equipment, 114-116

comprehensive sex education and condom availability in schools, 116-120

HIV prevention in correctional settings, 120-128

lack of leadership, 104-105

misperceptions, 103-104

poverty, racism, and gender inequality, 98-100

the sexual “code of silence,” 100-101

stigma of HIV/AIDS, 101-103

Social Security Disability Insurance (SSDI), 109

Societal interventions, to prevent HIV infection, 157-158

Special Projects of National Significance, established under the Ryan White CARE Act of 1990, 123, 170

Spermicides, 85

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

SSDI. See Social Security Disability Insurance

SSI. See Supplemental Security Income

Standard Metropolitan Statistical Areas, 41, 173

State health departments, 58-59, 190-193

additional information needed by for planning, implementing, or monitoring HIV prevention programs, 192

additional technical assistance needed by from the federal government to support HIV prevention activities, 192

barriers encountered by to planning or implementing effective HIV prevention programs, 193

evaluations of HIV prevention programs for workability by, 192

potential new partnerships or alliances for, 193

prioritizing and selecting HIV prevention strategies for implementation by, 191

unrealized opportunities for improving HIV prevention by, 193

State resource allocation, support for, 46-47

States and territories, grants to under the Ryan White CARE Act of 1990, 169

“The States of the HIV/AIDS Epidemic,” 139n

Statewide Community HIV Evaluation Project, 75n

Statistical modeling, 19

STDs. See AIDS;

HIV

Sterile drug injection equipment

access to, 114-116

policy recommendations concerning, 13

Stigma of HIV/AIDS, as a social barrier, 3, 97, 101-103

Strategic vision for HIV prevention investments

in allocating resources, 37

elements of, 4

Stroke, 190

Substance Abuse and Mental Health Administration (SAMHSA), 28, 77, 108n, 167-168

Knowledge Development and Application programs under, 168

SAPT block grant-funded early intervention services (HIV set-asides) under, 167-168

SAPT block grants under, 167

spending on HIV/AIDS, 167-168

studies by, 110

Targeted Capacity Expansion and HIV outreach grants under, 168

Substance Abuse Prevention and Treatment (SAPT) block grants, 28, 58

funding of early intervention services (HIV set-asides), 167-168

under the Substance Abuse and Mental Health Administration, 167

SUDS. See Single Use Diagnostic System test

Supplemental Security Income (SSI), 109

Support for HIV prevention. See Allocating resources for HIV prevention;

HIV prevention investments

Surveillance approaches

alternative to case finding, 16

behavioral, 17

in Centers for Disease Control and Prevention programs, 165

comparison of HIV, 22

developing an accurate, for new HIV infections, 4-5

hierarchical, 141n

sentinel, 19

in tracking the national AIDS epidemic, 14-15

Survey of Childbearing Women, 20, 29

Syphilis elimination plan, 62

T

Targeted Capacity Expansion (TCE), under the Substance Abuse and Mental Health Administration, 168

Technical assistance

in Centers for Disease Control and Prevention programs, 165, 186

requests for public comment on, 186

Technological interventions, to prevent HIV infection, 156-157

Technologies, for developing HIV prevention investments, 7-8

Technology transfer

barriers at the community level to effective, 72-74

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

current efforts in prevention, 68-72

opportunities for improving prevention, 74-77

Territories. See States and territories

Testing

confidential, 22-23

by race and ethnicity, 30

Therapies, antiretroviral, 86-87

Time lapse, in diagnosis time for AIDS cases, 4, 81n

Tools, 80-89

alternative barrier methods, 83-86

antiretroviral therapies, 86-87

for developing HIV prevention investments, 7-8

promising new collaborations for, 89-91

promising new tools, 80-89

rapid testing methods for detecting HIV antibodies, 80-83

searching for new, 80-96

vaccines, 87-89

Tracking the epidemic, 14-25

HIV case reporting, 16-19

national AIDS surveillance system, 15

population-based HIV incidence estimation, 19-23

rationale for a national system of HIV surveillance, 16

Training, integrating HIV prevention early in health professionals’, 54

Transfusion-related infections, 35

Translating research into action, 6-7, 68-79

barriers to effective technology transfer at the community level, 72-74

current efforts in prevention technology transfer, 68-72

opportunities for improving prevention technology transfer, 74-77

Translation of prevention research into practice, requests for public comment on, 187

Transmission

modes of, 140-142

trends in, 140-142

Treatment of co-occurring conditions, interventions to prevent HIV infection, 156

Trends in the United States, 139-148

AIDS and co-occurring conditions, 147-148

changing demographic face of the epidemic, 142-146

modes of transmission, 140-142

Tuberculosis, 52, 147-148

U

Uganda, National AIDS Control Programme in, 105

United States

adult correctional systems in, 122

Standard Metropolitan Statistical Areas in, 41

trends in, 139-148

U.S. General Accounting Office (GAO), 34

U.S. Preventive Services Task Force Guide to Clinical Preventive Services, 51

V

VA. See Department of Veterans Affairs Health Care System

Vaccine research

under the National Institutes of Health, 167

return on investment issue, 88

Vaccine Research Center, 167

Vaccines, 87-89

advances in, 7

W

Western Blot test, 81n, 82

WHO Ad Hoc Committee on Health Research, 90

William and Flora Hewlett Foundation, 90

Women

AIDS cases in, 142-143

funding programs aimed at, 46, 189

health care settings utilized by, 56

programs for under the Ryan White CARE Act of 1990, 170

1999 Work Group Report on HIV Prevention Activities, 74

Workability, evaluating HIV prevention programs for, 192

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×

World Bank, 90

Y

Youth

AIDS cases in, 143-144

health care settings utilized by, 56

programs for under the Ryan White CARE Act of 1990, 170

Z

Zidovudine (ZDV), 34, 142, 156

Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 213
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 214
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 215
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 216
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 217
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 218
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 219
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 220
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 221
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 222
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 223
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 224
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 225
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 226
Suggested Citation:"Index." Institute of Medicine. 2001. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The National Academies Press. doi: 10.17226/9964.
×
Page 227
No Time to Lose: Getting More from HIV Prevention Get This Book
×
 No Time to Lose: Getting More from HIV Prevention
Buy Hardback | $54.00 Buy Ebook | $43.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

The United States has spent two productive decades implementing a variety of prevention programs. While these efforts have slowed the rate of infection, challenges remain. The United States must refocus its efforts to contain the spread of HIV and AIDS in a way that would prevent as many new HIV infections as possible. No Time to Lose presents the Institute of Medicine's framework for a national prevention strategy.

READ FREE ONLINE

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!