American journal of preventive medicine
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Although HIV pre-exposure prophylaxis can decrease new cases of HIV by up to 99%, many patients who could benefit from pre-exposure prophylaxis never receive prescriptions for it. Because pre-exposure prophylaxis is indicated for patients who do not have an infectious disease, increasing pre-exposure prophylaxis prescribing by primary care and generalist clinicians represents a key element of the Ending the HIV Epidemic in the U. S. initiative. ⋯ In the setting of the COVID-19 pandemic, interest in virtual delivery of academic detailing has grown, which could inform efforts to implement academic detailing in rural communities and other underserved areas. Increasing this capacity could make an important contribution to Ending the HIV Epidemic in the U. S. and other HIV prevention efforts.
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Equitable access to HIV pre- and postexposure prophylaxis for women is essential to ending the HIV epidemic. Providers' lack of knowledge and comfort in discussing and prescribing pre-exposure prophylaxis to women persist as barriers. ⋯ After public health detailing, women's healthcare providers report increased adoption of recommended practices that promote pre- and postexposure prophylaxis uptake and sexual wellness among women. Detailing may be adaptable to other regions and contexts to reach providers.
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The proportion of individuals infected with hepatitis C virus that receive direct-acting antiviral treatment is unclear. ⋯ Hepatitis C virus treatment gaps were identified using administrative claims data among patients with commercial and Medicaid insurance.
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Formal volunteering in later life is beneficial for both physical and psychological well-being. However, research points to potential selection bias because older adults with key advantages, such as wealth, are more likely to volunteer and reap its benefits. Accordingly, this study addresses this selection bias by considering the characteristics of volunteers and nonvolunteers using the inverse probability of treatment weighting. It also examines whether volunteering has differential impacts between the highest and lowest wealth quintiles using inverse probability of treatment weighting. ⋯ The study enhances the understanding of formal volunteering and health while suggesting that volunteers with low wealth may benefit more from volunteering in terms of their health. Hindrances to volunteering among the least wealthy, such as financial distress, discrimination, or lack of organizational support, may attenuate the benefits of voluntary activity.
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Interventions that increase physical activity behavior can reduce morbidity and prolong life, but long-term effects in large populations are unproven. This study investigates the association of medical fitness facility membership and frequency of attendance with all-cause mortality and rate of hospitalization. ⋯ Membership at a medical fitness facility was associated with a reduced risk of all-cause mortality and hospitalizations. Healthcare systems should consider the medical fitness model as a preventative public health strategy to encourage physical activity participation.