Journal of general internal medicine
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HIV outbreaks among people who inject drugs (PWID) and experience homelessness are increasing across the USA. Despite high levels of need, multilevel barriers to accessing antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention persist for this population. The Boston Health Care for the Homeless Program (BHCHP) initiated a low-threshold, outreach-based program to support engagement in PrEP services among PWID experiencing homelessness. ⋯ Findings suggest that more patient-centered services formed the basis of BHCHP's innovative, successful PrEP program. While contextual challenges including competing public health emergencies and homeless encampment "sweeps" necessitate ongoing programmatic adaptations, lessons from BHCHP's PrEP program can inform PrEP delivery in a range of community-based settings serving this population, including syringe service programs and shelters.
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Bessie Anaya, a patient at La Clínica del Pueblo in Washington, D. C. contributes the following patient perspective on diabetes care. The interview in Spanish has been condensed and edited from two conversations with Angela Suarez and Rodrigo Stein, staff at La Clínica del Pueblo. An English translation of the interview follows.
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Observational Study
Diversity of Participation in Clinical Trials and Influencing Factors: Findings from the Health Information National Trends Survey 2020.
Clinical trial diversity is critical to advance health and health equity. Research addressing the discrepancy between goals of achieving clinical trial diversity and realities of study enrollment remains underdeveloped. ⋯ While personal healthcare providers were trusted sources of information, racial/ethnic minority populations noted lower odds of clinical trial participation influence from providers and family. Thus, it is imperative for the healthcare, government, and industry organizations to build trust in medicine and science.
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Many states have adopted laws that limit the amount or duration of opioid prescriptions. These limits often focus on prescriptions for acute pain, but there may be unintended consequences for those diagnosed with chronic pain, including reduced opioid prescribing without substitution of appropriate non-opioid treatments. ⋯ These findings do not support an association between state opioid prescribing cap laws and changes in the treatment of chronic non-cancer pain.