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Targeting AIDS Prevention and Treatment Toward HIV-1—Infected PersonsThe Concept of Early Intervention
Donald P. Francis, MD, DSc;
Robert E. Anderson, MD;
Michael E. Gorman, PhD, MPH;
Martin Fenstersheib, MD;
Nancy S. Padian, PhD;
Kenneth W. Kizer, MD, MPH;
Marcus A. Conant, MD
JAMA. 1989;262(18):2572-2576.
Abstract
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We propose establishing private and public outpatient facilities where persons with human immunodeficiency virus, type 1 (HIV-1), infection can receive state-of-the-art clinical and behavioral follow-up, treatment, and assistance. The possible advantages of enrolling HIV-1—positive persons into long-term follow-up are early treatment of clinical conditions and resulting gains in life quality and life expectancy, decreased transmission of HIV-1 to uninfected persons, more efficient use of scarce patient-care resources, and improved estimates of the total number of HIV-infected persons. The possible disadvantages of such a program are adverse psychological reactions to knowledge of HIV-1 infection, adverse societal actions against infected persons, and, finally, the economic cost of the program. These facilities, with the proper expertise and safeguards of confidentiality and trust, could prolong and improve the lives of infected persons while preventing infection of others.
(JAMA. 1989;262:2572-2576)
Author Affiliations
From the Center for Prevention Services, Centers for Disease Control, Atlanta, Ga (assigned to the California Department of Health Services, Berkeley) (Dr Francis); the California Department of Health Services, Sacramento (Drs Francis, Anderson, and Kizer); the RAND Corporation, Santa Monica, Calif (Dr Gorman); the Santa Clara County Health Department, San Jose, Calif (Dr Fenstersheib); and the University of California—San Francisco (Drs Padian and Conant). Dr Anderson is now with ViRx Inc, San Francisco, Calif.
Footnotes
Reprint requests to Room 715, 2151 Berkeley Way, Berkeley, CA 94704 (Dr Francis).
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