1. Integrated prevention services offer providers and programs the opportunity to address multiple infectious diseases and related health conditions at one time or at a single facility, thereby increasing the likelihood that clients will receive needed services.
A. True B. False2. Persons who use drugs illicitly are defined as those who use prescription drugs that are not prescribed to them or those who use illicit drugs such as opiates, stimulants, or other so-called 'club drugs'.
A. True B. False3. According to the authors, the risk for acquiring and transmitting infectious disease in a population is generally a reflection of each of the following EXCEPT:
A. The prevalence of a given infection in the population B. The efficiency of transmission of the organism C. The burden of infectious diseases and patterns of the risk behaviors in which that population engages D. The likelihood of re-infection within a population4. Program collaboration is a mutually beneficial and well defined relationship entered into by two or more programs, organizations, or organizational units to:
A. Achieve common goals B. Maximize the efficient use of resources C. Enhance health-care supports D. Incorporate multiple strategies5. Increasing demands for compliance with the Health Insurance Portability and Accountability Act (HIPAA) regulations have made electronic and portable health records consistently available, which will likely enhance the integration and delivery of health-care services for at-risk populations.
A. True B. False6. Persons who inject drugs illicitly are at high risk for mortality and comorbidities and:
A. Over 50% of them use more than one drug illicitly through means other than injection B. They tend to drink alcohol in excess and tend to smoke tobacco C. They are generally in settings where medical help is not available or accessible in a timely manner if they overdose D. All of the above7. Among persons who are at risk for infectious diseases, men who have sex with men (MSM) are affected disproportionately by HIV, and according to the CDC, the rate of new HIV diagnoses among MSM is between 24 and 56 times that among other men, and between 30 and 67 times that among women.
A. True B. False8. Research indicates that prevention efforts aimed at reducing drug injection risk can be successful, and in recent years, a convergence in HIV prevalence and incidence among those who engage illicitly in injection or non-injection drug use suggests that a decrease has occurred in HIV transmission.
A. True B. False9. Co-occurring infections increase the likelihood of infection transmission and progression of infectious diseases, which is known as endemic toxicity.
A. True B. False10. Which of the following is NOT one of the goals of Screening, Brief Intervention, Referral, and Treatment (SBIRT) approaches in primary care settings to identify problematic use of drugs and to reduce substance abuse?
A. Encourage health-care providers to screen and provide brief advice or counseling to their patients who misuse alcohol or abuse other drugs so as to reduce hazardous use of substances B. Promote the use of effective medications in conjunction with science-based behavioral treatments C. Reduce vulnerability to the negative consequences of substance use D. Improve linkages between general community health care and specialized substance abuse providers to facilitate access to care when needed11. Community-based outreach, in which peer educators or other persons have established trust and rapport with persons who use drugs illicitly, can be particularly useful in reaching and assisting those who are not ready to enter substance abuse treatment or to be involved in other interventions.
A. True B. False12. While Hepatitis A vaccination is recommended for all adults in STD clinics, HIV testing and treatment facilities, substance abuse treatment settings, and correctional facilities, Hepatitis B vaccination is recommended for all persons who use drugs illicitly.
A. True B. False13. Sexual transmission of HIV among persons who use drugs illicitly is associated with several factors, including recent initiation of illicit drug injection, exchange of sex for money or for illicit drugs, and:
A. A lack of self-care strategies such as the use of sterile syringes or drug-preparation equipment B. Failure to seek testing and prevention services C. A history of other STDs D. Poor access to community-based educational interventions14. For all sexually active adolescents and for adults at increased risk for STDs and HIV infection, targeted testing programs and brief intervention strategies are recommended.
A. True B. False15. All pregnant women should be screened for HIV infection, syphilis, chlamydia, and gonorrhea at the first prenatal visit, and pregnant women who use drugs illicitly should be considered for tuberculosis screening.
A. True B. False16. One of the benefits of substance abuse treatment is that it can serve as an entry point to medical care, and can improve adherence to medical treatment regimens for infectious diseases.
A. True B. False17. Medication-assisted therapy with methadone or buprenorphine is highly effective for opioid addiction and has shown to have each of the following effects EXCEPT:
A. It reduces the frequency of heroin injection B. It increases rates of retention in substance abuse treatment programs C. It markedly decreases criminal activity D. It enhances productivity and improves overall lifestyle factors18. One approach to referral and linkage to care is the ________________________approach, which calls on clients to identify internal abilities and to develop a personal plan that includes meeting with case managers to acquire necessary resources.
A. Strengths-based case management B. Needs assessment and follow-through C. Competence-driven contingency D. Individual evaluation and maintenance19. Although persons who use drugs illicitly need to receive appropriate treatment for infectious diseases, most do not have the capability of adhering actively to complex medical regimens, and generally those who use drugs illicitly and are HIV-positive are not likely to cooperate with HIV treatment.
A. True B. False20. Among persons who use drugs illicitly and who have active TB, use of incentives and enablers to encourage clinic visits has been associated with improved treatment adherence, better doctor-patient relationships, and better delivery of TB treatment in substance abuse treatment programs.
A. True B. False21. Which of the following is NOT one of the factors that influences decisions about the comprehensive interventions to be offered in a particular program or community?
A. The local epidemiology of infectious diseases and substance use and mental disorders B. The spectrum of already existing services C. The presence of science-based public health strategies that have been implemented successfully D. The patterns of illicit drug use22. An important service in TB clinical treatment settings is case management for housing and for prevention and treatment of drug use, alcohol misuse, and mental health disorders.
A. True B. False23. Contextual factors differentially influence the exposure of majority and minority racial and ethnic groups to risky environments, ___________________, and access to prevention and treatment services.
A. Risk-reduction interventions B. Increased psychosocial problems C. Social marginalization D. Negative community perceptions24. Persons who use drugs illicitly have reported avoiding screening or counseling and testing because they perceive health-care providers to be uncaring, indifferent, or unfamiliar with treating patients with substance use disorders.
A. True B. False25. Programmatic considerations for providers of public health programs aimed at reducing infectious diseases in persons who use drugs illicitly include:
A. Ensuring that staff develop a professional relationship that shows mutual respect and avoids blame or judgment B. Providing recommended science-based comprehensive services C. Including persons who use drugs illicitly in decisions about their treatment D. Recognizing that success in building relationships and healthful behaviors might require several attempts26. Although maximizing opportunities for providing comprehensive services might be ideal, service integration may not be achievable in every setting because it is dependent on local needs and because of funding, organizational, or policy constraints.
A. True B. False27. An integrated service delivery plan should describe how services have been provided in the past and whether or not this was successful, and supply evidence as to how an integrated approach would be an improvement over a single infection-or disease-specific approach.
A. True B. False28. Whether prevention services are provided in a single or in a coordinated fashion between multiple locations or services, providers might need training in the screening, diagnosis, treatment, and prevention of other related infectious diseases, along with training on:
A. How to help clients set realistic healthful behavior goals B. The importance of teaching risk reduction measures C. Educating persons about health care and how to advocate for their own wellness D. Issues related to co-infection29. When calculating the costs and benefits of integrated service programs, a health care-system perspective cost-effectiveness analysis includes all costs and benefits associated with a program.
A. True B. False30. The integration of prevention services for persons who use drugs illicitly must make epidemiologic and programmatic sense, and it should be contextually appropriate and consistent with state and local laws and policies.
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