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Continuum of HIV care

M Reuel Friedman, Jordan M Sang, Leigh A Bukowski, Derrick D Matthews, Lisa A Eaton, H Fisher Raymond, Ron Stall
INTRODUCTION: Differences across the HIV care continuum between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO) are emerging in recent literature but have not been comprehensively documented among Black MSM. Although MSMW have lower HIV prevalence than MSMO, they are more likely to be HIV-positive unaware and be virally unsuppressed. Explanatory factors for these differences have not previously been assessed. METHODS: Between 2014-2016, we surveyed sexually active Black MSM ≥18 years old at Black Gay Pride events in six U...
January 15, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Howard J Cabral, Kendra Davis-Plourde, Mariana Sarango, Jane Fox, Joseph Palmisano, Serena Rajabiun
Racial/ethnic minorities living with HIV and behavioral health co-morbidities are more likely to be disengaged from HIV primary care. Peer programs have been effective in HIV outreach and prevention but effectiveness of such programs for retention in care and viral suppression is understudied. Subjects (n = 348) were randomized in equal allocation to a peer navigation and education intervention versus standard clinical care at three urban clinics in the United States. The intervention group received seven structured interventions plus weekly contact to address medical and social needs...
January 6, 2018: AIDS and Behavior
Jennifer M Stewart, Hyejeong Hong, Terrinieka W Powell
Providing comprehensive services across the HIV care continuum through African American churches may improve HIV treatment outcomes for African Americans. We explored the feasibility of a church-led HIV care program in six churches in Baltimore, Maryland. Church leaders (n = 57) participated in focus groups and eight pastors participated in interviews. Data were analyzed by qualitative hybrid thematic analysis. Findings revealed eight themes: four themes were related to linkage to care: being unaware of community resources, concerns about HIV-associated regulations, ongoing personalized contact with HIV-infected persons, and desire for integration of spiritual education; four themes were related to HIV care and support services, including existing church infrastructure, provision of HIV support groups, using the church as an HIV care resource hub, and prevention education for uninfected people...
November 22, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
Evin Uzun Jacobson, Katherine A Hicks, Emily L Tucker, Paul G Farnham, Stephanie L Sansom
CONTEXT: Human immunodeficiency virus (HIV) incidence and prevalence in the United States are characterized by significant disparities by race/ethnicity. National HIV care goals, such as boosting to 90% the proportion of persons whose HIV is diagnosed and increasing to 80% the proportion of persons living with diagnosed HIV who are virally suppressed, will likely reduce HIV incidence, but their effects on HIV-related disparities are uncertain. OBJECTIVE: We sought to understand by race/ethnicity how current HIV care varies, the level of effort required to achieve national HIV care goals, and the effects of reaching those goals on HIV incidence and disparities...
December 27, 2017: Journal of Public Health Management and Practice: JPHMP
Cody Cichowitz, Noriah Maraba, Robin Hamilton, Salome Charalambous, Christopher J Hoffmann
We sought to assess mental health at the time of antiretroviral therapy (ART) initiation and subsequent retention in care over a six-month follow-up period. A total of 136 people living with HIV in South Africa were administered surveys measuring demographic information and mental health indicators at the time of ART initiation. Follow-up was completed via chart abstraction to assess for six-month outcomes of retention in care and viral suppression. At enrollment, 45/136 (33%), 67/136 (49%), and 45/136 (33%) participants screened positive for depression, anxiety, and alcohol use disorder, respectively...
2017: PloS One
Anne M Neilan, Richard Dunville, M Cheryl Bañez Ocfemia, Joshua A Salomon, Jordan A Francke, Alexander J B Bulteel, Li Yan Wang, Katherine K Hsu, Elizabeth A DiNenno, Rochelle P Walensky, Robert A Parker, Kenneth A Freedberg, Andrea L Ciaranello
PURPOSE: To assess the optimal age at which a one-time HIV screen should begin for adolescents and young adults (AYA) in the U.S. without identified HIV risk factors, incorporating clinical impact, costs, and cost-effectiveness. METHODS: We simulated HIV-uninfected 12-year-olds in the U.S. without identified risk factors who faced age-specific risks of HIV infection (.6-71.3/100,000PY). We modeled a one-time screen ($36) at age 15, 18, 21, 25, or 30, each in addition to current U...
January 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Irene S Yoon, Martin J Downing, Richard Teran, Mary Ann Chiasson, Steven T Houang, Jeffrey T Parsons, Sabina Hirshfield
Antiretroviral Therapy (ART) suppresses HIV replication, reducing the risk of transmission. However, many people living with HIV in the US are not virally suppressed even after diagnosis and initiating ART, and may become disengaged from care at each stage of the HIV care continuum (HCC). In the current study we assessed the sexual risk behaviors of MSM by HCC stage. US MSM who completed an online survey (N = 12,995) in 2015 were categorized into 6 HCC groups. Mean age was 39.2 and a majority identified as White (49...
December 19, 2017: AIDS Care
Steven Bailey, Kathryn Gilmore, Lauren Yerkes, Anne Rhodes
Incarcerated individuals are disproportionately affected by HIV and often experience risk factors associated with poor maintenance of HIV care upon release. Therefore, the transition period from incarceration to the community is a particularly critical time for persons living with HIV to ensure continuity of care and treatment. By building relationships with Department of Corrections staff and community partners, the Virginia Department of Health developed a program to link recently incarcerated persons living with HIV to care and treatment immediately upon release from correctional facilities across Virginia...
December 16, 2017: AIDS and Behavior
Irene Inwani, Nok Chhun, Kawango Agot, Charles M Cleland, Jasmine Buttolph, Harsha Thirumurthy, Ann E Kurth
BACKGROUND: Sub-Saharan Africa is the region with the highest HIV burden. Adolescent girls and young women (AGYW) in the age range of 15 to 24 years are twice as likely as their male peers to be infected, making females in sub-Saharan Africa the most at-risk group for HIV infection. It is therefore critical to prioritize access to HIV testing, prevention, and treatment for this vulnerable population. OBJECTIVE: Using an implementation science framework, the purpose of this research protocol was to describe the approaches we propose to optimize engagement of AGYW in both the HIV prevention and care continuum and to determine the recruitment and testing strategies that identify the highest proportion of previously undiagnosed HIV infections...
December 13, 2017: JMIR Research Protocols
Carol Dawson-Rose, Jessica E Draughon, Yvette Cuca, Roland Zepf, Emily Huang, Bruce A Cooper, Paula J Lum
BACKGROUND: Substance use is common among people living with HIV (PLHIV) and is associated with worse outcomes along the HIV care continuum. One potentially effective clinic-based approach to addressing unhealthy substance use is screening, brief intervention, and referral to treatment (SBIRT). METHODS: We conducted a two-arm randomized trial to examine the effects of a self-administered, computerized SBIRT intervention compared to a clinician-administered SBIRT intervention in an HIV primary clinic...
December 12, 2017: Addiction Science & Clinical Practice
Mimi Doll, J Dennis Fortenberry, Denise Roseland, Kathleen McAuliff, Craig M Wilson, Cherrie B Boyer
PURPOSE: Linkage of HIV-negative youth to prevention services is increasingly important with the development of effective pre-exposure prophylaxis that complements behavioral and other prevention-focused interventions. However, effective infrastructure for delivery of prevention services does not exist, leaving many programs to address HIV prevention without data to guide program development/implementation. The objective of this study was to provide a qualitative description of barriers and facilitators of linkage to prevention services among high-risk, HIV-negative youth...
December 7, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Ye Ma, Zhihui Dou, Wei Guo, Yurong Mao, Fujie Zhang, Jennifer M McGoogan, Yan Zhao, Decai Zhao, Yasong Wu, Zhongfu Liu, Zunyou Wu
Background: Human immunodeficiency virus (HIV) care continuum attrition is a major global public health challenge. Few studies have examined this problem in resource-limited settings. We aimed to assess cumulative, current, and historical achievement along China's HIV continuum of care. Methods: A nationwide, serial cross-sectional study of all individuals with HIV infection diagnosed in China between 1 January 1985 and 31 December 2015 was conducted using data from China's HIV/AIDS information systems...
December 5, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Carol S Camlin, Edwin D Charlebois, Elvin Geng, Fred Semitala, Jeanna Wallenta, Monica Getahun, Leatitia Kampiire, Elizabeth A Bukusi, Norton Sang, Dalsone Kwarisiima, Tamara D Clark, Maya L Petersen, Moses R Kamya, Diane V Havlir
INTRODUCTION: The concept of "therapeutic citizenship" has drawn attention to ways in which public testimony, the "story-telling in the public sphere" undertaken by people living with HIV (PLHIV), has shaped the global response to the epidemic. This paper presents qualitative findings from two large studies in eastern Africa that reveal how the advent of population-based HIV testing campaigns and efforts to accelerate antiretroviral "treatment for all" has precipitated a rapidly expanding therapeutic citizenship "project," or social movement...
December 2017: Journal of the International AIDS Society
Gitau Mburu, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Siyan Yi
BACKGROUND: People who use drugs are an important priority for HIV programs. However, data related to their utilization of HIV services are limited. This paper reports patterns of HIV testing, drug use, and risk and service perception among people who use drugs. Study participants were receiving HIV and harm reduction services from a community-based program in Phnom Penh, comprised of itinerant peer-led outreach and static drop-in centers. METHODS: This was a mixed-methods study conducted in 2014, comprising of a quantitative survey using a structured questionnaire, followed by two focus group discussions among a sub-sample of survey participants...
December 5, 2017: Addiction Science & Clinical Practice
Angela M Bayer, Chanelle M Díaz, Marina Chiappe, Amira N Baker, Miguel S Egoavil, José E Pérez-Lu, Pamina M Gorbach, Patricia J García
Background: In Peru, there is little information about the HIV care continuum. Therefore, we conducted a study to describe the HIV care continuum among male sex workers (MSWs) in Lima. Methods: We applied close-ended surveys with 209 MSWs about their engagement in the HIV care continuum and open-ended surveys with 34 MSWs who are people living with HIV (PLHIV) to explore their linkage to and retention in HIV care. Results: Of 209 MSWs, only 71% (n=148) reported a lifetime HIV test and 56% (n=116) of all MSWs received confirmatory HIV test results...
January 2017: Journal of HIV and AIDS
Florence M Momplaisir, Deborah Storm, Hervette Nkwihoreze, Olakunle Jayeola, John B Jemmott
: Research findings have consistently demonstrated that women living with HIV (WLWH) in the United States and globally experience declines in medication adherence and retention in care after giving birth. A number of studies have identified factors associated with postpartum retention in care, but the evidence base for interventions to address the problem and close this gap in the HIV care continuum is limited. Furthermore, the majority of studies have been conducted in low-or moderate resource countries and may be less applicable or require adaptation for use in high resource countries...
November 30, 2017: AIDS
Rebecca Marcus, Rashida A Ferrand, Katharina Kranzer, Linda-Gail Bekker
INTRODUCTION: The success of HIV treatment programmes globally has resulted in children with perinatally acquired HIV reaching adolescence in large numbers. The number of adolescents living with HIV is growing further due to persisting high HIV incidence rates among adolescents in low- and middle-income settings, particularly in sub-Saharan Africa. Although expanding access to HIV viral load monitoring is necessary to achieve the 90-90-90 targets across the HIV care continuum, implementation is incomplete...
November 2017: Journal of the International AIDS Society
Hilary K Whitham, Stephanie L Sansom, Cyprian Wejnert, Teresa Finlayson, Ya-Lin A Huang, Qian An, Gabriela Paz-Bailey
Using National HIV Behavioral Surveillance (NHBS) cross-sectional survey and HIV testing data in 21 U.S. metropolitan areas, we identify sex practices among sexually active men who have sex with men (MSM) associated with: (1) awareness of HIV status, and (2) engagement in the HIV care continuum. Data from 2008, 2011, and 2014 were aggregated, yielding a sample of 5079 sexually active MSM living with HIV (MLWH). Participants were classified into HIV status categories: (1) unaware; (2) aware and out of care; (3) aware and in care without antiretroviral therapy (ART); and (4) aware and on ART...
November 23, 2017: AIDS and Behavior
Cristina Rodriguez-Hart, Rashelle Musci, Rebecca G Nowak, Danielle German, Ifeanyi Orazulike, Uchenna Ononaku, Hongjie Liu, Trevor A Crowell, Stefan Baral, Man Charurat
Sexual stigma facilitates the spread of HIV and sexually transmitted infections (STIs) but little is known about stigma affecting Nigerian men who have sex with men (MSM). We assessed patterns of sexual stigma across Nigerian MSM and their relationship to HIV and STIs. Data were collected from the TRUST/RV368 Study, a prospective cohort of 1480 Nigerian MSM enrolled from March 2013 to February 2016 using respondent driven sampling. Structural equation modeling was utilized to assess the association between stigma classes and HIV and STI prevalence, adjusting for participants' characteristics...
November 22, 2017: AIDS and Behavior
Alexandra C Vrazo, Jacqueline Firth, Anouk Amzel, Rebecca Sedillo, Julia Ryan, B Ryan Phelps
OBJECTIVES: Despite the success of Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs, low uptake of services and poor retention pose a formidable challenge to achieving the elimination of vertical HIV transmission in low and middle-income countries. This systematic review summarizes interventions that demonstrate statistically significant improvements in service uptake and retention of HIV-positive pregnant and breastfeeding women and their infants along the PMTCT cascade...
November 22, 2017: Tropical Medicine & International Health: TM & IH
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