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Cascade of HIV care

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https://www.readbyqxmd.com/read/27930599/the-hiv-care-cascade-among-female-sex-workers-in-zimbabwe-results-of-a-population-based-survey-from-the-sisters-antiretroviral-therapy-programme-for-prevention-of-hiv-an-integrated-response-sapph-ire-trial
#1
Frances M Cowan, Calum Davey, Elizabeth Fearon, Phillis Mushati, Jeffrey Dirawo, Valentina Cambiano, Sue Napierala Mavedzenge, Dagmar Hanisch, Ramona Wong-Gruenwald, Milton Chemhuru, Nyasha Masuka, Karin Hatzold, Owen Mugurungi, Joanna Busza, Andrew Phillips, James R Hargreaves
INTRODUCTION: Female sex workers (FSW) in sub-Saharan Africa have a higher prevalence of HIV than other women of reproductive age. Social, legal, and structural barriers influence their access to care. Little is known about the HIV diagnosis and care cascade in most countries in southern Africa. We aimed to describe the HIV diagnosis and care cascade among FSW in Zimbabwe. METHODS: We conducted cross-sectional respondent driven sampling (RDS) surveys of FSW in 14 sites across Zimbabwe as the baseline for a cluster-randomised controlled trial investigating a combination HIV prevention and care package...
December 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27906057/the-hiv-treatment-cascade-and-care-continuum-updates-goals-and-recommendations-for-the-future
#2
REVIEW
Emma Sophia Kay, D Scott Batey, Michael J Mugavero
The HIV care continuum is a framework that models the dynamic stages of HIV care. The continuum consists of five main steps, which, at the population level, are depicted cross-sectionally as the HIV treatment cascade. These steps include diagnosis, linkage to care (LTC), retention in care (RiC), adherence to antiretroviral therapy (ART), and viral suppression. Although the HIV treatment cascade is represented as a linear, unidirectional framework, persons living with HIV (PLWH) often experience the care continuum in a less streamlined fashion, skip steps altogether, or even exit the continuum for a period of time and regress to an earlier stage...
November 8, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27898526/uptake-of-hiv-pre-exposure-prophylaxis-prep-in-a-national-cohort-of-gay-and-bisexual-men-in-the-united-states-the-motivational-prep-cascade
#3
Jeffrey T Parsons, H Jonathon Rendina, Jonathan M Lassiter, Thomas H F Whitfield, Tyrel J Starks, Christian Grov
OBJECTIVES: The HIV care cascade provides milestones to track the progress of HIV-positive people from seroconversion through viral suppression. We propose a Motivational PrEP Cascade involving five stages based upon the Transtheoretical Model of Change. METHODS: We analyzed data from 995 men in One Thousand Strong, a longitudinal study of a national panel of HIV-negative gay and bisexual men in the United States. RESULTS: Nearly all (89%) participants were sexually active in the past 3 months, and 65% met CDC criteria for PrEP candidacy...
November 24, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27888205/engagement-in-the-hiv-care-cascade-and-barriers-to-antiretroviral-therapy-uptake-among-female-sex-workers-in-port-elizabeth-south-africa-findings-from-a-respondent-driven-sampling-study
#4
Sheree Schwartz, Andrew Lambert, Nancy Phaswana-Mafuya, Zamakayise Kose, Mfezi Mcingana, Claire Holland, Sosthenes Ketende, Clarence Yah, Stephanie Sweitzer, Harry Hausler, Stefan Baral
BACKGROUND: Female sex workers (FSWs) are disproportionately affected by HIV, even in the context of broadly generalised HIV epidemics such as South Africa. This has been observed in spite of the individual and population-level benefits of HIV treatment. We characterise the HIV care cascade among FSWs and relationships with antiretroviral therapy (ART) use. METHODS: FSWs ≥18 years were recruited through respondent-driven sampling into a cross-sectional study in Port Elizabeth, South Africa...
November 25, 2016: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/27865052/retention-in-care-and-reasons-for-discontinuation-of-lifelong-antiretroviral-therapy-in-a-cohort-of-cameroonian-pregnant-and-breastfeeding-hiv-positive-women-initiating-option-b-in-the-south-west-region
#5
Pascal N Atanga, Harrison T Ndetan, Eric A Achidi, Henry D Meriki, Michael Hoelscher, Arne Kroidl
OBJECTIVE: To assess linkage and retention in care along the PMTCT cascade in HIV-positive pregnant and breastfeeding women initiating Option B+ in Cameroon. METHODS: We prospectively determined uptake of HIV testing and counselling (HTC), uptake of ART and retention in care after Option B+ initiation between October 2013 and December 2014 in pregnant and breastfeeding women from five sites within the Kumba Health District. Retention in care was assessed over at least 12 months follow-up and estimated by Kaplan Meier analysis...
November 16, 2016: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27851713/a-multi-state-model-examining-patterns-of-transitioning-among-states-of-engagement-in-care-in-hiv-positive-individuals-initiating-combination-antiretroviral-therapy
#6
Jennifer Gillis, Mona Loutfy, Ahmed M Bayoumi, Tony Antoniou, Ann N Burchell, Sharon Walmsley, Curtis Cooper, Marina B Klein, Nima Machouf, Julio S G Montaner, Sean B Rourke, Christos Tsoukas, Robert Hogg, Janet Raboud
BACKGROUND: Common measures of engagement in care fail to acknowledge that infrequent follow-up may occur either intentionally among patients with sustained virologic suppression or unintentionally among patients with poor clinical outcomes. METHODS: Five states of HIV care were defined within the Canadian Observational Cohort Collaboration following combination antiretroviral therapy (cART) initiation: (1) guidelines HIV care [suppressed viral load (VL) and CD4 >200 cells per cubic millimeter, no gaps in cART >3 months, no gaps in CD4 or VL measurement >6 months], (2) successful care with decreased frequency of follow-up (as above except no gaps in CD4 or VL measurement >12 months), (3) suboptimal care (unsuppressed VL, CD4 <200 cells per cubic millimeter on 2 consecutive visits, ≥1 gap in cART >3 months, or ≥1 gap in CD4 or VL measurement >12 months), (4) loss to follow-up (no contact for 18 months), and (5) death...
December 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27846074/implementation-and-operational-research-active-referral-of-children-of-hiv-positive-adults-reveals-high-prevalence-of-undiagnosed-hiv
#7
Anjuli D Wagner, Cyrus Mugo, Irene N Njuguna, Elizabeth Maleche-Obimbo, Kenneth Sherr, Irene W Inwani, James P Hughes, Dalton C Wamalwa, Grace C John-Stewart, Jennifer A Slyker
OBJECTIVES: Few routine systems exist to test older, asymptomatic children for HIV. Testing all children in the population has high uptake but is inefficient, whereas testing only symptomatic children increases efficiency but misses opportunities to optimize outcomes. Testing children of HIV-infected adults in care may efficiently identify previously undiagnosed HIV-infected children before symptomatic disease. METHODS: HIV-infected parents in HIV care in Nairobi, Kenya were systematically asked about their children's HIV status and testing history...
December 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27831945/the-lorenz-curve-a-novel-method-for-understanding-viral-load-distribution-at-the-population-level
#8
Katerina Christopoulos, Wendy Hartogensis, David V Glidden, Christopher D Pilcher, Monica Gandhi, Elvin H Geng
Existing HIV care cascade metrics fail to capture whether viremia is equally distributed in a population or concentrated within groups. We applied the Lorenz cure, which has been used to describe disparities in the distribution of income and other resources, to the distribution of viremia in a safety-net HIV clinic in 2012. Among 1,855 established clinic patients, 1% of the population held 50% of the virus and 10% of the population held 94% of virus.
November 7, 2016: AIDS
https://www.readbyqxmd.com/read/27826353/the-hiv-treatment-cascade-and-care-continuum-updates-goals-and-recommendations-for-the-future
#9
REVIEW
Emma Sophia Kay, D Scott Batey, Michael J Mugavero
The HIV care continuum is a framework that models the dynamic stages of HIV care. The continuum consists of five main steps, which, at the population level, are depicted cross-sectionally as the HIV treatment cascade. These steps include diagnosis, linkage to care (LTC), retention in care (RiC), adherence to antiretroviral therapy (ART), and viral suppression. Although the HIV treatment cascade is represented as a linear, unidirectional framework, persons living with HIV (PLWH) often experience the care continuum in a less streamlined fashion, skip steps altogether, or even exit the continuum for a period of time and regress to an earlier stage...
2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27819151/depression-retention-in-care-and-uptake-of-pmtct-service-in-kinshasa-the-democratic-republic-of-congo-a-prospective-cohort
#10
Kelly A Yotebieng, Kunuwo Fokong, Marcel Yotebieng
There is a clear need for effective strategies to address the factors that affect retention, or lost-to-follow-up (LTFU) and adherence to HIV care and treatment. Depression in particular may play an important role in the high rates of LTFU along the prevention of mother-to-child HIV transmission (PMTCT) cascade in sub-Saharan Africa. This study assessed the association between prenatal depression and (1) LTFU or (2) uptake of PMTCT services. As part of a randomized control trial to evaluate the effect of conditional cash transfers on retention in and uptake of PMTCT services, newly diagnosed HIV-infected women, ≤32 weeks pregnant, registering for antenatal care (ANC), in 85 clinics in Kinshasa, Democratic Republic of Congo (DRC), were recruited and followed-up until LTFU, death, transfer out, or six weeks postpartum...
November 6, 2016: AIDS Care
https://www.readbyqxmd.com/read/27813471/people-living-with-hiv-in-estonia-engagement-in-hiv-care-in-2013
#11
Kaja-Triin Laisaar, Mait Raag, Irja Lutsar, Anneli Uusküla
Estonia had the highest rate of newly diagnosed human immunodeficiency virus (HIV) cases in the European Union (24.6/100,000) and an estimated adult HIV prevalence of 1.3% in 2013. HIV medical care, including antiretroviral therapy (ART), is free of charge for people living with HIV (PLHIV). To maximise the health benefits of HIV treatment, universal access should be achieved. Using data from surveillance and administrative databases and the treatment cascade model, we assessed the number of people infected with HIV, diagnosed with HIV, linked to HIV care, retained in HIV care, on ART, and with suppressed viral load (HIV-RNA: < 200 copies/mL)...
October 27, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27776722/infectious-diseases-and-the-criminal-justice-system
#12
Ank E Nijhawan
The United States leads the world in incarceration, which disproportionately affects disadvantaged individuals, including those who are mentally ill, poor, homeless and racial minorities. Incarceration is disruptive to families and communities and contributes to health disparities in sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). The objective of this grand rounds is to review (1) the epidemiology of incarceration in the United States, (2) the social factors which contribute to high rates of STIs in incarcerated individuals and (3) the HIV care cascade in incarcerated and recently released individuals...
October 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27774350/the-art-of-hiv-elimination-past-and-present-science
#13
Collins C Iwuji, Nuala McGrath, Tulio de Oliveira, Kholoud Porter, Deenan Pillay, Martin Fisher, Melanie Newport, Marie-Louise Newell
INTRODUCTION: Remarkable strides have been made in controlling the HIV epidemic, although not enough to achieve epidemic control. More recently, interest in biomedical HIV control approaches has increased, but substantial challenges with the HIV cascade of care hinder successful implementation. We summarise all available HIV prevention methods and make recommendations on how to address current challenges. DISCUSSION: In the early days of the epidemic, behavioural approaches to control the HIV dominated, and the few available evidence-based interventions demonstrated to reduce HIV transmission were applied independently from one another...
November 30, 2015: Journal of AIDS & Clinical Research
https://www.readbyqxmd.com/read/27771231/evaluating-strategies-to-improve-hiv-care-outcomes-in-kenya-a-modelling-study
#14
Jack J Olney, Paula Braitstein, Jeffrey W Eaton, Edwin Sang, Monicah Nyambura, Sylvester Kimaiyo, Ellen McRobie, Joseph W Hogan, Timothy B Hallett
BACKGROUND: With expanded access to antiretroviral therapy (ART) in sub-Saharan Africa, HIV mortality has decreased, yet life-years are still lost to AIDS. Strengthening of treatment programmes is a priority. We examined the state of an HIV care programme in Kenya and assessed interventions to improve the impact of ART programmes on population health. METHODS: We created an individual-based mathematical model to describe the HIV epidemic and the experiences of care among adults infected with HIV in Kenya...
December 2016: Lancet HIV
https://www.readbyqxmd.com/read/27696523/alcohol-use-and-human-immunodeficiency-virus-hiv-infection-current-knowledge-implications-and-future-directions
#15
REVIEW
Emily C Williams, Judith A Hahn, Richard Saitz, Kendall Bryant, Marlene C Lira, Jeffrey H Samet
Alcohol use is common among people living with human immunodeficiency virus (HIV). In this narrative review, we describe literature regarding alcohol's impact on transmission, care, coinfections, and comorbidities that are common among people living with HIV (PLWH), as well as literature regarding interventions to address alcohol use and its influences among PLWH. This narrative review identifies alcohol use as a risk factor for HIV transmission, as well as a factor impacting the clinical manifestations and management of HIV...
October 2016: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/27695679/dotting-the-three-i-s-for-collaborative-tb-hiv-activities-evaluation-of-a-pilot-programme-in-kathmandu-nepal
#16
S K Sah, S K Sahu, B Lamichhane, G K Bhatta, K B Bhandari, P Owiti, S S Majumdar
Setting: The three government tertiary care hospitals providing care for people living with the human immunodeficiency virus (PLHIV) in Kathmandu, Nepal. Objectives: To assess 1) the screening cascades for intensified case finding for tuberculosis (TB), 2) isoniazid preventive therapy (IPT), including demographic and clinical factors associated with treatment interruption, and 3) TB infection control (IC) in the health facilities. Design: A cross-sectional study of new PLHIV enrolled from January 2012 to December 2014...
September 2016: Public Health Action
https://www.readbyqxmd.com/read/27684099/different-modalities-of-entry-in-a-large-urban-clinic-in-uganda-and-impact-on-outcomes-of-patients-assessing-hiv-care-and-treatment
#17
Barbara Castelnuovo, Rachel Musomba, Joseph Musaazi, Agnes N Kiragga
In resource-limited settings, a number of patients do not receive continuous HIV care. In this analysis, we compared outcomes in patients who entered care by different modality of entry. This was a retrospective analysis of all patients started on antiretroviral treatment (ART) at a large urban center in Uganda from 2005 to 2012. Patients were categorized into three groups (1) Front door: started on ART without interruption during follow-up; (2) drop-out side door: restarted on ART after having an interruption >6 months and (3) transfer-in side door: transferred-in after being started on ART somewhere else...
August 15, 2016: AIDS Care
https://www.readbyqxmd.com/read/27684066/household-knowledge-of-antimicrobials-and-antimicrobial-resistance-in-the-wake-of-an-accredited-drug-dispensing-outlet-addo-program-rollout-in-tanzania
#18
Daudi Simba, Deodatus Kakoko, Innocent Semali, Anna Kessy, Martha Embrey
INTRODUCTION: Private sector drug shops are an important source of medicines in Tanzania. In 2003, the government introduced the accredited drug dispensing outlet (ADDO) program to improve access to good-quality medicines in rural and peri-urban areas that have frequent drug shortages in public health facilities and few or no registered pharmacies. However, increasing access may also contribute to antimicrobial resistance (AMR) due to the potential overuse and misuse of drugs. METHODS: We conducted a cross-sectional household survey in four regions in mainland Tanzaniato characterize consumer care-seeking habits and medicines use and to determine the extent to which members of the community are knowledgeable about antimicrobials and AMR...
2016: PloS One
https://www.readbyqxmd.com/read/27649038/active-referral-of-children-of-hiv-positive-adults-reveals-high-prevalence-of-undiagnosed-hiv
#19
Anjuli D Wagner, Cyrus M Wachira, Irene N Njuguna, Elizabeth Maleche-Obimbo, Kenneth Sherr, Irene W Inwani, James P Hughes, Dalton C Wamalwa, Grace C John-Stewart, Jennifer A Slyker
OBJECTIVES: Few routine systems exist to test older, asymptomatic children for HIV. Testing all children in the population has high uptake but is inefficient, while testing only symptomatic children increases efficiency but misses opportunities to optimize outcomes. Testing children of HIV-infected adults in care may efficiently identify previously undiagnosed HIV-infected children before symptomatic disease. METHODS: HIV-infected parents in HIV care in Nairobi, Kenya were systematically asked about their children's HIV status and testing history...
September 19, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27629869/significant-improvements-are-needed-in-hiv-care-continuum-to-meet-90-90-90-targets-in-georgia
#20
Nikoloz Chkhartishvili, Otar Chokoshvili, Natia Dvali, Akaki Abutidze, Lali Sharvadze, Tengiz Tsertsvadze
The objective of this report was to assess Georgia's progress toward Joint United Nations Programme on HIV/AIDS 90-90-90 targets over the period between 2011 and 2015. The number of HIV-positive persons was estimated using Spectrum software. Number of persons diagnosed, on antiretroviral therapy (ART) and virally suppressed were quantified using data from the national AIDS health information system. By the end of 2015, out of the estimated 7100 persons living with HIV, 62% were diagnosed, 38% were on ART, and 32% were virally suppressed...
September 14, 2016: Journal of the International Association of Providers of AIDS Care
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