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Cascade of HIV care

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https://www.readbyqxmd.com/read/28070923/the-cascade-of-hiv-care-among-refugees-and-nationals-in-nakivale-refugee-settlement-in-uganda
#1
K N O'Laughlin, J Kasozi, D J Rabideau, R A Parker, E Mulogo, Z M Faustin, K E Greenwald, S Doraiswamy, R P Walensky, I V Bassett
OBJECTIVES: Refugees living in Uganda come from HIV-endemic countries, and many remain in refugee settlements for over a decade. Our objective was to evaluate the HIV care cascade in Nakivale Refugee Settlement and to assess correlates of linkage to care. METHODS: We prospectively enrolled individuals accessing clinic-based HIV testing in Nakivale Refugee Settlement from March 2013 to July 2014. Newly HIV-diagnosed clients were followed for 3 months post-diagnosis...
January 10, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28055823/mental-health-in-2020-for-men-who-have-sex-with-men-in-the-united-states
#2
Abigail W Batchelder, Steven Safren, Avery D Mitchell, Ivan Ivardic, Conall O'Cleirigh
Despite continued advances in HIV prevention and treatment, gay and bisexual men and other men who have sex with men (MSM) remain the population most impacted by HIV/AIDS in the US and many other Western countries. Additionally, MSM are disproportionately affected by various psychological problems, including depression, distress, trauma and substance use. These challenges frequently co-occur, and are associated with higher rates of behaviours related to HIV acquisition and transmission, HIV infection, and, for those living with HIV/AIDS, lower levels of treatment engagement...
January 6, 2017: Sexual Health
https://www.readbyqxmd.com/read/28051324/progress-towards-achieving-the-unaids-90-90-90-goals-in-hiv-care-from-diagnosis-to-durable-viral-suppression-in-the-country-of-georgia
#3
Nikoloz Chkhartishvili, Otar Chokoshvili, Akaki Abutidze, Natia Dvali, Carlos Del Rio, Tengiz Tsertsvadze
Successful engagement in HIV care is required to reach UNAIDS targets of 90-90-90. We analyzed routine programmatic data to quantify losses along the HIV care continuum in the country of Georgia. Analysis was limited to diagnosed persons and did not include estimated number of HIV infected persons. Cascade of HIV care continuum was constructed for adult (age≥18 years) HIV-infected persons newly diagnosed in Georgia in 2008-2012. Data was extracted from the national AIDS Health Information System as of June 30, 2014...
January 4, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/27984917/the-south-carolina-rural-urban-hiv-continuum-of-care
#4
Babatunde Edun, Medha Iyer, Helmut Albrecht, Sharon Weissman
The HIV continuum of care model is widely used by various agencies to describe the HIV epidemic in stages from diagnosis through to virologic suppression. It identifies the various points at which persons living with HIV (PLWHIV) within a population fail to reach their next step in HIV care. The rural population in the Southern United States is disproportionally affected by the HIV epidemic. The purpose of this study was to examine these rural-urban disparities using the HIV care continuum model and determine at what stages these differences become apparent...
December 16, 2016: AIDS Care
https://www.readbyqxmd.com/read/27968864/hiv-testing-campaigns-and-treatment-interventions-for-control-of-epidemic-hiv-growth-among-heterosexuals-a-mathematical-modelling-study
#5
Ngai Sze Wong, Ka Hing Wong, Owen T Y Tsang, Man Po Lee, Shui Shan Lee
BACKGROUND: In 2015, WHO recommended universal antiretroviral treatment for HIV irrespective of CD4 cell count. The impact of this recommendation on heterosexual HIV transmission, especially in low prevalence countries, has not been well-characterised. In Hong Kong, 38% of reported HIV cases are heterosexually acquired. We aimed to model the impacts of enhanced HIV testing and immediate treatment to provide a reference to other provinces in China. METHODS: We developed deterministic compartmental models (sexually active heterosexual males and females) for simulation of HIV epidemiology for 1983-2011 in Hong Kong, with data projected to 2012-20...
October 2016: Lancet
https://www.readbyqxmd.com/read/27956646/engagement-in-and-continuity-of-hiv-care-among-african-and-caribbean-black-women-living-with-hiv-in-ontario-canada
#6
Carmen H Logie, Victoria L Kennedy, Wangari Tharao, Uzma Ahmed, Mona R Loutfy
Engagement in care is a key component of the HIV care cascade, yet there are knowledge gaps regarding how to assess HIV care engagement. This study aimed to develop a tool to assess HIV care engagement and to assess associations between HIV care engagement and quality of life (QOL) among African, Caribbean and Black (ACB) women living with HIV (WLWH). We conducted a cross-sectional survey with ACB WLWH across Ontario, Canada. We developed the 'HIV Engagement in and Continuity of Care Scale' (HECCS). We conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to test the scale's factor structure...
December 12, 2016: International Journal of STD & AIDS
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
Katerina A 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 curve, 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 1855 established clinic patients, 1% of the population held 50% of the virus and 10% of the population held 94% of virus.
January 14, 2017: AIDS
https://www.readbyqxmd.com/read/27826353/the-hiv-treatment-cascade-and-care-continuum-updates-goals-and-recommendations-for-the-future
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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