Timing of HIV diagnosis relative to pregnancy and postpartum HIV care continuum outcomes among Latin American women, 2000 to 2017

BACKGROUND: Ethiopia has pledged to the UNAIDS 90-90-90 framework. However, the achievements of these UNAIDS targets are not assessed in Southwest Ethiopia. Using HIV care and treatment outcomes as surrogate markers, we assessed all targets.METHODS: Complex surrogate makers were used to assess the HIV care continuum outcomes using antiretroviral therapy data in Jimma University Teaching Hospital. Early HIV diagnosis was a surrogate marker to measure the first 90. Numbers of people on HIV treatment and who have good adherence were used to measure the second 90. To measure the third 90, we used immunological success that was measured using numbers of CD4 counts, clinical success using WHO clinical stages and treatment success using immunological and clinical successes.RESULTS: In total, 8172 patients were enrolled for HIV care from June 2003 to March 2015. For the diagnosis target, the prevalence of early HIV diagnosis among patients on ART was 35% (43% among children and 33.3% among adults). For the treatment target, 5299(65%) received ART of which 1154(22%) patients lost to follow-up or defaulted from ART treatment, and 1015(19%) patients on treatment transferred out to other sites. In addition, 17% had fair or good adherence. Finally, 81% had immunological success, 80% had clinical success and 66% treatment success.CONCLUSIONS: The study revealed that Southwest Ethiopia achieved 35%, 65% and 66% of the first, second and third UNAIDS targets, a very far performance from achieving the target. These highlight further rigorous interventions to improve outcome of HIV continuum of care.

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The impact of COVID-19 pandemic on HIV care continuum in Jiangsu, China

BMC Infectious Diseases ◽

10.1186/s12879-021-06490-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lingen Shi ◽

Weiming Tang ◽

Haiyang Hu ◽

Tao Qiu ◽

Gifty Marley ◽

...

Keyword(s):

Moving Average ◽

Information Management System ◽

Hiv Care ◽

Hiv Care Continuum ◽

Newly Diagnosed ◽

Public Health Services ◽

Hiv Diagnosis ◽

Cd4 Cell Count ◽

Care Continuum ◽

The Impact

Abstract Background The COVID-19 pandemic seriously threatens general public health services globally. This study aimed to evaluate the impact of the COVID-19 pandemic on the HIV care continuum in Jiangsu province, China. Methods Data on newly diagnosed HIV persons for analysis were retrieved from Chinas’ web-based Comprehensive Response Information Management System (CRIMS) for HIV/AIDS from 2016 to 2020. We recorded data for the first 3 months (January to March, 2020) of strictly implementing COVID-19 measures from publicly available disease databases of the Jiangsu provincial Health Committee. We used seasonal autoregressive integrated moving average (SARIMA) and exponential smoothing in forecasting the parameters. Subgroup differences were accessed using Chi-square tests. Results Compared to the estimated proportions, the HIV testing rates decreased by 49.0% (919,938) in the first three months of implementing COVID-19 measures. Of an estimated 1555 new HIV diagnosis expected in the same period, only 63.0% (980) new diagnoses were recorded. According to actual data recorded during the said period, 980 positively tested persons received confirmatory tests, of which 71.4% (700) were reportedly linked to care. And only 49.5% (235) out of the expected 475 newly diagnosed HIV persons received CD4 cell count testing. Meanwhile 91.6% (208) of newly diagnosed HIV persons who received CD4 count tests reportedly initiated antiretroviral therapy (ART) compared to the 227 expected. Compared to the same period from 2016 to 2019, PLWH less than 30 years old and migrants were more likely to be affected by the COVID-19 policies. Conclusions The COVID-19 pandemic negatively impacted HIV healthcare systems in Jiangsu, China. Further measures that can counter the impact of the pandemic are needed to maintain the HIV care continuum.

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Characterizing the HIV Care Continuum and Identifying Barriers and Facilitators to HIV Diagnosis and Viral Suppression Among Black Transgender Women in the United States

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001831 ◽

2018 ◽

Vol 79 (4) ◽

pp. 413-420 ◽

Cited By ~ 20

Author(s):

Leigh A. Bukowski ◽

Cristian J. Chandler ◽

Stephanie L. Creasy ◽

Derrick D. Matthews ◽

Mackey R. Friedman ◽

...

Keyword(s):

United States ◽

Viral Suppression ◽

The United States ◽

Transgender Women ◽

Barriers And Facilitators ◽

Hiv Care ◽

Hiv Care Continuum ◽

Hiv Diagnosis ◽

Care Continuum

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The HIV care continuum in publicly funded clinics

Public Health Reports ◽

10.1016/s0033-3549(04)50157-7 ◽

2002 ◽

Vol 117 (3) ◽

pp. 231-232 ◽

Cited By ~ 4

Author(s):

T.Anne Richards ◽

Karen Vernon ◽

Herminia Palacio ◽

James G Kahn ◽

Stephen F Morin

Keyword(s):

Hiv Care ◽

Hiv Care Continuum ◽

Publicly Funded ◽

Care Continuum

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The importance of domain-specific self-efficacy assessment for substance use and HIV care continuum outcomes among adults in an urban HIV clinic network

AIDS Care ◽

10.1080/09540121.2021.1904501 ◽

2021 ◽

pp. 1-9

Author(s):

Tyrel J. Starks ◽

Simone J. Skeen ◽

S. Scott Jones ◽

Brett M. Millar ◽

Sitaji Gurung ◽

...

Keyword(s):

Substance Use ◽

Self Efficacy ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Domain Specific ◽

Efficacy Assessment

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Machine Learning and Clinical Informatics for Improving HIV Care Continuum Outcomes

Current HIV/AIDS Reports ◽

10.1007/s11904-021-00552-3 ◽

2021 ◽

Vol 18 (3) ◽

pp. 229-236

Author(s):

Jessica P. Ridgway ◽

Alice Lee ◽

Samantha Devlin ◽

Jared Kerman ◽

Anoop Mayampurath

Keyword(s):

Machine Learning ◽

Clinical Informatics ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum

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1311. Ryan White HIV Care Continuum Model Doubled the Rate of Community HIV Viral Suppression for Newly Diagnosed Patients: A 10-Year Review

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1174 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S473-S473

Author(s):

Christina Rizk ◽

Alice Zhao ◽

Janet Miceli ◽

Portia Shea ◽

Merceditas Villanueva ◽

...

Keyword(s):

Viral Suppression ◽

Linkage To Care ◽

Hiv Care ◽

Hiv Care Continuum ◽

Newly Diagnosed ◽

New Haven ◽

Care Continuum ◽

Art Initiation ◽

Ryan White ◽

Hiv Viral Suppression

Abstract Background It is estimated that 1,295 per 100,000 are people living with HIV (PLWH) in New Haven, which is the second highest rate of HIV prevalence in Connecticut. Since 2009, New Haven has established the Ryan White (RW) HIV Care Continuum. The main goals of HIV care are early linkage to care, ART initiation, and HIV viral suppression. This study is designed to understand the trends and outcomes in newly diagnosed PLWH in New Haven County. Methods This study is a retrospective medical record review of all newly diagnosed RW eligible PLWH from January 1, 2009 to December 31, 2018. The data were collected in REDCap database and included demographics, HIV risk factor, presence of mental health and/or substance abuse disorder, date of diagnosis, date of initial visit, and ART initiation. Health outcomes such as AIDS at diagnosis and rate of viral suppression were evaluated. The data were then analyzed to show the trends over 10 years. Results From January 1, 2009 to December 31, 2018 there were 420 newly diagnosed RW PLWH. Sixty-seven percent of those were male, 56% were non-white, 47% self-identified as Men who have Sex with Men (MSM), and 41% were heterosexual. Twenty-nine percent had AIDS-defining condition at the time of the diagnosis. Thirty-four percent of the 420 patients had a mental health and/or substance use disorder; 53% of those were MSM and 51% were non-white. Over the 10-year period, it was noted that the duration between date of HIV diagnosis and linkage to care as well as ART initiation decreased. This decline was associated with a substantial increase in viral suppression. The average time between the dates of HIV diagnosis and initial visit decreased from 269 days in 2009 to 13 days in 2018. Moreover, the average time between the dates of diagnosis and ART initiation dropped from 308 days in 2009 to 15 days in 2018. The 1-year HIV viral suppression rate subsequently doubled from 44% in 2009 to 87% in 2018 (P < 0.01). Conclusion The Ryan White HIV Care Continuum Model with emphasis on early linkage to care and ART initiation can have a significant impact on HIV viral suppression at a community level for newly diagnosed patients. Another important observation in this study was the alarming high rate of AIDS at diagnosis, which highlights the need for universal HIV testing, and early diagnosis. Disclosures All authors: No reported disclosures.

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High Rates of Retention and Viral Suppression in the US HIV Safety Net System: HIV Care Continuum in the Ryan White HIV/AIDS Program, 2011

Clinical Infectious Diseases ◽

10.1093/cid/ciu722 ◽

2014 ◽

Vol 60 (1) ◽

pp. 117-125 ◽

Cited By ~ 66

Author(s):

R. K. Doshi ◽

J. Milberg ◽

D. Isenberg ◽

T. Matthews ◽

F. Malitz ◽

...

Keyword(s):

Viral Suppression ◽

Safety Net ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Ryan White ◽

The Us ◽

Aids Program ◽

Hiv Aids

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African American Clergy Perspectives About the HIV Care Continuum: Results From a Qualitative Study in Jackson, Mississippi

Ethnicity & Disease ◽

10.18865/ed.28.2.85 ◽

2018 ◽

Vol 28 (2) ◽

pp. 85 ◽

Cited By ~ 4

Author(s):

Amy Nunn ◽

Sharon Parker ◽

Katryna McCoy ◽

Mauda Monger ◽

Melverta Bender ◽

...

Keyword(s):

African American ◽

African Americans ◽

Hiv Infection ◽

Racial Disparities ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Adherence To Medication ◽

African American Clergy ◽

American Clergy

Mississippi has some of the most pronounced racial disparities in HIV infection in the country; African Americans comprised 37% of the Mississippi population but represented 80% of new HIV cases in 2015. Improving outcomes along the HIV care continuum, including linking and retaining more individuals and enhancing adherence to medication, may reduce the disparities faced by African Americans in Mississippi. Little is understood about clergy’s views about the HIV care continuum. We assessed knowledge of African American pastors and ministers in Jackson, Mississippi about HIV and the HIV care continuum. We also assessed their willingness to promote HIV screening and biomedical prevention technologies as well as efforts to enhance linkage and retention in care with their congregations. Four focus groups were conducted with 19 African American clergy. Clergy noted pervasive stigma associated with HIV and believed they had a moral imperative to promote HIV awareness and testing; they provided recommendations on how to normalize conversations related to HIV testing and treatment. Overall, clergy were willing to promote and help assist with linking and retaining HIV positive individuals in care but knew little about how HIV treatment can enhance prevention or new biomedical technologies such as pre-exposure prophylaxis (PrEP). Clergy underscored the importance of building coalitions to promote a collective local response to the epidemic. The results of this study highlight important public health opportunities to engage African American clergy in the HIV care continuum in order to reduce racial disparities in HIV infection. Ethn Dis.2018; 28(2): 85-92; doi:10.18865/ed.28.2.85.

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