Effectiveness of a Viral Load Suppression Intervention for Highly Vulnerable People Living with HIV

2019 ◽  
Vol 23 (9) ◽  
pp. 2443-2452 ◽  
Author(s):  
Toorjo Ghose ◽  
Virginia Shubert ◽  
Vaty Poitevien ◽  
Sambuddha Choudhuri ◽  
Robert Gross
Keyword(s):  
Viral Load ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Vulnerable People ◽  
Living With Hiv

scholarly journals Cascade of care for people living with HIV infection in Southern Brazil: results from a public health network

2018 ◽  
Vol 34 (12) ◽  
Author(s):  
Ingridt Hildegard Vogler ◽  
Daniela Frizon Alfieri ◽  
Heloisa Damazio Bruna Gianjacomo ◽  
Elaine Regina Delicato de Almeida ◽  
Edna Maria Vissoci Reiche
Keyword(s):  
Public Health ◽  
Viral Load ◽  
Hiv Infection ◽  
Retention In Care ◽  
People Living With Hiv ◽  
Southern Brazil ◽  
Viral Load Suppression ◽  
Health Network ◽  
Cascade Of Care ◽  
Living With Hiv

Abstract: The cascade of care for people living with HIV infection (PLHIV) describes steps in diagnosis, linkage and retention in care, as well as the provision and success of combination antiretroviral therapy (cART). The aim of this study was to evaluate the rates regarding the retention in care, on cART, and suppressed viral load for PLHIV attended at a Brazilian public health network. Data on PLHIV from 116 cities of Paraná, Southern Brazil, attended from 2012 to 2015, were retrospectively collected through the Laboratory Tests Control System (SISCEL). The number of PLHIV related to care increased about 22.5% from 2012 to 2015 (4,106 to 5,030 individuals). The proportion of PLHIV retained in care showed a trend toward stabilization around 81.7-86.9%. Every year, the use of cART increased up to 90.3% for PLHIV retained in care. Viral load suppression was achieved by 72.8% of patients on cART and 57.1% by those linked to care. Retention in care and HIV viral suppression were more likely to occur in older PLHIV than younger ones; similarly, patients living in medium-sized cities were more susceptible to these factors than in large- or small-sized cities. In conclusion, the study showed a high level of retention in care and HIV suppression on cART, as well as emphasized that current efforts for treating already-infected PLHIV remain a challenge for our health public institutions and may contribute to highlight steps for improvement of the HIV cascade of care in our population.

Daily and near-daily cannabis use is associated with HIV viral load suppression in people living with HIV who use cocaine

AIDS Care ◽  
2020 ◽  
pp. 1-8
Author(s):  
Deepika E. Slawek ◽  
Julia Arnsten ◽  
Nancy Sohler ◽  
Chenshu Zhang ◽  
Robert Grossberg ◽  
...  
Keyword(s):  
Viral Load ◽  
Cannabis Use ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Hiv Viral Load ◽  
Living With Hiv

scholarly journals Factors Associated With Virological Suppression of HIV Viral Load in Patients on Antiretroviral Therapy in Conakry, Guinea

2021 ◽  
Author(s):  
Alimou camara ◽  
Penda Maladho Diallo ◽  
Mamadou Bobo Diallo ◽  
Talla Nioké ◽  
Adama Cissé ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Detection Threshold ◽  
Virological Suppression ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Viral Load Data ◽  
Living With Hiv ◽  
Hiv Aids

Abstract BackgroundThe viral load has become an indispensable tool in evaluating antiretroviral therapy (ART) in people living with HIV / AIDS. This study aimed to assess virological suppression among in people living with HIV / AIDS on antiretroviral therapy in Guinea.MethodsThis was a descriptive cross-sectional study of more than three years that involved adult HIV-positive patients treated in different sites in Conakry. A total of 9815 viral load data were collected. The viral load was quantified by the Generic Biocentric technique and the detection threshold set at 350 copies/ml. Statistical analyses were performed by R software version R4.0.3..ResultsA total of 9815 viral load data collected at the national public health laboratory were analysed. The sample was dominated by women (72%), with an average age of 29 [29, 39]. Of these, 6,706 (68%) of HIV-positive people on ART had viral load suppression. The univaried analysis showed that women were 22% more likely to have VL suppression (p-value <0.001) moreover, the chance for all HIV-positive people on treatment to achieve viral load suppression was related to the length of treatment.Conclusionthe results of this study show viral load suppression greater than 68%. The length of antiretroviral therapy, female gender, and advancing age of PLHIV were all favourable to VL suppression.

scholarly journals Determinants of viral load non-suppression among people living with HIV on antiretroviral therapy in Kumasi, Ghana

2021 ◽  
Vol 55 (2) ◽  
pp. 111-117
Author(s):  
David Ansah ◽  
Emmanuel Kumah ◽  
Vitalis Bawontuo ◽  
Peter Agyei-Baffour ◽  
Emmanuel K Afriyie
Keyword(s):  
Viral Load ◽  
Educational Level ◽  
Viral Suppression ◽  
Outcome Measure ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Cross Sectional ◽  
Factors Associated ◽  
Comorbidity Status ◽  
Living With Hiv

Objectives: To determine the rate and factors associated with viral load non-suppression among adults living with HIV/AIDS on active anti-retroviral therapy (ART).Design: A retrospective cross-sectional studySetting: Three ART clinics in Kumasi, GhanaParticipants: All HIV-infected adults who were ≥18 years and on active ART for 12 months and whose viral loadnhad been estimated were included.Main outcome measure: Unsuppressed viral load among patients on ARTResults: In all, 483 HIV patients were included in the study, with 369 (76.4%) achieving viral load suppression. Gender, educational level, comorbidity status, and duration on ART were independently associated with viral nonsuppression (p < 0.05).Conclusions: This study has revealed that the rate of viral suppression in the study area is lower than the UNAIDS 90% target. The findings have implications on designing new and stemming up implementation of existing interventions to improve the rate of viral suppression among patients in the study area. It is also necessary that more of such studies are replicated in other parts of the country to identify risk factors for virological failure among patients on ART.

scholarly journals Changes in D-Dimer after initiation of antiretroviral therapy in adults living with HIV in Kenya

2020 ◽  
Author(s):  
Chloe A Teasdale ◽  
Cecilia Hernandez ◽  
Allison Zerbe ◽  
Duncan Chege ◽  
Mark Hawken ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Clinical History ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Median Viral Load ◽  
Art Initiation ◽  
Living With Hiv ◽  
D Dimer

Abstract Background: Increased coagulation biomarkers are associated with poor outcomes among people living with HIV(PLHIV). There are few data available from African cohorts demonstrating the effect of antiretroviral therapy (ART) on coagulation biomarkers. Methods: From March 2014 to October 2014, ART-naïve PLHIV initiating non-nucleoside reverse transcriptase inhibitor-based ART were recruited from seven clinics in western Kenya and followed for up to 12 months. Demographics, clinical history and blood specimens were collected. Logistic regression models adjusted for intrasite clustering examined associations between viral load and D-Dimer at baseline. Mixed linear effects models were used to estimate mean change from baseline to six months overall, and by baseline viral load, sex and TB status at enrollment. Mean change in D-dimer at six months is reported on the log10 scale and as percentage change from baseline. Results: Among 611 PLHIV enrolled, 66% were female, median age was 34 years (interquartile range (IQR) 29-43 years), 31 (5%) participants had tuberculosis and median viral load was 113,500 copies/mL (IQR: 23,600-399,000). At baseline, 311 (50.9%) PLHIV had elevated D-dimer (>500 ng/mL) and median D-dimer was 516.4 ng/mL (IQR: 302.7-926.6) (log baseline D-dimer: 2.7, IQR: 2.5-3.0). Higher baseline D-dimer was significantly associated with higher viral load (p<0.0001), female sex (p=0.02) and tuberculosis (p=-0.02). After six months on ART, 518 (84.8%) PLHIV had achieved viral load <1,000 copies/mL and median D-dimer was 390.0 (IQR: 236.6-656.9) (log D-dimer: 2.6, IQR: 2.4-2.8). Mean change in log D-dimer from baseline to six months was -0.12 (95%CI -0.15, - 0.09) (p<0.0001) indicating at 31.3% decline (95%CI -40.0, -23.0) in D-dimer levels over the first six months on ART. D-dimer decline after ART initiation was significantly greater among PLHIV with tuberculosis at treatment initiation (-172.1%, 95%CI -259.0, -106.3; p<0.0001) and those with log viral load >6.0 copies/mL (-91.1%, 95%CI -136.7, -54.2; p<0.01). Conclusions: In this large Kenyan cohort of PLHIV, women, those with tuberculosis and higher viral load had elevated baseline D-dimer. ART initiation and viral load suppression among ART-naïve PLHIV in Kenya were associated with significant decrease in D-dimer at six months in this large African cohort.

scholarly journals The Prevalence of HIV Load Suppression and Related Factors Among Patients on ART at Phedisong 4 Clinic, Pretoria, South Africa

2018 ◽  
Vol 11 (1) ◽  
pp. 135-146
Author(s):  
N.J. Mogosetsi ◽  
L.H. Mabuza ◽  
G.A. Ogunbanjo
Keyword(s):  
Viral Load ◽  
Clinical Characteristics ◽  
People Living With Hiv ◽  
Large Sample Size ◽  
Viral Load Suppression ◽  
Hiv Viral Load ◽  
Related Factors ◽  
Behavioural Characteristics ◽  
Patient Groups ◽  
Living With Hiv

Background: Globally, the benefits of viral load suppression in improving the lives of people living with HIV/AIDS have been established. In 2010, the South African Government decentralised ART to the primary care level. This study intended to determine the effect of this decentralisation in achieving viral load suppression among patients. Objective: To determine the prevalence of HIV viral load suppression and factors related to the suppression among patients initiated on ART at Pedisong 4 clinic, Tshwane District in Pretoria. Methods: A prospective cohort study was conducted on 98 patients initiated on ART between 01 November 2012 and 30 April 2013. Based on the viral load results, they were divided into those who achieved Viral Load Suppression (VLS), and those who did not (NVLS). Analyses were done using SAS® (version 9.2) for Microsoft software. A p < 0.05 was considered significant. Results: Ninety patients (91.8%; 95%CI, 84.7% – 95.8%) achieved viral load suppression while eight (8.2%; 95%CI, 4.2% – 15.3%), did not. Of the 98 patients, 63 (64%) were female. In the NVLS group, the female to male ratio was 7:1 (p = 0.038). There was no relationship between viral load suppression and patients’ baseline characteristics, behavioural characteristics and clinical characteristics (p > 0.05). ART adherence reported in both patient groups was ≥ 87.0%. Conclusion: There was good viral load suppression in patients initiated on ART at Pedisong 4 clinic. Patients’ baseline, behavioural and clinical characteristics were not related to viral load suppression, necessitating further large sample size studies in various health facilities.

scholarly journals Deployment and Assessment of a Virtual Coaching Platform to Support Healthy Habits and Whole Health for Vulnerable People Living with HIV

Iproceedings ◽  
10.2196/15069 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e15069
Author(s):  
Ezzat Saad ◽  
Claire Kamoun
Keyword(s):  
Physical Activity ◽  
Viral Load ◽  
Digital Health ◽  
Case Managers ◽  
People Living With Hiv ◽  
Evidence Based ◽  
Health Technologies ◽  
Healthy Habits ◽  
Vulnerable People ◽  
Living With Hiv

Background Office of Health and Human Services of Rhode Island (0HHS-RI) provides care to the most vulnerable people in the state living with HIV. While most of their clients achieve viral load suppression, the majority of these individuals still lack the support they need to tackle mental health issues, manage comorbidities, be physically active, and address other social determinants of Health. Digital health technologies have demonstrated value to provide this support and help people manage whole health. Digital platforms can deliver tailored health interventions and improved outcomes for people with HIV. However, this vulnerable population most in need of that support lacks access to current technology and platforms designed to meet their particular needs. Objective The objective wo design, deploy, and assess an evidence-based digital health platform to support healthy habits and improve outcomes for the target population, TAVIE Red. The platform is the product of two years of patient-centered iterative design and built upon theories of behavioral medicine. The core technology is a clinically-validated virtual nurse app that delivers tailored education to users. On the patient app, clients self-manage health (eg, monitor symptoms and receive treatment reminders), access social services (eg, locate food banks and clinics) and receive evidence-based interventions to promote mental and physical health (eg, decrease stress and increase physical activity). Users receive personalized feedback and rewards that incentivize and engage during each phase of treatment. On the professional portal, case managers can monitor clients remotely, receive actionable insights, and intervene appropriately. Administrators access real-time analytics on health status and delivery of services through a set of customizable dashboards. Methods Eligible clients received an Android phone preloaded with the app. Case managers received access to the professional platform on a desktop and in some cases, tablet devices to use the app in the field. Three generations of the platform were deployed over a two-year period. Participants completed a survey at baseline and follow-up on paper and digitally through the app. Thus far, 200 people living with HIV have participated in this program along with their case managers. Results Two years into the project, users are engaged with the app, enjoying it, and benefiting from it. Seventy-seven percent of users actively engage with the app, earning points and progressing through the coaching sessions with 67% completing self-assessments through the app and most track measures including physical activity, symptoms, and CD4 count and viral load. There was a 5% increase in viral suppression in this population over two years. Eighty-eight percent of users recommend the app to others. Conclusions To date, the TAVIE platform is an engaging appealing platform. Users remain on the app over time and report great benefits of use. Formal evaluation of outcomes ongoing.

Foundations for Living: Evaluation of an Integrated Employment and Housing Program for People Living With HIV

2020 ◽  
pp. 003435522096217
Author(s):  
Yung-Chen Jen Chiu ◽  
Liza M. Conyers ◽  
SunHee J. Eissenstat ◽  
Mark Misrok
Keyword(s):  
Viral Load ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Structural Barriers ◽  
Viral Load Suppression ◽  
Housing Program ◽  
Complex Needs ◽  
Integrated Employment ◽  
Living With Hiv

Unstable housing and unemployment have been identified as major structural barriers to optimal HIV treatment outcomes among people living with HIV (PLWH). One solution is to provide integrated services that combine medical, employment, housing, and other psychosocial services to address the complex needs of PLWH. This program evaluation reports outcomes of the Foundations for Living program: an integrated employment and housing services program designed for PLWH. Employment and housing outcomes of participants who completed at least one 6-month reassessment were reported by frequency analysis. HIV immune health (CD4 count and viral load) are examined using a matched paired t test. HIV prevention outcomes were assessed by examining changes in the percent of participants with an undetectable viral load. Our findings indicate that among the participants who completed reassessments, 44.8% gained or maintained employment, 86.2% achieved viral load suppression, 75.9% achieved undetectable at the final reassessment. There was no statistical difference between the mean of CD4 count and viral load reported at intake and those reported during the final reassessment. Over half of the participants experienced unstable employment during the program, indicating that significant barriers to employment remain for this population. Implications for rehabilitation counseling practice and research are discussed.

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