Universal access to DAA therapy paves the way for HCV control and elimination among people living with HIV in Australia

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). We identified that about one quarter of the 8,628 HIV-positive people estimated to live in Estonia in 2013 had not been diagnosed with HIV, and another quarter, although aware of their HIV-positive serostatus, had not accessed HIV medical care. Although altogether only 12–15% of all PLHIV in Estonia had achieved viral suppression, the main gap in HIV care in Estonia were the 58% of PLHIV who had accessed HIV medical care at least once after diagnosis but were not retained in care in 2013.

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Delayed Treatment for People Living with HIV in China, 2004–2016: An Analysis of An Observational Cohort

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051809 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1809

Author(s):

Junfang Xu ◽

Anders Sönnerborg ◽

Liangmin Gao ◽

Peicheng Wang ◽

Jennifer Z.H. Bouey ◽

...

Keyword(s):

Risk Factors ◽

Universal Access ◽

Binary Logistic Regression ◽

Lag Time ◽

Cd4 Count ◽

People Living With Hiv ◽

Hiv Diagnosis ◽

Delayed Initiation ◽

Living With Hiv ◽

Late Testing

Early universal access to antiretroviral treatment (ART) is critical in the control of the HIV epidemic. However, prompt initiation of ART remains problematic in China. This study analyzed the late testing and lag time between HIV diagnosis and initiation of ART from 2004 to 2016 and identified the risk factors for delayed initiation of ART. Data from 16,957 people living with HIV were abstracted from a hospital electronic health record database and a case report database for AIDS prevention and control in Yunnan province. Reasons for delayed initiation of ART were categorized into late testing, defined as CD4 count of < 350 cells/μL at baseline HIV diagnosis, and delayed access, defined as a lag time of > 1 month between the diagnosis and initiation of ART. Binary logistic regression models were used to identify risk factors for late testing and delayed access. The CD4 counts at diagnosis increased from 201 ± 147 cells/μL (mean ± SD) in 2004 to 324 ± 238 cells/μL in 2016 (p = 0.024). The CD4 count was higher for persons < 45 years, unmarried, and men who have sex with men (MSM) (356, 357, and 409 cells/μL, respectively) compared to their peers in 2016 (p < 0.05). The lag time from diagnosis to initiation of ART was significantly reduced from 59.2 months in 2004 to 0.9 months in 2016 (p < 0.05). The shorter lag time over the years was consistent when analysis was stratified by sex, age, marital status, and transmission routes, even though the lag time for people using drugs was longest in 2016 (> 2 months versus 0.82 and 0.72 month of heterosexuals and MSM, respectively). Compared to their peers, married persons (AOR = 0.63, 95%CI: 0.57, 0.69) were less likely to have delayed access to ART, and drugs-using patients (AOR = 3.58, 95%CI: 2.95,4.33) were more likely to have delayed access to ART. Late testing rather than delayed access to ART after a diagnosis remains problematic in China, although improvements have been seen for both parameters from 2004 to 2016. Our data highlight the importance of continued efforts to promote early diagnosis of HIV to prevent transmission, morbidity, and early mortality in HIV infection.

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Current status of HIV treatment in Asia and the Pacific region

Sexual Health ◽

10.1071/sh13045 ◽

2014 ◽

Vol 11 (2) ◽

pp. 119 ◽

Cited By ~ 5

Author(s):

Angsana Phuphuakrat ◽

Sasisopin Kiertiburanakul ◽

Somnuek Sungkanuparph

Keyword(s):

Low Income ◽

Universal Access ◽

Scale Up ◽

Hiv Treatment ◽

High Income ◽

Low Income Countries ◽

Current Status ◽

People Living With Hiv ◽

The Pacific ◽

Living With Hiv

Asia and the Pacific represent a diverse group of nations facing HIV epidemic profiles of differing severity. Compared to other parts of the world, the burden of HIV disease is high in this region because of its large populations. At the end of 2011, 5 million people were living with HIV in Asia and the Pacific. This accounted for 15% of people living with HIV worldwide. The prevalence of people living with HIV, as well as access to HIV treatment and care, varies widely between countries. Differences between high-income economies and the rest of the continent are remarkable. Many high-income countries provide antiretroviral therapy (ART) to their citizens. Middle- and low-income countries have rapid ART scale-up and are dependent on international funding. This may compromise the sustainability of ART availability. In addition, lack of access to second- and third-line therapy remains a problem in many countries. The global goal of achieving universal access to ART by 2015 requires mainly low- and middle-income countries to be targeted. Regional policy should be developed in order to identify new infections in key populations, to start earlier treatment, to retain patients in care and to maintain funding.

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Juridical Action for the Protection of Collective Rights and Its Legal Impact: A Case Study

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2002.tb00432.x ◽

2002 ◽

Vol 30 (4) ◽

pp. 644-654 ◽

Cited By ~ 1

Author(s):

Enrique González Mac Dowell

Keyword(s):

Human Rights ◽

Universal Access ◽

Antiretroviral Drugs ◽

Hiv And Aids ◽

New Drugs ◽

People Living With Hiv ◽

Access To Treatment ◽

Human Rights Advocacy ◽

Legal Strategies ◽

Living With Hiv

The development in 1996 of a new generation of antiretroviral drugs was a major pharmaceutical advancement in the struggle against the epidemics of HIV and AIDS. However, due to high costs, access to these new drugs was almost impossible for most people living with HIV or AIDS. This situatiowhas been even more dramatic for those living with HIV/AIDS in poorer countries. Many of the organizations that are fighting for the rights of those with HIV have since developed human rights advocacy and legal strategies to try to achieve universal access to treatment. These organizations are also fighting for states’ compliance with human rights obligations under health-related treatises and conventions. This paper draws upon the experience gained in Latin America, focusing on the legal strategies that have been explored in Venezuela and the legal consequences for domestic law.

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The “Right to Know” or “Know Your Rights”?

When People Come First ◽

10.23943/princeton/9780691157382.003.0005 ◽

2013 ◽

Author(s):

Joseph J. Amon

Keyword(s):

Human Rights ◽

Universal Access ◽

People Living With Hiv ◽

Right To Know ◽

Global Organizations ◽

Human Rights Abuses ◽

Grassroots Groups ◽

The Right To Know ◽

The Right ◽

Living With Hiv

Human rights abuses fuel vulnerability to HIV infection and act as barriers to universal access to prevention, treatment, and care. This has been recognized in numerous international declarations, and attention to human rights has been incorporated into the mission statements and work plans of grassroots groups and global organizations alike. Yet how recognition of this relationship is translated into action varies. This explores different contexts in which the claim of one particular right, the “right to know,” has emerged, and how this claim relates to the experience of people living with HIV. The “right to know,” defined variously and used to advance competing and controversial agendas, is then contrasted with efforts encouraging individuals to “know their rights.”

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Kaposi’s Sarcoma in Virally Suppressed People Living with HIV: An Emerging Condition

Cancers ◽

10.3390/cancers13225702 ◽

2021 ◽

Vol 13 (22) ◽

pp. 5702

Author(s):

Romain Palich ◽

Alain Makinson ◽

Marianne Veyri ◽

Amélie Guihot ◽

Marc-Antoine Valantin ◽

...

Keyword(s):

Kaposi's Sarcoma ◽

Universal Access ◽

Case Series ◽

Kaposi’S Sarcoma ◽

People Living With Hiv ◽

Short Term ◽

Hiv Replication ◽

Dead End ◽

Living With Hiv ◽

New Strategies

Since the advent of highly effective combined antiretroviral treatment (cART), and with the implementation of large HIV testing programs and universal access to cART, the burden of AIDS-related comorbidities has dramatically decreased over time. The incidence of Kaposi’s sarcoma (SK), strongly associated with HIV replication and CD4 immunosuppression, was greatly reduced. However, KS remains the most common cancer in patients living with HIV (PLHIV). HIV physicians are increasingly faced with KS in virally suppressed HIV-patients, as reflected by increasing description of case series. Though SK seem less aggressive than those in PLHIV with uncontrolled HIV-disease, some may require systemic chemotherapy. Persistent lack of specific anti-HHV-8 cellular immunity could be involved in the physiopathology of these KS. These clinical forms are a real therapeutic challenge without possible short-term improvement of anti-HHV-8 immunity, and no active replication of HIV to control. The cumulative toxicity of chemotherapies repeatedly leads to a therapeutic dead end. The introduction or maintenance of protease inhibitors in cART does not seem to have an impact on the evolution of these KS. Research programs in this emerging condition are important to consider new strategies.

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On the way towards zero discrimination; What do people living with HIV think?

Sri Lanka Journal of Venereology ◽

10.4038/sljv.v3i1.5410 ◽

2013 ◽

Vol 3 (1) ◽

pp. 33

Author(s):

MPW Gunathilake ◽

S Samarkoon

Keyword(s):

People Living With Hiv ◽

Living With Hiv ◽

The Way

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“My Friend with HIV Remains a Friend”: HIV/AIDS Stigma Reduction through Education in Secondary Schools—A Pilot Project in Buea, Cameroon

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/2325958219900713 ◽

2020 ◽

Vol 19 ◽

pp. 232595821990071

Author(s):

Christoph Arnim Jacobi ◽

Pascal Nji Atanga ◽

Leonard Kum Bin ◽

Akenji Jean Claude Fru ◽

Gerd Eppel ◽

...

Keyword(s):

Universal Access ◽

Pilot Project ◽

Hiv And Aids ◽

Sub Saharan Africa ◽

People Living With Hiv ◽

School Students ◽

Access To Treatment ◽

Infected People ◽

Living With Hiv ◽

Hiv Aids

The universal access to treatment and care for people living with HIV (PLWHIV) is still a major problem, especially in sub-Saharan Africa, where 70% of HIV-infected people live. Equally important is the fact that HIV/AIDS-related stigma is recognized to be a major obstacle to successfully control the spread of this disease. We devised a pilot project (titled “My friend with HIV remains a friend”) to fight the HIV/AIDS stigmatization through educating secondary school students by openly HIV-positive teachers. In a first step, we have measured the amount and type of stigma felt by the PLWHIV in Buea/Cameroon using the “The people living with HIV Stigma Index” from Joint United Nations Programme on HIV/AIDS. Gossiping and verbal insults were experienced by 90% of the interviewees, while 9% have experienced physical assaults. Using these data and material from the “Toolkit for action” from the “International Centre for the Research on Women,” the teachers educated the students on multiple aspects of HIV/AIDS and stigma. The teaching curriculum included role-plays, picture visualizations, drawing, and other forms of interactions like visits to HIV and AIDS treatment units. Before and after this intervention, the students undertook “True/False” examinations on HIV/AIDS and stigma. We compared these results with results from students from another school, who did not participate in this intervention. We were able to show that the students taking part in the intervention improved by almost 20% points in comparison to the other students. Their results did not change.

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