scholarly journals Effect of the US National HIV/AIDS Strategy targets for improved HIV care engagement: a modelling study

2016 ◽  
Vol 3 (3) ◽  
pp. e140-e146 ◽  
Author(s):  
Maunank Shah ◽  
Allison Perry ◽  
Kathryn Risher ◽  
Sunaina Kapoor ◽  
Jeremy Grey ◽  
...  
Keyword(s):  
Hiv Care ◽  
The Us ◽  
Hiv Care Engagement ◽  
Modelling Study ◽  
Hiv Aids

scholarly journals 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

2014 ◽  
Vol 60 (1) ◽  
pp. 117-125 ◽  
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

scholarly journals Mental health in 2020 for men who have sex with men in the United States

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 59 ◽  
Author(s):  
Abigail W. Batchelder ◽  
Steven Safren ◽  
Avery D. Mitchell ◽  
Ivan Ivardic ◽  
Conall O'Cleirigh
Keyword(s):  
Mental Health ◽  
Hiv Prevention ◽  
The United States ◽  
Hiv Care ◽  
Hiv Care Cascade ◽  
Age Related ◽  
The Us ◽  
Prevention And Treatment ◽  
Sex With Men ◽  
Hiv Aids

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. Moreover, racial disparities exist among MSM in the US; for example, young African American MSM bear a disproportionate burden of the continuing HIV epidemic, likely related to disparate HIV prevalence in partner pools as well as long-standing structural inequities. In this review, the mental health challenges facing MSM primarily in the US, related to HIV and STI prevention and across the HIV care cascade, including HIV diagnosis, engagement and retention in care, and antiretroviral adherence, are illustrated. Disparities among MSM including racial and ethnic, age-related and structural barriers associated with HIV prevention and treatment, as well as current interventions, are also described. Moving forward towards 2020, resources will be needed to assess and implement scalable intervention strategies to address psychological and social barriers to HIV and STI risk reduction and treatment for MSM, with a particular focus on the most vulnerable subpopulations. As access to prevention and treatment strategies expand, and new breakthroughs continue to emerge, behavioural strategies will continue to be needed to reduce risk and increase uptake and engagement among MSM most at risk through 2020 and beyond.

scholarly journals Repeat Western Blot Testing After Receiving an HIV Diagnosis and Its Association with Engagement in Care

2012 ◽  
Vol 6 (1) ◽  
pp. 196-204 ◽  
Author(s):  
Wayne A Duffus ◽  
Kristina W Kintziger ◽  
James D Heffelfinger ◽  
Kevin P Delaney ◽  
Terri Stephens ◽  
...  
Keyword(s):  
South Carolina ◽  
Western Blot ◽  
Surveillance System ◽  
Linear Models ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Confirmatory Testing ◽  
Hiv Care Engagement ◽  
Western Blot Testing ◽  
Hiv Aids

Objectives: To examine the prevalence of and factors associated with potentially unnecessary repeat confirmatory testing after initial HIV diagnosis and the relationship of repeat testing to medical care engagement. Design: South Carolina HIV/AIDS surveillance data for 12,504 individuals who were newly diagnosed with HIV infection between January 1997 and December 2008 were used for this analysis. State law requires that all positive Western blot [WB] results be reported regardless of frequency. Methods: HIV-infected persons, diagnosed from 1997-2008 and followed through 2009, with repeat positive WB results were compared to those who did not have repeat positive WB results. We defined repeat positive testing as documentation of one or more positive WB obtained ≥90 days following initial WB confirmatory result. HIV care engagement for the period from 2007-2009 was assessed by documentation of CD4+ T-cell/viral load reports to the South Carolina HIV/AIDS surveillance system during each six-month period of a calendar year for those individuals diagnosed prior to the assessment period and still alive at the end. Relative risk [RR] with 95% confidence intervals [CI] and multivariable general linear models were used to assess if any covariates of interest were independently associated with repeat positive confirmatory testing. Results:A total of 4,237 [34%] of 12,504 HIV-infected individuals had results of repeat positive WB testing reported to the surveillance system during 1997-2008. Persons who had repeat positive WB testing were more likely than persons who did not have repeat WB testing to have progressed to AIDS >1 year following diagnosis [RR: 1.70; 95% CI: 1.61, 1.80] and to be consistently in care [RR: 1.35; 95% CI: 1.24, 1.47] or have sporadic care [RR: 1.80; 95% CI: 1.68, 1.94]. Discussion:Having repeat positive WB tests may be a marker of engaging HIV care. However, given the limited resources available for care, it is important that healthcare reform policy and clinical recommendations promote improvements in communications about previous test results.

scholarly journals Effects of transition on HIV and non-HIV services and health systems in Kenya: a mixed methods evaluation of donor transition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniela C. Rodríguez ◽  
Diwakar Mohan ◽  
Caroline Mackenzie ◽  
Jess Wilhelm ◽  
Ezinne Eze-Ajoku ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Service Delivery ◽  
Health Systems ◽  
Local Level ◽  
Health Facilities ◽  
Government Support ◽  
Hiv Care ◽  
Local Context ◽  
Mixed Methods Evaluation ◽  
The Us

Abstract Background In 2015 the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiated its Geographic Prioritization (GP) process whereby it prioritized high burden areas within countries, with the goal of more rapidly achieving the UNAIDS 90–90-90 targets. In Kenya, PEPFAR designated over 400 health facilities in Northeastern Kenya to be transitioned to government support (known as central support (CS)). Methods We conducted a mixed methods evaluation exploring the effect of GP on health systems, and HIV and non-HIV service delivery in CS facilities. Quantitative data from a facility survey and health service delivery data were gathered and combined with data from two rounds of interviews and focus group discussions (FGDs) conducted at national and sub-national level to document the design and implementation of GP. The survey included 230 health facilities across 10 counties, and 59 interviews and 22 FGDs were conducted with government officials, health facility providers, patients, and civil society. Results We found that PEPFAR moved quickly from announcing the GP to implementation. Despite extensive conversations between the US government and the Government of Kenya, there was little consultation with sub-national actors even though the country had recently undergone a major devolution process. Survey and qualitative data identified a number of effects from GP, including discontinuation of certain services, declines in quality and access to HIV care, loss of training and financial incentives for health workers, and disruption of laboratory testing. Despite these reports, service coverage had not been greatly affected; however, clinician strikes in the post-transition period were potential confounders. Conclusions This study found similar effects to earlier research on transition and provides additional insights about internal country transitions, particularly in decentralized contexts. Aside from a need for longer planning periods and better communication and coordination, we raise concerns about transitions driven by epidemiological criteria without adaptation to the local context and their implication for priority-setting and HIV investments at the local level.

National estimates of case‐mix, mortality, and economic outcomes among inpatient HIV/AIDS mono‐infection and hepatitis C co‐infection cases in the US

2018 ◽  
Vol 25 (5) ◽  
pp. 806-821
Author(s):  
Timothy Pham ◽  
R. Chris Rathbun ◽  
Shellie Keast ◽  
Nancy Nesser ◽  
Kevin Farmer ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Economic Outcomes ◽  
Case Mix ◽  
The Us ◽  
National Estimates ◽  
Hiv Aids

scholarly journals Association between Compliance Level on Fixed-Dose Combination Antiretroviral Drug and CD4 Level among HIV Patients

2020 ◽  
Author(s):  
Fadhil Ilham Mustafa ◽  
◽  
Nurfitri Bustamam ◽  
Andri Pramesyanti ◽  
◽  
...  
Keyword(s):  
Significant Relationship ◽  
Fixed Dose Combination ◽  
Hiv Care ◽  
Fixed Dose ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Drug Induced ◽  
Cross Sectional ◽  
Dose Combination ◽  
Hiv Aids

Background: People living with HIV / AIDS (PLWHA) have weak immune systems and are prone to infection. Therefore, PLWHA must take antiretroviral (ARV) to maintain their immunity. This study aimed to determine the relationship between the level of adherence to taking ARV fixed-dose combination (FDC) drugs and CD4 levels of HIV patients. Subjects and Method: This was a cross-sectional study conducted at Pengayoman Cipinang Hospital, Indonesia, in 2018. Total of 91 HIV patient over 17 years of age, had or had received FDC ARV therapy for at least 1 year, and did not experience drug-induced hepatitis were enrolled in this study. The dependent variable was CD4 level. The independent variable was level of adherence to taking ARV fixed-dose combination (FDC). The data were taken from the Voluntary Counseling and Testing Poli Pengayoman Cipinang Hospital. This study used secondary data from the Overview of HIV Care and ARV Therapy. The data were analyzed using Chi-square. Results: A total of 65.93% HIV patients had a good level of medication adherence and 79.12% had an increase of CD4 levels. There was a significant relationship between adherence to taking FDC ARV drugs and CD4 levels (OR = 6.50; 95% CI = 2.15 to 19.62; p<0.001), and it was statistically significant. Conclusion: There is a significant relationship between the level of adherence to taking FDC ARV drugs and CD4 levels. Therefore, patients must receive education and support to improve adherence to taking ARV drugs. Keywords: antiretroviral, CD4, fixed-dose combination, adherence to taking medication, people with HIV / AIDS Correspondence: Fadhil Ilham Mustafa. Faculty of Medicine, Universitas Pembangunan Nasional Veteran, Jakarta. Jl. RS Fatmawati, Pondok Labu, South Jakarta. Email: [email protected]. Mobile: 081283681755. DOI: https://doi.org/10.26911/the7thicph.02.03

scholarly journals “Part of Getting to Where We Are is Because We Have Been Open to Change”Integrating Community Health Workers on Care Teams at Ten Ryan White HIV/AIDS Program Recipient Sites

2021 ◽  
Author(s):  
Linda Sprague Martinez ◽  
Melissa Davoust ◽  
Serena Rajabiun ◽  
Allyson Baughman ◽  
Sara Bachman ◽  
...  
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Care Delivery ◽  
Implementation Strategies ◽  
Hiv Care ◽  
Organizational Policies ◽  
Ryan White ◽  
Aids Program ◽  
Group Interviews ◽  
Hiv Aids

Abstract Background: Community Health Workers (CHWs) have long been integrated in the delivery of HIV care, in middle- and low-income countries. However, less is known about CHW integration into HIV care teams in the United States (US). To date, US based CHW integration studies have studies explored integration in the context of primary care and patient-centered medical homes.There is a need for research related to strategies that promote the successful integration of CHWs into HIV care delivery systems. In 2016, the Health Resources and Services Administration HIV/AIDS Bureau launched a three-year initiative to provide training, technical assistance and evaluation for Ryan White HIV/AIDS Program (RWHAP) recipient sites to integrate CHWs into their multidisciplinary care teams, and in turn strengthen their capacity to reach communities of color and reduce HIV inequities. Methods: Ten RWHAP sites were selected from across eight states. The multi-site program evaluation included a process evaluation guided by RE-AIM to understand how the organizations integrated CHWs into their care teams. Site team members participated in group interviews to walk-the-process during early implementation and following the program period. Directed content analysis was employed to examine program implementation. Codes developed using implementation strategies outlined in the Expert Recommendations for Implementing Change project were applied to group interviews (n=20). Findings: Implementation strategies most frequently described by sites were associated with organizational-level adaptations in order to integrate the CHW into the HIV care team. These included revising, defining, and differentiating professional roles and changing organizational policies. Strategies used for implementation, such as network weaving, supervision, and promoting adaptability, were second most commonly cited strategies, followed by training and TA strategies. Conclusions: Wrapped up in the implementation experience of the sites there were some underlying issues that pose challenges for health care organizations. Organizational policies and the ability to adapt proved significant in facilitating CHW implementation. The integration of the CHW role may present an occasion for health care delivery organizations to reassess policies that may unintentionally marginalize communities and both limit career opportunities and patient engagement.

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