Violence Screening and Viral Load Suppression Among HIV-Positive Women of Color

Abstract Background In 2015, Namibia implemented an Acceleration Plan to address the high burden of HIV (13.0% adult prevalence and 216 311 people living with HIV [PLHIV]) and achieve the UNAIDS 90-90-90 targets by 2020. We provide an update on Namibia’s overall progress toward achieving these targets and estimate the percent reduction in HIV incidence since 2010. Methods Data sources include the 2013 Namibia Demographic and Health Survey (2013 NDHS), the national electronic patient monitoring system, and laboratory data from the Namibian Institute of Pathology. These sources were used to estimate (1) the percentage of PLHIV who know their HIV status, (2) the percentage of PLHIV on antiretroviral therapy (ART), (3) the percentage of patients on ART with suppressed viral loads, and (4) the percent reduction in HIV incidence. Results In the 2013 NDHS, knowledge of HIV status was higher among HIV-positive women 91.8% (95% confidence interval [CI], 89.4%–93.7%) than HIV-positive men 82.5% (95% CI, 78.1%–86.1%). At the end of 2016, an estimated 88.3% (95% CI, 86.3%–90.1%) of PLHIV knew their status, and 165 939 (76.7%) PLHIV were active on ART. The viral load suppression rate among those on ART was 87%, and it was highest among ≥20-year-olds (90%) and lowest among 15–19-year-olds (68%). HIV incidence has declined by 21% since 2010. Conclusions With 76.7% of PLHIV on ART and 87% of those on ART virally suppressed, Namibia is on track to achieve UNAIDS 90-90-90 targets by 2020. Innovative strategies are needed to improve HIV case identification among men and adherence to ART among youth.

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Observational study of the populations accessing rapid point-of-care HIV testing in Winnipeg, Manitoba, Canada, through a retrospective chart review of site records

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053195 ◽

2017 ◽

Vol 94 (3) ◽

pp. 194-199 ◽

Cited By ~ 4

Author(s):

James Blain Johnston ◽

Joss N Reimer ◽

John L Wylie ◽

Jared Bullard

Keyword(s):

Viral Load ◽

Hiv Testing ◽

Clinical Outcomes ◽

Point Of Care ◽

Age Groups ◽

Linkage To Care ◽

Hiv Positive ◽

Hiv Status ◽

Viral Load Suppression ◽

Hiv Test

ObjectivesHIV point-of-care testing (POCT) has been available in Manitoba since 2008. This study evaluated the effectiveness of POCT at identifying individuals with previously unknown HIV status, its effects on clinical outcomes and the characteristics of the populations reached.MethodsA retrospective database review was conducted for individuals who received HIV POCT from 2011 to 2014. Time to linkage to care and viral load suppression were compared between individuals who tested positive for HIV using POCT and controls identified as positive through standard screening. Testing outcomes for labouring women with undocumented HIV status accessing POCT during labour were also assessed.Results3204 individuals received POCT (1055 females (32.9%) and 2149 males (67.1%)), being the first recorded HIV test for 2205 (68.8%). Males were more likely to be targeted with POCT as their first recorded HIV test (adjusted OR (AOR) 1.40). Between the two main test sites (Main Street Project (MSP) and Nine Circles Community Health Centre), MSP tested relatively fewer males (AOR 0.79) but a higher proportion of members of all age groups over 30 years old (AOR 1.83, 2.51 and 3.64 for age groups 30–39, 40–49 and >50, respectively). There was no difference in time to linkage to care (p=0.345) or viral load suppression (p=0.405) between the POCT and standard screening cohorts. Of 215 women presenting in labour with unknown HIV status, one was identified as HIV positive.ConclusionsPOCT in Manitoba has been successful at identifying individuals with previously unknown HIV-positive status. Demographic differences between the two main testing sites support that this intervention is reaching unique populations. Given that we observed no significant difference in time to clinical outcomes, it is reasonable to continue using POCT as a targeted intervention.MeSH termsHIV infection; rapid HIV testing; vertical infectious disease transmission; community outreach; service delivery; marginalised populations.

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Unintended Repeat Pregnancies Among HIV Positive Women in Rio De Janeiro, Brazil

The Open AIDS Journal ◽

10.2174/1874613601812010174 ◽

2018 ◽

Vol 12 (1) ◽

pp. 174-180

Author(s):

Bernardo B. Wittlin ◽

Alice W. Carvalho ◽

Giulia P. Lima ◽

Rune Andersson ◽

Susanne Johansson ◽

...

Keyword(s):

Viral Load ◽

Family Planning ◽

Antenatal Care ◽

Unintended Pregnancy ◽

Rio De Janeiro ◽

Hiv Positive ◽

Continuous Family ◽

Unintended Pregnancies ◽

Illegal Abortion ◽

Hiv Positive Women

Introduction: High rates of unintended pregnancies among HIV positive women have been reported by several studies. Among repeated pregnancies, these rates may be higher. Our aim was to describe the unintended pregnancy rate in repeat gestations of the same group of HIV-positive women. Methodology: From a prospective cohort of HIV-infected pregnant women followed-up from 1995 to 2013 in an Antenatal Clinic (ANC) in Rio de Janeiro, we selected women who had at least two consecutive pregnancies. Patient data were prospectively obtained from standardized questionnaires. The main dependent variable was if the pregnancy was intended or unintended. Some of the other variables were: age, the interval between pregnancies, household income, CD4 cells count at admission in the ANC and at delivery, viral load<1000 copies/ml at admission and close to delivery, and attempts to illegal abortion. Results: From a total of 287 women included, the number of unintended pregnancies increased from 138 (63.6%) at first pregnancy to 198 (81.8%) at second pregnancy (p < 0.01). At first pregnancy, we observed 8 women who had made an attempt to illegal abortion (7 with an unintended pregnancy and 1 with a wanted pregnancy, p = 0.06), while at second pregnancy, 34 of them had made an attempt (33 with unintended pregnancy and 1 with a wanted pregnancy, p < 0.01). Regarding viral load suppression close to delivery, there was no statistic difference between first and second pregnancies (72,7% vs. 70,5%, p = 0.36) as well as between intended and unintended pregnancies (in first pregnancy: 80% vs. 86%, p = 0.4; in second pregnancy: 72% vs. 83%, p = 0,1). Conclusion: High rates of unintended pregnancies and illegal abortion attempts, along with their increase from one pregnancy to the subsequent, reinforce the need for continuous family planning practices in HIV-infected patients. The majority of the women were able to reach undetectable viral load at the end of the pregnancy, including those with unintended pregnancies. Implications: HIV infected patients presenting in antenatal care for sequential unintended pregnancies. Despite the fact that abortion is illegal in this country, a substantial number of women, still attempt it before attending antenatal care. Family planning actions should be performed during the antenatal care.

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Clinical profile and viral load suppression among HIV positive adolescents attending a tertiary hospital in North Central Nigeria

Journal of Medicine in the Tropics ◽

10.4103/jomt.jomt_13_20 ◽

2020 ◽

Vol 22 (2) ◽

pp. 133

Author(s):

EstherS Yiltok ◽

CordeliaY Agada ◽

Ruth Zoakah ◽

AwengG Malau ◽

DoohA Tanyishi ◽

...

Keyword(s):

Viral Load ◽

Tertiary Hospital ◽

Clinical Profile ◽

Hiv Positive ◽

Viral Load Suppression ◽

North Central

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Associations between drug use patterns and viral load suppression among HIV-positive individuals who use support services in New York City

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2018.12.015 ◽

2019 ◽

Vol 197 ◽

pp. 15-21 ◽

Cited By ~ 7

Author(s):

Matthew B. Feldman ◽

Kelsey L. Kepler ◽

Mary K. Irvine ◽

Jacinthe A. Thomas

Keyword(s):

New York ◽

New York City ◽

Viral Load ◽

Drug Use ◽

Support Services ◽

York City ◽

Hiv Positive ◽

Viral Load Suppression ◽

Use Patterns ◽

Drug Use Patterns

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Impact of Age and Prior Care on Barriers to Engagement in HIV Care for HIV Positive Women of Color

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2013.10.063 ◽

2014 ◽

Vol 54 (2) ◽

pp. S24-S25

Author(s):

Jeffrey M. Birnbaum ◽

Elizabeth A. Eastwood ◽

Jennifer E. Lee

Keyword(s):

Women Of Color ◽

Hiv Care ◽

Hiv Positive ◽

Hiv Positive Women ◽

Engagement In Hiv Care

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Predictors of undetectable HIV plasma viral load in 250 HIV-positive women receiving care

AIDS ◽

10.1097/00002030-199815000-00021 ◽

1998 ◽

Vol 12 (15) ◽

pp. 2075-2076 ◽

Cited By ~ 5

Author(s):

B P. Dickinson ◽

J A. Mitty ◽

E Mylonakis ◽

J D. Rich ◽

N A. Merriman ◽

...

Keyword(s):

Viral Load ◽

Plasma Viral Load ◽

Hiv Positive ◽

Hiv Positive Women

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What gaps remain in the HIV cascade of care? Results of a population-based survey in Nsanje District, Malawi

PLoS ONE ◽

10.1371/journal.pone.0248410 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0248410

Author(s):

Nolwenn Conan ◽

Cyrus P. Paye ◽

Reinaldo Ortuno ◽

Alexander Chijuwa ◽

Brown Chiwandira ◽

...

Keyword(s):

Young Adults ◽

Viral Load ◽

Health Facility ◽

Population Based ◽

Hiv Care ◽

Hiv Positive ◽

Viral Load Suppression ◽

Hiv Rna ◽

Hiv Test ◽

Cascade Of Care

Introduction The Malawi Ministry of Health (MoH) has been in collaboration with Médecins sans Frontières (MSF) to increase access to quality HIV care through decentralization of antiretroviral therapy (ART) diagnosis and treatment from hospital to clinics in Nsanje District since 2011. A population-based household survey was implemented to provide information on HIV prevalence and cascade of care to inform and prioritize community-based HIV interventions in the district. Methods A cross-sectional survey was conducted between September 2016 and January 2017. Using two-stage cluster sampling, eligible adult individuals aged ≥15 years living in the selected households were asked to participate. Participants were interviewed and tested for HIV at home. Those tested HIV-positive had their HIV-RNA viral load (VL) measured, regardless of their ART status. All participants tested HIV-positive at the time of the survey were advised to report their HIV test result to the health facility of their choice that MSF was supported in the district. HIV-RNA VL results were made available in this health facility. Results Among 5,315 eligible individuals, 91.1% were included in the survey and accepted an HIV test. The overall prevalence was 12.1% (95% Confidence Interval (CI): 11.2–13.0) and was higher in women than in men: 14.0% versus 9.5%, P<0.001. Overall HIV-positive status awareness was 80.0% (95%CI: 76.4–83.1) and was associated with sex (P<0.05). Linkage to care was 78.0% (95%CI: 74.3–81.2) and participants in care 76.2% (95%CI: 72.4–79.5). ART coverage among participants aware of their HIV-positive status was 95.3% (95%CI: 92.9–96.9) and was not associated with sex (P = 0.55). Viral load suppression among participants on ART was 89.9% (95%CI: 86.6–92.4) and was not statistically different by sex (p = 0.40). Conclusions Despite encouraging results in HIV testing coverage, cascade of care, and UNAIDS targets in Nsanje District, some gap remains in the first 90, specifically among men and young adults. Enhanced community engagement and new strategies of testing, such as index testing, could be implemented to identify those who are still undiagnosed, particularly men and young adults.

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A Retrospective Study of the Management of HIV, Hepatitis B and Hepatitis C-Positive Pregnancies in Edinburgh, UK from 1997-2002.

McGill Journal of Medicine ◽

10.26443/mjm.v7i2.820 ◽

2004 ◽

Vol 7 (2) ◽

Author(s):

Wendy Russell

Keyword(s):

Viral Load ◽

Management Practices ◽

Tracking System ◽

Undetectable Viral Load ◽

Hiv Positive ◽

Hiv Therapy ◽

Hiv Positive Women ◽

Valid Data ◽

Study Child ◽

Intrapartum Management

STUDY AIMS: This study aims to examine management practices for HIV-positive, HBV-positive and HCV-positive pregnancies over 1997-2002 in Edinburgh, UK, and the effects the diseases have on pregnancy outcomes. RESULTS: Equally for HIV, HBV, and HCV, 50% of the diagnoses were made before pregnancy while the other 50% were detected and diagnosed through antenatal testing. Of the 17 HBV-positive pregnancies 31.6% of the women were highly infectious at delivery and 57.9% were carriers with low infectivity. Of the 17 HIV-positive pregnancies 47.1% of the women had an undetectable viral load and 17.6% were unrecorded at delivery. All 17 HIV-positive pregnancies received ART in varying regimes, 15 (88.2%) were on combination therapy, one delivered vaginally and no women breastfed. All neonates of HBV-positive mothers received immunoglobulin and vaccination and were then breastfed. There were no specific interventions for HCV. Only one study child out of the 38 pregnancies became infected, and this was with HIV. CONCLUSION: Routine screening identifies women with no obvious risk factors, and interventions are largely accepted and effective at reducing vertical transmission. HIV therapy is individually tailored and increasingly uses several agents. Moreover, there is a movement towards allowing low viral load HIV-positive women to deliver vaginally. There are no interventions recommended for HCV infectivity alone. The difficulty collecting information illustrates that no adequate tracking system of infected pregnant women exists. Recommended is the creation of a formal database that includes standardized information such as the viral load of HIV or HCV at delivery, so that outcomes of intrapartum management can be more effectively assessed. No comment can be made on virus-related pregnancy complications, as study numbers are too small for statistically valid data.

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