scholarly journals HIV incidence fall in Italy: a –20% fall in 2018 to be explained

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Salvati ◽  
R Croci ◽  
A Odone ◽  
C Signorelli
Keyword(s):  
At Risk ◽  
Viral Suppression ◽  
Preventive Measures ◽  
European Countries ◽  
Hiv Care ◽  
Hiv Incidence ◽  
Screening Programs ◽  
At Risk Populations ◽  
Incident Cases ◽  
Hiv Aids

Abstract Background HIV is still a critical public health threat in Europe, especially in some at-risk populations. Stigma keeps undermining access to prevention, diagnosis, and care. Treatment as Prevention (TasP) and Pre-Exposure Prophylaxis (PrEP) have spread heterogeneously across the continent. The study aimed to compare recent HIV incidence trends in five European countries (Italy, Spain, Germany, France, UK), and to speculate about TasP and PrEP's relative contribution as preventive measures in Italy. Methods We collected incidence data by consulting the ECDC HIV/AIDS Surveillance Report 2019, and a preliminary Italian 2019 report issued by the National Institute of Health. We used the latest ECDC Continuum of HIV care data to appraise European trends in HIV viral suppression. Results All the considered European countries reported a decreasing trend in 2018, compared to 2017. In Italy, according to raw preliminary data, the number of new HIV infections dropped from 3,561 (5.9/100,000) to 2,847 (4.7/100,000), thus resulting in a -20% fall. Interestingly, Spain shows an even sharper decrease of -22%, dropping from 3,795 new cases in 2017 to 2,527 in 2018, that is from a rate of 8.2/100,000 to 6.4/100,000. Conclusions Since 2008, when the coordinated ECDC/WHO Regional Office for Europe HIV/AIDS surveillance system was set up, Italy has never witnessed such a sharp yearly fall in incident cases, thus representing, together with Spain, an epidemiological peculiarity in the European context. TasP could have played a major role in Italy. Indeed, Continuum of HIV care data show a positive trend in viral suppression in European countries. PrEP has been introduced in the Italian guidelines in 2016 and is nowadays adopted in a few urban areas, as a co-pay, on-demand service for high-risk populations with limited diffusion. It is thus plausible that PrEP carries a much lower epidemiologic weight in the Italian 2018 incidence reduction. Key messages We need to spread PrEP, TasP and screening programs, especially in at-risk populations. We must search for a causal association between preventive measures and decreasing incidence.

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 HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project

2019 ◽  
Vol 17 (1) ◽  
pp. 171
Author(s):  
Hanna B. Demeke ◽  
Qingwei Luo ◽  
Ruth E. Luna-Gierke ◽  
Mabel Padilla ◽  
Gladys Girona-Lozada ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
Medical Monitoring ◽  
Place Of Birth ◽  
Sustained Viral Suppression ◽  
Medical Monitoring Project ◽  
Hiv Aids

Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes between mainland US-born (referent group), Puerto Rican (PR-born), and those born outside the United States (non-US-born). We reported weighted percentages of characteristics and used logistic regression with predicted marginal means to examine differences between groups (p < 0.05). PR-born Hispanics/Latinos were more likely to be prescribed antiretroviral therapy (ART) (94%) and retained in care (94%) than mainland-US-born (79% and 77%, respectively) and non-US-born (91% and 87%, respectively) Hispanics/Latinos. PR-born Hispanics/Latinos were more likely to have sustained viral suppression (75%) than mainland-US-born Hispanics/Latinos (57%). Non-US-born Hispanics/Latinos were more likely to be prescribed ART (91% vs. 79%), retained in care (87% vs. 77%), and have sustained viral suppression (74% vs. 57%) than mainland-US-born Hispanics/Latinos. Greater Ryan White HIV/AIDS-funded facility usage among PR-born, better mental health among non-US-born, and less drug use among PR-born and non-US-born Hispanics/Latinos may have contributed to better HIV outcomes. Expanding programs with comprehensive HIV/AIDS services, including for mental health and substance use, may reduce HIV outcome disparities among Hispanics/Latinos.

scholarly journals HIV Care Visits and Time to Viral Suppression, 19 U.S. Jurisdictions, and Implications for Treatment, Prevention and the National HIV/AIDS Strategy

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e84318 ◽  
Author(s):  
H. Irene Hall ◽  
Tian Tang ◽  
Andrew O. Westfall ◽  
Michael J. Mugavero
Keyword(s):  
Viral Suppression ◽  
Hiv Care ◽  
Hiv Aids

scholarly journals Understanding Community-based HIV/AIDS Service Organizations: An Invaluable Source of HPV-related Cancer Information for At-risk Populations

2020 ◽  
Vol 25 (1) ◽  
pp. 23-32
Author(s):  
Lisa T. Wigfall ◽  
Patricia Goodson ◽  
George B. Cunningham ◽  
Idethia S. Harvey ◽  
Tamika D. Gilreath ◽  
...  
Keyword(s):  
At Risk ◽  
Service Organizations ◽  
Cancer Information ◽  
Community Based ◽  
At Risk Populations ◽  
Hiv Aids

scholarly journals Influence of Jail Incarceration and Homelessness Patterns on Engagement in HIV Care and HIV Viral Suppression among New York City Adults Living with HIV/AIDS

PLoS ONE ◽  
2015 ◽  
Vol 10 (11) ◽  
pp. e0141912 ◽  
Author(s):  
Sungwoo Lim ◽  
Denis Nash ◽  
Laura Hollod ◽  
Tiffany G. Harris ◽  
Mary Clare Lennon ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Viral Suppression ◽  
Hiv Care ◽  
Hiv Viral Suppression ◽  
Engagement In Hiv Care ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals HIV/AIDS-Related Knowledge and Behaviors Among Most-at-Risk Populations in Vietnam

2012 ◽  
Vol 6 (1) ◽  
pp. 259-265 ◽  
Author(s):  
Taryn Vian ◽  
Katherine Semrau ◽  
Davidson H Hamer ◽  
Le Thi Thanh Loan ◽  
Lora L Sabin
Keyword(s):  
At Risk ◽  
Condom Use ◽  
Risk Behaviors ◽  
Outreach Worker ◽  
Commercial Sex ◽  
Needle Sharing ◽  
Outreach Programs ◽  
At Risk Populations ◽  
Most At Risk Populations ◽  
Hiv Aids

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported the Vietnamese Ministry of Health (MOH) in implementing behavior change strategies to slow the HIV epidemic. These programs target commercial sex workers (CSW), injection drug users (IDU), and men who have sex with men (MSM). Using data from a program evaluation to assess effectiveness of the PEPFAR intervention, we conducted a sub-analysis of HIV/AIDS knowledge, sexual behaviors, and injection drug risk behaviors among 2,199 Vietnamese respondents, including those reporting recent contact with an outreach worker and those who did not report contact. We found overall high levels of HIV/AIDS knowledge, low rates of needle sharing, and moderate to high rates of inconsistent condom use. Average knowledge scores of IDU were significantly higher than non-IDU for antiretroviral treatment knowledge, while MSM had significantly less knowledge of treatment compared to non-MSM. HIV/AIDS-related knowledge was not significantly associated with needle-sharing practices. Knowledge was modestly but significantly associated with more consistent use of condoms with primary and commercial sex partners, even after controlling for contact with an outreach worker. Contact with an outreach worker was also an independent predictor of more consistent condom use. Outreach programs appear to play a meaningful role in changing sexual behavior, though the effect of outreach on IDU risk behaviors was less clear. More research is needed to understand the relationship between outreach programs and skill development, motivation, and use of referral services by most-at-risk populations in Vietnam.

scholarly journals 1030. Medicaid Expansion: How Does it Impact HIV Outcomes in One Non-urban Southeastern Ryan White HIV/AIDS Program Clinic?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S544-S546
Author(s):  
Kathleen A McManus ◽  
Karishma R Srikanth ◽  
Samuel D Powers ◽  
Rebecca Dillingham ◽  
Elizabeth T Rogawski McQuade
Keyword(s):  
Viral Suppression ◽  
Hiv Care ◽  
Baseline Viral Load ◽  
Medicaid Expansion ◽  
Engagement In Care ◽  
Medicaid Enrollment ◽  
Ryan White ◽  
Aids Program ◽  
Research Grant ◽  
Hiv Aids

Abstract Background People living with HIV (PLWH) with Medicaid historically have lower viral suppression (VS) rates than those with other insurance. VS rates with Medicaid expansion (ME) are unknown. We examined HIV outcomes (engagement in care, VS) by insurance status for a non-urban Southeastern Ryan White HIV/AIDS Program (RWHAP) Clinic cohort for year after ME. Methods Participants were PLWH ages 18-63 who attended &gt; 1 HIV medical visit/year in 2018 and 2019. Log-binomial models were used to estimate the association of characteristics with Medicaid enrollment prevalence and one-year risks of engagement in care and VS in 2019. Results Among 577 patients, 241 (42%) were newly eligible for Medicaid due to ME and 79 (33%) enrolled (Figure 1a). For those without Medicare, Medicaid enrollment was higher for those with incomes &lt; 100% FPL (adjusted prevalence ratio [aPR] 1.67; 95% confidence interval [CI] 1.00-1.86) compared to those with incomes &gt; 101% FPL. Those enrolled in Medicaid due to ME had 87% engagement in care compared to 80-92% for other insurance plans (Figure 1b). Controlling for 2018 engagement, older age (adjusted risk ratio [aRR] for 10 years 1.03, 95% CI 1.00-1.05; Table 1) was associated with being engaged in 2019. Engagement was lower for those with employment-based insurance (aRR 0.91, 95% CI 0.83-0.99) and Medicare (aRR 0.87, 95% CI 0.78-0.96). Of those with viral loads in 2018 and 2019 (n=549), those who newly enrolled in Medicaid due to ME had 85% VS compared to 87-99% for other insurance plans (Figure 1c). In univariate analysis, age, income, and baseline viral load status were associated with viral suppression (Table 2), and those with Medicaid due to ME (aRR 0.90, 95% CI 0.81-1.00) were less likely to achieve VS compared with others. Figure 1 Table 1 Table 2 Conclusion The low uptake of ME was likely influenced by many PLWH already having Medicare. While the RWHAP supports high quality HIV care, Medicaid enrollment improves access to non-HIV care and should be supported by RWHAP. Given that engagement in care was high for PLWH who newly enrolled in Medicaid, the finding of lower VS is surprising. The discordance may be due to medication access gaps associated with changes in pharmacy logistics. Future studies with larger cohorts will need to examine how ME contributes to PLWH’s overall health and to ending the HIV epidemic. Disclosures Kathleen A. McManus, MD, MSCR, Gilead Sciences, Inc (Research Grant or Support, Shareholder) Rebecca Dillingham, MD, MPH, Gilead Sciences, Inc (Research Grant or Support)Warm Health Technologies, Inc (Consultant)

scholarly journals The age-specific differences in histopathological tumor characteristics and TNM classification of breast carcinomas in Quality assured mamma diagnostic (QuaMaDi) program in the state of Schleswig–Holstein in Germany

2021 ◽  
Author(s):  
L.-J. Kramp ◽  
M. Mathiak ◽  
H.-M. Behrens ◽  
F. W. Schäfer ◽  
M. van Mackelenbergh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
At Risk ◽  
Tnm Classification ◽  
Quality Standards ◽  
The State ◽  
Breast Cancers ◽  
High Quality ◽  
Screening Programs ◽  
Diagnostic Mammography ◽  
At Risk Populations

Abstract Background We explored the hypothesis that high-quality standards in diagnostic mammography can lead to an early diagnosis of breast cancers and identifies at risk populations outside screening programs. The histopathological features and distribution of the TNM classification were examined in relation to patient age in a large group of women with breast cancers participating in the Quality Assured Mamma Diagnostic (QuaMaDi) program of the state of Schleswig–Holstein. Patients and methods Surgical pathological reports were studied for clinicopathological characteristics, receptor status, molecular subtype and tumor stage. The analysis was conducted by dividing the study population into three age groups: women under 50 years (pre-screening), 50–69 years (peri-screening) and over 70 years (post-screening). Results 7.111 biopsies and 2.887 resection specimens were included. Breast cancer was diagnosed in 4.241 (59.7%) cases, one fourth of them in women < 50 years. Elderly women (> 70 years) had more well-differentiated, estrogen receptor (ER)-positive and HER2-negative carcinomas, whereas younger women (< 50 years) tended to have more poorly differentiated, ER negative, and HER2-positive carcinomas. 47% of breast carcinoma were luminal B tumors and were most common regardless of age. 70.4% of resected specimen had pT1 stage. Nodal negative were 71.2%. Conclusion In QuaMaDi breast cancer was diagnosed at an early and potentially curable stage of the disease due to high-quality standards in diagnostic mammography. In addition, regardless of age, an increased number of prognostically unfavorable molecular subtypes were detected. Thus, QuaMaDi helps to identify at risk populations. QuaMaDi significantly improves diagnostic mammography and complements mammography screening programs.

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