“Don’t disrespect me, I’m Ms., not Mr.”

HIV ◽  
2020 ◽  
pp. 241-252
Author(s):  
Antonio E. Urbina
Keyword(s):  
Sexual Orientation ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Infectious Diseases ◽  
Hormone Therapy ◽  
Medical Record ◽  
Undetectable Viral Load ◽  
Body Parts ◽  
Living With Hiv ◽  
Transgender Patient

Care of the transgender patient living with HIV is not too dissimilar from the care of any patient living with HIV. Clinicians should be comfortable asking patients about their gender identity and sexual orientation. Once preferred gender has been identified, providers should be mindful of using the patient’s preferred name and pronouns even if not incorporated into the patient’s medical record. Obtaining an organ inventory is an important element to the clinical examination as patients may use terms other than the anatomical names of body parts to refer to their bodies. All transgender patients living with HIV should be offered antiretroviral therapy (ART), with the goal of achieving an undetectable viral load. HIV and ART are not contraindications to gender-affirming hormone therapy (GAHT). Many of the currently approved ART regimens do not interact with GAHT and can be safely coadministered. Importantly, continuation of GAHT has been associated with improved adherence to ART. Last, immunizations against infectious diseases are an important component of care for transgender individuals living with HIV.

scholarly journals Antiretroviral Therapy Adherence and Use of an Electronic Shared Medical Record Among People Living with HIV

2015 ◽  
Vol 19 (S2) ◽  
pp. 177-185 ◽  
Author(s):  
Parya Saberi ◽  
Sheryl L. Catz ◽  
Wendy A. Leyden ◽  
Christine Stewart ◽  
James D. Ralston ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Medical Record ◽  
People Living With Hiv ◽  
Therapy Adherence ◽  
Antiretroviral Therapy Adherence ◽  
Living With Hiv

scholarly journals Trends in antiretroviral treatment use and treatment response in three Australian states in the first decade of combination antiretroviral treatment

Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 141 ◽  
Author(s):  
Kathleen Falster ◽  
Linda Gelgor ◽  
Ansari Shaik ◽  
Iryna Zablotska ◽  
Garrett Prestage ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Treatment ◽  
Undetectable Viral Load ◽  
Lower Proportion ◽  
The Other ◽  
Early Disease ◽  
Community Based ◽  
Disease Research ◽  
Sex With Men ◽  
Living With Hiv

Objectives: To determine if there were any differences in antiretroviral treatment (ART) use across the three eastern states of Australia, New South Wales (NSW), Victoria and Queensland, during the period 1997 to 2006. Methods: We used data from a clinic-based cohort, the Australian HIV Observational Database (AHOD), to determine the proportion of HIV-infected patients on ART in selected clinics in each state and the proportion of treated patients with an undetectable viral load. Data from the national Highly Specialised Drugs program and AHOD were used to estimate total numbers of individuals on ART and the proportion of individuals living with HIV on ART nationally and by state. Data from the HIV Futures Survey and the Gay Community Periodic Survey were used to determine the proportion of community-based men who have sex with men on ART. The proportion of patients with primary HIV infection (PHI) who commenced ART within 1 year of diagnosis was obtained from the Acute Infection and Early Disease Research Program (AIEDRP) CORE01 protocol and Primary HIV and Early Disease Research: Australian Cohort (PHAEDRA) cohorts. Results: We estimated that the numbers of individuals on ART increased from 3181 to 4553 in NSW, 1309 to 1926 in Victoria and 809 to 1615 in Queensland between 2000 and 2006. However, these numbers may reflect a lower proportion of individuals living with HIV on ART in NSW compared with the other states (37% compared with 49 and 55% in 2000). We found similar proportions of HIV-positive men who have sex with men participants were on ART in all three states over the study period in the clinic-based AHOD cohort (81–92%) and two large, community-based surveys in Australia (69–85% and 49–83%). Similar proportions of treated patients had an undetectable viral load across the three states, with a consistently increasing trend over time observed in all states. We found that more PHI patients commenced treatment in the first year following HIV diagnosis in NSW compared with Victoria; however, the sample size was very small. Conclusions: For the most part, patterns of ART use were similar across NSW, Victoria and Queensland using a range of available data from cohort studies, community surveys and national prescription databases in Australia. However, there may be a lower proportion of individuals living with HIV on ART in NSW compared with the other states, and there is some indication of a more aggressive treatment approach with PHI patients in NSW compared with Victoria.

scholarly journals Late Onset of Antiretroviral Therapy in Adults Living with HIV in an Urban Area in Brazil: Prevalence and Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Priscila Ribeiro Guimarães Pacheco ◽  
Ana Laura Sene Amâncio Zara ◽  
Luiz Carlos Silva e Souza ◽  
Marília Dalva Turchi
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Perceived Risk ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Late Initiation ◽  
Living With Hiv

Introduction. Highly active antiretroviral therapy has been available since 1996. Early initiation of antiretroviral therapy (ART) leads to improved therapeutic response and reduced HIV transmission. However, a significant number of people living with HIV (PLHIV) still start treatment late. Objective. This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods. This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count < 200 cells/mm3 or presence of AIDS-defining illness. Uni- and multivariate analysis were performed to evaluate associated factors for late ARV using SPSS®, version 21. The significance level was set at p<0.05. Results. 1,141 individuals were included, with a median age of 41 years, and 69.1% were male. The prevalence of late initiation of ART was 55.8% (95%CI: 52.9-58.7). The more common opportunistic infections at ART initiation were pneumocystosis, cerebral toxoplasmosis, tuberculosis, and histoplasmosis. Overall, 38.8% of patients had HIV viral load equal to or greater than 100,000 copies/mL. Late onset of ART was associated with higher mortality. After logistic regression, factors shown to be associated with late initiation of ARV were low education level, sexual orientation, high baseline viral load, place of residence outside metropolitan area, and concomitant infection with hepatitis B virus. Conclusion. These results revealed the need to increase early treatment of HIV infection, focusing especially on groups of people who are more socially vulnerable or have lower self-perceived risk.

scholarly journals Workshop: Screening infectious diseases amongst migrants in Europe: The diversity of policies

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Viral Load ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Infectious Diseases ◽  
Access To Care ◽  
Latent Tuberculosis ◽  
Undetectable Viral Load ◽  
Active Tuberculosis ◽  
People Living With Hiv ◽  
European Guidelines

Abstract In Europe, the prevalence of several infectious diseases such as HIV, hepatitis B, hepatitis C and tuberculosis is higher amongst migrants. Late diagnosis of HIV, hepatitis B and C is a health issue that thwarts prevention efforts. Early diagnosis has obvious benefits, both for the individuals (i.e. earlier access to care with a better life expectancy) and for the community. As regard for HIV, treated patients with an undetectable viral load do not transmit the virus. This is in line with the UNAIDS 90-90-90 target that in every country 90% of people living with HIV should be aware of their positive status, 90% of them should be treated with antiretroviral and within 90% should have an undetectable viral load. Widespread testing of HIV, HBV and HCV is recommended by European guidelines, such those from European Centre for disease Prevention and Control (ECDC). The ECDC recommends that screening for HIV, hepatitis B, hepatitis C and tuberculosis should be offered to every migrant from countries with a high prevalence (≥1% for HIV and ≥2% for hepatitis B and C). Other recommendations include ensuring that screening and vaccination is voluntary and confidential, that migrants have a quick access to care, addressing barriers to screening, and taking into account the particular issues and needs of migrants. However, European countries have developed diverse guidelines and initiatives to address the issue of screening infectious diseases amongst migrants. The objective of this workshop is to present several European initiatives to improve the screening of infectious diseases amongst migrants. Four initiatives will be presented and discussed: screening of active tuberculosis amongst asylum seekers with the use of a questionnaire in Switzerland; replacing the systematic chest X-ray with a screening questionnaire for active tuberculosis and introducing rapid tests for HIV, HBV and HCV for all legal migrants at entry point in France, adding HIV, HBV and HCV testing to the compulsory targeted tuberculosis test in the Netherlands and offering targeted tests for latent tuberculosis, HBV and HCV to migrants registering for primary care in the UK. Key messages Screening of infectious diseases should be targeted to migrants from high-incidence countries. European practices should be harmonized.

Association between atazanavir plasma levels and renal function in HIV-positive individuals on antiretroviral therapy with undetectable viral load

2013 ◽  
Vol 41 (5) ◽  
pp. 497-498
Author(s):  
Ana Júlia Luz ◽  
Júlia Poeta ◽  
Rafael Linden ◽  
Marina Venzon Antunes ◽  
Luiza Isola Caminha ◽  
...  
Keyword(s):  
Renal Function ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Plasma Levels ◽  
Undetectable Viral Load ◽  
Hiv Positive

scholarly journals Dental Caries in Association With Viral Load in Children Living With HIV in Phnom Penh, Cambodia

2020 ◽  
Author(s):  
Kimiyo Kikuchi ◽  
Junko Yasuoka ◽  
Sovannary Tuot ◽  
Sumiyo Okawa ◽  
Sokunthea Yem ◽  
...  
Keyword(s):  
Viral Load ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Undetectable Viral Load ◽  
Oral Health Status ◽  
Deciduous Teeth ◽  
Detectable Viral Load ◽  
Phnom Penh ◽  
Living With Hiv

Abstract Background: Oral health status is known to be associated with overall health among people living with HIV. However, it is unclear whether dental caries is associated with viral load among this population. In particular, dental caries among children living with HIV needs to be better understood, as this can affect their overall health and well-being in future. This study assessed the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia. Methods: This cross-sectional study was conducted at the National Paediatric Hospital as a baseline survey of a randomized controlled trial. The study population included children living with HIV aged 3–15 years and their primary caregivers. We collected data on the children’s oral health status by oral examination and the latest HIV viral load data stored in the patients’ information system of the hospital. Multiple logistic regression analysis was conducted to assess association between dental caries and viral load. The cut-off point of undetectable viral load was set at <40 copies/mL. Results: Data from 328 children were included in the analyses. Moreover, 68.3% had an undetectable viral load. The mean number of permanent or deciduous teeth with caries was 7.7 (standard deviation [SD], 5.0). In the regression analysis, dental caries in permanent or deciduous teeth were positively associated with detectable viral load (adjusted odds ratio [AOR]: 1.07, 95% confidence interval [CI]: 1.01, 1.14). Having received antiretroviral therapy ≥1 year and self-reported excellent adherence to the antiretroviral drug were also negatively associated with detectable viral load. Among children with detectable levels of viral load, dental caries in permanent or deciduous teeth were also positively associated with non-suppression of viral load (>1000 copies/mL) (AOR: 1.12, 95% CI: 1.03, 1.23). Conclusions: Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that oral health status may affect the immune status of the children. Oral health of children living with HIV should be strengthened, and further research is needed to clarify the causal relationship between viral load and oral health status.

scholarly journals Dental caries in association with viral load in children living with HIV in Phnom Penh, Cambodia: a cross-sectional study

2020 ◽  
Author(s):  
Kimiyo Kikuchi ◽  
Junko Yasuoka ◽  
Sovannary Tuot ◽  
Sumiyo Okawa ◽  
Sokunthea Yem ◽  
...  
Keyword(s):  
Viral Load ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Undetectable Viral Load ◽  
Oral Health Status ◽  
Deciduous Teeth ◽  
Detectable Viral Load ◽  
Cross Sectional ◽  
Living With Hiv

Abstract Background: Oral health status is known to be associated with overall health among people living with HIV. However, it is unclear whether dental caries is associated with viral load among this population. In particular, dental caries among children living with HIV needs to be better understood, as this can affect their overall health and future well-being. This study assessed the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia.Methods: This cross-sectional study was conducted at the National Paediatric Hospital as a baseline survey of a randomized controlled trial. The study population included children living with HIV aged 3–15 years and their primary caregivers. We collected data on the children’s oral health status by oral examination and the latest HIV viral load data stored in the patients’ information system at the hospital. We also conducted a questionnaire-based interview of the children and their primary caregivers. Multiple logistic regression analysis was conducted to assess the association between dental caries and viral load. The cut-off point for undetectable viral load was set at <40 copies/mL.Results: Data from 328 children were included in the analysis; 68.3% had an undetectable viral load. The mean number of permanent or deciduous teeth with caries was 7.7 (standard deviation, 5.0). In the regression analysis, dental caries in permanent or deciduous teeth was positively associated with detectable viral load (adjusted odds ratio: 1.07, 95% confidence interval: 1.01–1.14). Conversely, antiretroviral therapy of ≥1 year and self-reported better adherence to antiretroviral drugs were negatively associated with detectable viral load. Among children with detectable viral load, dental caries in permanent or deciduous teeth was also positively associated with non-suppression of viral load (>1000 copies/mL) (adjusted odds ratio: 1.12, 95% confidence interval: 1.03–1.23).Conclusions: Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that oral health status may affect the immune status of children. The oral health of children living with HIV should be strengthened, and further research is needed to clarify the causal relationship between viral load and oral health status.

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