HIV continuum of care

Abstract Background Brescia Province, northern Italy, was one of the worst epicenters of the COVID-19 pandemic. The division of infectious diseases of ASST (Azienda Socio Sanitaria Territoriale) Spedali Civili Hospital of Brescia had to face a great number of inpatients with severe COVID-19 infection and to ensure the continuum of care for almost 4000 outpatients with HIV infection actively followed by us. In a recent manuscript we described the impact of the pandemic on continuum of care in our HIV cohort expressed as number of missed visits, number of new HIV diagnosis, drop in ART (antiretroviral therapy) dispensation and number of hospitalized HIV patients due to SARS-CoV-2 infection. In this short communication, we completed the previous article with data of HIV plasmatic viremia of the same cohort before and during pandemic. Methods We considered all HIV-patients in stable ART for at least 6 months and with at least 1 available HIV viremia in the time window March 01–November 30, 2019, and another group of HIV patients with the same two requisites but in different time windows of the COVID-19 period (March 01–May 31, 2020, and June 01–November 30, 2020). For patients with positive viremia (PV) during COVID-19 period, we reported also the values of viral load (VL) just before and after PV. Results: the percentage of patients with PV during COVID-19 period was lower than the previous year (2.8% vs 7%). Only 1% of our outpatients surely suffered from pandemic in term of loss of previous viral suppression. Conclusions Our efforts to limit the impact of pandemic on our HIV outpatients were effective to ensure HIV continuum of care.

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The Parasol Protocol: An Implementation Science Study of HIV Continuum of Care Interventions for Gay Men and Transgender Women in Burma/Myanmar

JMIR Research Protocols ◽

10.2196/resprot.7642 ◽

2017 ◽

Vol 6 (5) ◽

pp. e90 ◽

Cited By ~ 10

Author(s):

Andrea L Wirtz ◽

Soe Naing ◽

Emily Clouse ◽

Kaung Htet Thu ◽

Sandra Hsu Hnin Mon ◽

...

Keyword(s):

Implementation Science ◽

Gay Men ◽

Continuum Of Care ◽

Transgender Women ◽

Science Study ◽

Hiv Continuum Of Care

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Peer Support and the HIV Continuum of Care: Results from a Multi-Site Randomized Clinical Trial in Three Urban Clinics in the United States

AIDS and Behavior ◽

10.1007/s10461-017-1999-8 ◽

2018 ◽

Vol 22 (8) ◽

pp. 2627-2639 ◽

Cited By ~ 14

Author(s):

Howard J. Cabral ◽

Kendra Davis-Plourde ◽

Mariana Sarango ◽

Jane Fox ◽

Joseph Palmisano ◽

...

Keyword(s):

United States ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Peer Support ◽

The United States ◽

Continuum Of Care ◽

Hiv Continuum Of Care

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Expanding HIV Continuum of Care Analyses

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000002307 ◽

2020 ◽

Vol 84 (1) ◽

pp. e7

Author(s):

Rebecca Jeanne Fisk

Keyword(s):

Continuum Of Care ◽

Hiv Continuum Of Care

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Acceptability and feasibility of point-of-care CD4 testing on HIV continuum of care in low and middle income countries: a systematic review

BMC Health Services Research ◽

10.1186/s12913-016-1588-y ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 17

Author(s):

Minh D. Pham ◽

Paul A. Agius ◽

Lorena Romero ◽

Peter McGlynn ◽

David Anderson ◽

...

Keyword(s):

Systematic Review ◽

Point Of Care ◽

Continuum Of Care ◽

Middle Income ◽

Middle Income Countries ◽

Hiv Continuum Of Care ◽

Cd4 Testing ◽

Low And Middle Income

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Comparative Effectiveness of Interventions to Improve the HIV Continuum of Care and HIV Preexposure Prophylaxis in Kenya: A Model-Based Analysis

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa633 ◽

2020 ◽

Author(s):

Liem B Luong Nguyen ◽

Kenneth A Freedberg ◽

Sitima Wanjala ◽

David Maman ◽

Elisabeth Szumilin ◽

...

Keyword(s):

Adult Population ◽

Hiv Infections ◽

Scaling Up ◽

Continuum Of Care ◽

Base Case ◽

Hiv Incidence ◽

Preexposure Prophylaxis ◽

Immunodeficiency Virus ◽

Hiv Continuum Of Care ◽

The Continuum

Abstract Background In Western Kenya up to one-quarter of the adult population was human immunodeficiency virus (HIV)-infected in 2012. The Ministry of Health, Médecins Sans Frontières, and partners implemented an HIV program that surpassed the 90-90-90 UNAIDS targets. In this generalized epidemic, we compared the effectiveness of preexposure prophylaxis (PrEP) with improving continuum of care. Methods We developed a dynamic microsimulation model to project HIV incidence and infections averted to 2030. We modeled 3 strategies compared to a 90-90-90 continuum of care base case: (1) scaling up the continuum of care to 95-95-95, (2) PrEP targeting young adults with 10% coverage, and (3) scaling up to 95-95-95 and PrEP combined. Results In the base case, by 2030 HIV incidence was 0.37/100 person-years. Improving continuum levels to 95-95-95 averted 21.5% of infections, PrEP averted 8.0%, and combining 95-95-95 and PrEP averted 31.8%. Sensitivity analysis showed that PrEP coverage had to exceed 20% to avert as many infections as reaching 95-95-95. Conclusions In a generalized HIV epidemic with continuum of care levels at 90-90-90, improving the continuum to 95-95-95 is more effective than providing PrEP. Continued improvement in the continuum of care will have the greatest impact on decreasing new HIV infections.

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Policy Interventions Shaping HIV Prevention: Providers’ Active Role in the HIV Continuum of Care

Health Education & Behavior ◽

10.1177/1090198118760681 ◽

2018 ◽

Vol 45 (5) ◽

pp. 714-722 ◽

Cited By ~ 3

Author(s):

Rogério M. Pinto ◽

Susan S. Witte ◽

Prema L. Filippone ◽

C. Jean Choi ◽

Melanie Wall

Keyword(s):

Primary Care ◽

Hiv Prevention ◽

Hiv Testing ◽

Support Services ◽

Behavioral Interventions ◽

Continuum Of Care ◽

High Impact ◽

Dose Effect ◽

Care And Support ◽

Hiv Continuum Of Care

The U.S. Centers for Disease Control and Prevention (CDC) Diffusion of Effective Behavioral Interventions project has disseminated HIV behavioral interventions (EBIs) across the United States since the 1990s. In 2011, the CDC launched the High-Impact HIV Prevention (HIP) project, providing EBIs plus high-impact services (HIV testing, primary care, and support services). Providers (nurses, social workers, educators) are unable to consistently make linkages; thus, numerous at-risk individuals are not benefitting from HIP. Research on providers’ roles in the HIV Continuum of Care—linking clients to HIV testing, primary care, and support services—is lacking. This article helps fill this gap with evidence that providers exposed to EBIs, whose agencies offer EBIs, more frequently link clients to high-impact services. This is based on diffusion of innovations theory, where individuals in social networks influence one another’s adoption of innovations. We hypothesize that providers are exposed to EBIs via training, reading and hearing about EBIs, and/or discussing EBIs with colleagues. We used cross-sectional data from 379 providers from 36 agencies in New York City. We used multilevel ordinal logistic regression models to test associations between provider exposure to EBIs (agency provides EBIs) and frequency of linkages to high-impact services. Providers exposed to greater numbers of EBIs more frequently link clients to HIV, hepatitis C (HEP-C), and sexually transmitted infections testing; to primary care; and to drug treatment and mental health services. Providers link clients most frequently to primary care and HIV testing and least frequently to HEP-C testing and syringe exchange. Findings suggest a dose effect, with exposure to more EBIs resulting in more linkages. Findings show a staged, evidence-based prevention approach that includes exposure to EBIs, leading to providers linking clients to high-impact services. There needs to be emphasis on inspiring providers to engage with high-impact services at the elevated levels needed to end the epidemic.

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