Evaluation of a public health referral system to re-engage individuals living with HIV who have interrupted antiretroviral therapy in British Columbia, Canada

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
David M. Moore ◽  
Hayden Kremer ◽  
Lu Wang ◽  
Katherine J. Lepik ◽  
Jenny Li ◽  
...  
Keyword(s):  
Public Health ◽  
British Columbia ◽  
Antiretroviral Therapy ◽  
Referral System ◽  
Living With Hiv

scholarly journals P312 Evaluation of an antiretroviral therapy (ART) interruption alert and referral system in british columbia (BC), canada

2019 ◽  
Author(s):  
Jon Kremer ◽  
Rolando Barrios ◽  
David Moore ◽  
Kate Salters ◽  
Katherine Lepik ◽  
...  
Keyword(s):  
British Columbia ◽  
Antiretroviral Therapy ◽  
Referral System

scholarly journals HIV Viral Suppression among People Living with HIV on Antiretroviral Therapy in Haut-Katanga and Kinshasa Provinces of Democratic Republic of Congo

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 69
Author(s):  
Gulzar H. Shah ◽  
Lievain Maluantesa ◽  
Gina D. Etheredge ◽  
Kristie C. Waterfield ◽  
Osaremhen Ikhile ◽  
...  
Keyword(s):  
Public Health ◽  
Antiretroviral Therapy ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Clinical Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
National Guidelines ◽  
Republic Of Congo ◽  
Living With Hiv

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and national guidelines and assess the factors associated with variation in VL levels. Purpose: This study had two objectives—(a) to describe the levels of HIV VL in persons on antiretroviral therapy (ART), and (b) to analyze the significance of variation in VL by patients’ demographic and clinical characteristics, outcomes of HIV care, and geographic characteristics of HIV care facilities. Methods: The study population for this quantitative study was 49,460 PLHIV in the Democratic Republic of Congo (DRC) receiving ART from 241 CDC-funded HIV/AIDS clinics in the Haut-Katanga and Kinshasa provinces of the DRC. Analysis of variance (ANOVA) was performed, including Tamhane’s T2 test for pairwise comparisons using de-identified data on all patients enrolled in the system by the time the data were extracted for this study by the HIV programs in May 2019. Results: The VL was undetectable (<40 copies/mL) for 56.4% of the patients and 24.7% had VL between 40 copies/mL and less than 1000 copies per mL, indicating that overall, 81% had VL < 1000 and were virologically suppressed. The remaining 19% had a VL of 1000 copies/mL or higher. The mean VL was significantly (p < 0.001) higher for males than for females (32,446 copies/mL vs. 20,786, respectively), persons <15 years of age compared to persons of ages ≥ 15 years at the time of starting ART (45,753 vs. 21,457, respectively), patients who died (125,086 vs. 22,090), those who were lost to follow-up (LTFU) (69,882 vs. 20,018), those with tuberculosis (TB) co-infection (64,383 vs. 24,090), and those who received care from urban clinics (mean VL = 25,236) compared to rural (mean VL = 3291) or semi-rural (mean VL = 26,180) clinics compared to urban. WHO clinical stages and duration on ART were not statistically significant at p ≤ 0.05 in this cohort. Conclusions: The VL was >1000 copies/mL for 19% of PLHIV receiving ART, indicating that these CDC-funded clinics and programs in the Haut-Katanga and Kinshasa provinces of DRC have more work to do. Strategically designed innovations in services are desirable, with customized approaches targeting PLHIV who are younger, male, those LTFU, with HIV/TB co-infection, and those receiving care from urban clinics.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

scholarly journals COVID-19 Pandemic Optimism and Vaccine Willingness among an Online Sample of US Gay, Bisexual, and Other Men Who Have Sex with Men

Vaccines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 745
Author(s):  
Rob Stephenson ◽  
Stephen P. Sullivan ◽  
Renee A. Pitter ◽  
Alexis S. Hunter ◽  
Tanaka MD Chavanduka
Keyword(s):  
Public Health ◽  
Three Dimensions ◽  
Vaccine Hesitancy ◽  
Binary Outcomes ◽  
Sex Partners ◽  
Black African ◽  
Factors Associated ◽  
Public Health Messages ◽  
Sex With Men ◽  
Living With Hiv

This paper presents data from an online sample of U.S gay, bisexual, and other men who have sex with men (GBMSM), to explore the factors associated with three dimensions of vaccine beliefs: perception of the likelihood of a COVID-19 vaccine becoming available, perception of when a COVID-19 vaccine would become available, and the likelihood of taking a COVID-19 vaccine. Data are taken from the Love and Sex in the Time of COVID-19 study, collected from November 2020 to January 2021. A sample of 290 GBMSM is analyzed, modeling three binary outcomes: belief that there will be a COVID-19 vaccine, belief that the COVID-19 vaccine will be available in 6 months, and being very likely to take the COVID-19 vaccine. In contrast to other studies, Black/African Americans and GBMSM living with HIV had higher levels of pandemic optimism and were more likely to be willing to accept a vaccine. Men who perceived a higher prevalence of COVID-19 among their friends and sex partners, and those who had reduced their sex partners, were more likely to be willing to take a COVID-19 vaccine. There remained a small percentage of participants (14%) who did not think the pandemic would end, that there would not be a vaccine and were unlikely to take a vaccine. To reach the levels of vaccination necessary to control the pandemic, it is imperative to understand the characteristics of those experiencing vaccine hesitancy and then tailor public health messages to their unique set of barriers and motivations.

scholarly journals Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sovannary Tuot ◽  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Pheak Chhoun ◽  
Chamroen Pall ◽  
...  
Keyword(s):  
Experimental Study ◽  
Antiretroviral Therapy ◽  
Scale Up ◽  
Economic Evaluations ◽  
People Living With Hiv ◽  
Cad Model ◽  
Community Based ◽  
Quasi Experimental ◽  
Living With Hiv ◽  
Art Delivery

Abstract Background Multi-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every 3-6 months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities’ burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model’s effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia. Methods We will conduct this quasi-experimental study in 20 ART clinics across the capital city and nine provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and adherence to ART. The secondary endpoints will include health providers’ work burden, the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective. Discussion This study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response. Trial registration ClinicalTrials.gov, NCT04766710. Registered 23 February 2021, Version 1.

scholarly journals Incidence of Herpes Zoster in HIV-Infected Patients Undergoing Antiretroviral Therapy: A Systematic Review and Meta-analysis

2021 ◽  
Vol 10 (11) ◽  
pp. 2300
Author(s):  
Han-Chang Ku ◽  
Yi-Tseng Tsai ◽  
Sriyani-Padmalatha Konara-Mudiyanselage ◽  
Yi-Lin Wu ◽  
Tsung Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Herpes Zoster ◽  
Antiretroviral Therapy ◽  
Random Effects ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Funnel Plots ◽  
Sex With Men ◽  
Treat All ◽  
Living With Hiv

The incidence of herpes zoster (HZ) in patients infected with HIV is higher than that of the general population. However, the incidence of HZ in HIV patients receiving antiretroviral therapy (ART) remains unclear. This meta-analysis aimed to estimate the pooled incidence rate and risk factors for HZ in the post-ART era. We identified studies assessing the incidence of HZ in the post-ART era between 1 January 2000 and 28 February 2021, from four databases. Pooled risk ratios were calculated from 11 articles using a random-effects model. The heterogeneity of the included trials was evaluated by visually inspecting funnel plots, performing random-effects meta-regression and using I2 statistics. Of the 2111 studies screened, we identified 11 studies that were eligible for final inclusion in the systematic review and 8 studies that were eligible for a meta-analysis. The pooled incidence of HZ in the post-ART era (after the introduction of ART in 1997) was 2.30 (95% confidence interval (CI): 1.56–3.05) per 100 person years (PYs). The risks of incidence of HZ among people living with HIV included male sex (AOR: 4.35 (95% CI: 054–2.41)), men who have sex with men (AOR: 1.21 (95% CI: −0.76–1.13)), CD4 count < 200 cells/μL (AOR: 11.59 (95% CI: 0.53–4.38)) and not receiving ART (AOR: 2.89 (95% CI: −0.44–2.56)). The incidence of HZ is substantially lower among HIV infected patients receiving ART than those not receiving ART. Initiating ART immediately after diagnosis to treat all HIV-positive individuals is crucial to minimize the disease burden of HZ.

scholarly journals The Promise of Improved Adherence With Long-Acting Antiretroviral Therapy: What Are the Data?

2021 ◽  
Vol 20 ◽  
pp. 232595822110090
Author(s):  
Kimberly K. Scarsi ◽  
Susan Swindells
Keyword(s):  
Medication Adherence ◽  
Antiretroviral Therapy ◽  
Hiv Treatment ◽  
Virologic Suppression ◽  
Social Barriers ◽  
Treatment And Prevention ◽  
Undetectable Viremia ◽  
Long Acting ◽  
Available Information ◽  
Living With Hiv

As with other chronic conditions, adherence to daily medications remains a challenge for many individuals living with HIV due to structural, behavioral, and social barriers. Unfortunately, high levels of adherence to antiretroviral therapy are required to maintain virologic suppression. Alternative approaches are being explored to decrease the burden of daily pill administration, including long-acting injectable, oral, and implantable products. Phase 3 data support the efficacy of nanoformulated injectable cabotegravir and rilpivirine for HIV treatment in patients with undetectable viremia, but we have yet to learn how this strategy may benefit those with medication adherence challenges. Despite this, the affected community and HIV providers are very interested in exploring the role of long-acting therapies to address some types of barriers to medication adherence. This review summarizes available information about the potential for long-acting therapy to improve adherence for some patients and outlines associated opportunities and challenges with the implementation of long-acting therapy for the treatment and prevention of HIV.

Sign in / Sign up

Export Citation Format

Share Document