scholarly journals Deep–sequence phylogenetics to quantify patterns of HIV transmission in the context of a universal testing and treatment trial — BCPP/ Ya Tsie trial

2021 ◽  
Author(s):  
Lerato E Magosi ◽  
Yinfeng Zhang ◽  
Tanya Golubchick ◽  
Victor De Gruttola ◽  
Eric J Tchetgen Tchetgen ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Population Level ◽  
Treatment As Prevention ◽  
Population Mobility ◽  
Mobility Patterns ◽  
Test And Treat ◽  
Hiv Intervention ◽  
Universal Test ◽  
Universal Test And Treat ◽  
The Impact

Mathematical models predict that community–wide access to HIV testing–and–treatment can rapidly and substantially reduce new HIV infections. Yet several large universal test–and–treat HIV prevention trials in high–prevalence epidemics demonstrated variable reduction in population–level incidence. To elucidate patterns of HIV spread in universal test–and–treat trials we quantified the contribution of geographic–location, gender, age and randomized–HIV–intervention to HIV transmissions in the 30–community Ya Tsie trial in Botswana (estimated trial population: 175,664). Deep–sequence phylogenetic analysis revealed that most inferred HIV transmissions within the trial occurred within the same or between neighboring communities, and between similarly–aged partners. Transmissions into intervention communities from control communities were more common than the reverse post–baseline (30% [12.2 – 56.7] versus 3% [0.1 – 27.3]) than at baseline (7% [1.5 – 25.3] versus 5% [0.9 – 22.9]) compatible with a benefit from treatment–as–prevention. Our findings suggest that population mobility patterns are fundamental to HIV transmission dynamics and to the impact of HIV control strategies.

scholarly journals Prevalence and predictors of persistent HIV viremia and viral rebound following universal test and treat: a population-based study

2021 ◽  
Author(s):  
M Kate Grabowski ◽  
Eshan U Patel ◽  
Gertrude Nakigozi ◽  
Victor Ssempijja ◽  
Robert Ssekubugu ◽  
...  
Keyword(s):  
Population Level ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Viral Rebound ◽  
Hiv Viral Load ◽  
Test And Treat ◽  
Universal Test ◽  
Persistent Viremia ◽  
Universal Test And Treat

Abstract Background There are limited data on individual HIV viral load (VL) trajectories at the population-level following the introduction of universal test and treat (UTT) in sub-Saharan Africa. Methods HIV VLs were assessed among HIV-positive participants at three population-based surveys in four Ugandan fishing communities surveyed between November 2011 and August 2017. The unit of analysis was a visit-pair (two consecutive person-visits), which were categorized as exhibiting durable VL suppression, new/renewed suppression, viral rebound, or persistent viremia. Adjusted relative risks (adjRRs) and 95%CIs of persistent viremia were estimated using multivariate Poisson regression. Results There were 1,346 HIV-positive participants (n=1,883 visit-pairs). The population-level prevalence of durable VL suppression increased from 29.7% to 67.9% during UTT rollout, viral rebound declined from 4.4% to 2.7%, and persistent viremia declined from 20.7% to 13.3%. Younger age (15-29 vs. 40-49 years, adjRR=1.80 [95%CI=1.19-2.71]), male sex (adjRR=2.09 [95%CI=1.47-2.95]), never being married (vs. currently married; adjRR=1.88 [95%CI=1.34-2.62]), and recent migration to the community (vs. long-term resident; adjRR=1.91 [95%CI=1.34-2.73]) were factors associated with persistent viremia. Conclusions Despite increases in durable VL suppression during roll-out of UTT in hyperendemic communities, a substantial fraction of the population, whose risk profile tended to be younger, male, and mobile, remained persistently viremic.

scholarly journals Population-level viral suppression among pregnant and postpartum women in a universal test and treat trial

AIDS ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jane Kabami ◽  
Laura B. Balzer ◽  
Hachem Saddiki ◽  
James Ayieko ◽  
Dalsone Kwarisiima ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Population Level ◽  
Postpartum Women ◽  
Test And Treat ◽  
Universal Test ◽  
Universal Test And Treat

Assessment of the Uptake of Universal Test and Treat Strategy of HIV/AIDS in Fako Health Districts of Cameroon

2020 ◽  
Vol 04 (03) ◽  
Author(s):  
Kah Emmanuel Nji ◽  
Dickson Shey Nsagha ◽  
Vincent Verla Siysi ◽  
Ayok Maureen Tembei ◽  
Eno Orock GE ◽  
...  
Keyword(s):  
Test And Treat ◽  
Universal Test ◽  
Universal Test And Treat ◽  
Health Districts ◽  
Hiv Aids

Barriers to HIV care in Uganda and implications for universal test-and-treat: a qualitative study

AIDS Care ◽  
2021 ◽  
pp. 1-9
Author(s):  
Sarah M. Lofgren ◽  
Sharon Tsui ◽  
Lynn Atuyambe ◽  
Leander Ankunda ◽  
Robina Komuhendo ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hiv Care ◽  
Test And Treat ◽  
Universal Test ◽  
Universal Test And Treat

Antiretroviral therapy adherence among patients enrolled after the initiation of the Universal Test and Treat strategy in Dessie town: a cross-sectional study

2020 ◽  
Vol 31 (9) ◽  
pp. 886-893
Author(s):  
Yitayish Damtie ◽  
Fentaw Tadese
Keyword(s):  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Poor Adherence ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Test And Treat ◽  
Universal Test ◽  
Universal Test And Treat ◽  
Morisky Scale

Poor adherence was the major challenge in providing treatment, care, and support for people living with HIV (PLHIV). Evidence of adherence to antiretroviral therapy (ART) after initiation of the Universal Test and Treat (UTT) strategy was limited in Ethiopia. So, this study aimed to determine the proportion of ART adherence after the initiation of UTT strategy and associated factors among adult PLHIV in Dessie town using two adherence measurements. A cross-sectional study was conducted on 293 PLHIV selected using a systematic sampling technique. The data were collected by face-to face-interview using a pretested questionnaire; chart review was also used to collect the data. The proportion of ART adherence measured by using the Morisky scale and seven-day recall was 49.3% (95% CI: [43.5%, 54.8%]) and 95.9% (95% CI: [93.2%, 98.2%]), respectively. Being urban in residence (AOR = 3.72, 95% CI: [1.80, 7.68]), the absence of depression (adjusted odds ratio [AOR] = 3.72, 95% CI: [1.22, 11.35]), taking one tablet per day (AOR = 3.26, 95% CI: [1.64, 6.49]), and the absence of concomitant illness (AOR = 0.23, 95% CI: [0.09, 0.59]) were factors associated with ART adherence. The proportion of ART adherence measured by the Morisky scale was very low; however, adherence measured by seven-day recall was higher and consistent with World Health Organization recommendations. Residence, depression, and the number of tablets taken per day had a positive association with good ART adherence whereas having concomitant illness had a negative association with good ART adherence. Efforts should be made to improve adherence and interventions should be given to overcome factors linked with poor adherence.

scholarly journals Domestic and international mobility trends in the United Kingdom during the COVID-19 pandemic: an analysis of facebook data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Harry E. R. Shepherd ◽  
Florence S. Atherden ◽  
Ho Man Theophilus Chan ◽  
Alexandra Loveridge ◽  
Andrew J. Tatem
Keyword(s):  
United Kingdom ◽  
Spatial Scales ◽  
International Travel ◽  
Population Mobility ◽  
International Mobility ◽  
Mobility Patterns ◽  
Social Distancing ◽  
The United Kingdom ◽  
The Uk ◽  
The Impact

Abstract Background Since early March 2020, the COVID-19 epidemic across the United Kingdom has led to a range of social distancing policies, which resulted in changes to mobility across different regions. An understanding of how these policies impacted travel patterns over time and at different spatial scales is important for designing effective strategies, future pandemic planning and in providing broader insights on the population geography of the country. Crowd level data on mobile phone usage can be used as a proxy for population mobility patterns and provide a way of quantifying in near-real time the impact of social distancing measures on changes in mobility. Methods Here we explore patterns of change in densities, domestic and international flows and co-location of Facebook users in the UK from March 2020 to March 2021. Results We find substantial heterogeneities across time and region, with large changes observed compared to pre-pademic patterns. The impacts of periods of lockdown on distances travelled and flow volumes are evident, with each showing variations, but some significant reductions in co-location rates. Clear differences in multiple metrics of mobility are seen in central London compared to the rest of the UK, with each of Scotland, Wales and Northern Ireland showing significant deviations from England at times. Moreover, the impacts of rapid changes in rules on international travel to and from the UK are seen in substantial fluctuations in traveller volumes by destination. Conclusions While questions remain about the representativeness of the Facebook data, previous studies have shown strong correspondence with census-based data and alternative mobility measures, suggesting that findings here are valuable for guiding strategies.

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