Estimating the impact of the US President's Emergency Plan for AIDS Relief on HIV treatment and prevention programmes in Africa

2015 ◽  
Vol 91 (8) ◽  
pp. 615-620 ◽  
Author(s):  
Laura M Heaton ◽  
Paul D Bouey ◽  
Joe Fu ◽  
John Stover ◽  
Timothy B Fowler ◽  
...  
2018 ◽  
Author(s):  
Jori Liesenborgs ◽  
Diana M Hendrickx ◽  
Elise Kuylen ◽  
David Niyukuri ◽  
Niel Hens ◽  
...  

ABSTRACTSimpactCyan is an open-source simulator for individual-based models in HIV epidemiology. Its core algorithm is written in C++ for computational efficiency, while the R and Python interfaces aim to make the tool accessible to the fast-growing community of R and Python users. Transmission, treatment and prevention of HIV infections in dynamic sexual networks are simulated by discrete events. A generic “intervention” event allows model parameters to be changed over time, and can be used to model medical and behavioural HIV prevention programmes. First, we describe a more efficient variant of the modified Next Reaction Method that drives our continuous-time simulator. Next, we outline key built-in features and assumptions of individual-based models formulated in SimpactCyan, and provide code snippets for how to formulate, execute and analyse models in SimpactCyan through its R and Python interfaces. Lastly, we give two examples of applications in HIV epidemiology: the first demonstrates how the software can be used to estimate the impact of progressive changes to the eligibility criteria for HIV treatment on HIV incidence. The second example illustrates the use of SimpactCyan as a data-generating tool for assessing the performance of a phylodynamic inference framework.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jori Liesenborgs ◽  
Diana M. Hendrickx ◽  
Elise Kuylen ◽  
David Niyukuri ◽  
Niel Hens ◽  
...  

AbstractSimpactCyan is an open-source simulator for individual-based models in HIV epidemiology. Its core algorithm is written in C++ for computational efficiency, while the R and Python interfaces aim to make the tool accessible to the fast-growing community of R and Python users. Transmission, treatment and prevention of HIV infections in dynamic sexual networks are simulated by discrete events. A generic “intervention” event allows model parameters to be changed over time, and can be used to model medical and behavioural HIV prevention programmes. First, we describe a more efficient variant of the modified Next Reaction Method that drives our continuous-time simulator. Next, we outline key built-in features and assumptions of individual-based models formulated in SimpactCyan, and provide code snippets for how to formulate, execute and analyse models in SimpactCyan through its R and Python interfaces. Lastly, we give two examples of applications in HIV epidemiology: the first demonstrates how the software can be used to estimate the impact of progressive changes to the eligibility criteria for HIV treatment on HIV incidence. The second example illustrates the use of SimpactCyan as a data-generating tool for assessing the performance of a phylodynamic inference framework.


RAHIS ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 168-169
Author(s):  
Dirce Inês Silva ◽  
Isabela Estrela Santos ◽  
Jaqueline Xavier Oliveira

INTRODUÇÃO : O tratamento da infecção pelo vírus da imunodeficiência humana (HIV) é realizado por meio da terapia antirretroviral (TARV) e vem apresentando avanços importantes no decorrer dos anos. Ocorreu a introdução de novas drogas e classes que ampliaram de modo significativo as opções para o tratamento da infecção pelo HIV-1. Existem razões para a troca (Swtich) da TARV, são eles : manutenção da supressão viral, resistência, probabilidade de maior adesão ao tratamento, eventos adversos, interações medicamentosas (1). Durante a pandemia de Covid-19 que vivenciamos desde março de 2020 no Brasil muitas dificuldades ocorreram nos serviços de saúde, principalmente para as pessoas que vivem com HIV como : acesso aos serviços, diagnóstico, tratamento e acompanhamento (2.3). OBJETIVO: Avaliar a prevalência de trocas de esquemas em um centro de referência da América Latina no período de Janeiro de 2020 a 31 de Julho de 2021.METODOLOGIA : Realizamos um estudo transversal no período de 2020 a 2021 , utilizando o sistema de informação : Sistema de Controle Logístico de Medicamentos (SICLOM) do Ministério da Saúde . Os dados foram analisados no Statistical Package for the Social Science(SPSS® ) 22.RESULTADOS : No período do estudo foram detectadas 473 trocas. Em 2020 ocorreram 283 trocas, 83 em mulheres e 200 em homens. E 2021 até o dia 31/07/2021 foram detectadas 190 trocas, 76 ocorreram em mulheres e 114 em homens. As trocas ocorreram devido : resistência, reações adversas, gestação , tratamento concomitante da tuberculose e simplificação do tratamento ( Figura 1 e 2)).   Figura 1 – Ocorências de Swtich de esquemas antirretroviraisFigura 2- Razões de Trocas de Esquemas Antiretrovirais CONCLUSÃO : Swtich dos esquemas antirretrovirais em utilização pode ser uma estratégia de simplificação da TARV, melhoria da adesão, e em muitos casos a redução de eventos adversos. O arsenal terapêutico no contexto brasileiro é diversificado permitindo uma troca com segurança e sem risco de perda da eficácia virológica. Sendo uma estratégia para enfrentamento da infecção pelo HIV mesmo em tempos de pandemia do COVID19. REFERÊNCIAS:1-Brites, Carlos. Terapia antirretroviral atual: tendências e desafios. Estratégias de troca (switch) naterapia antirretroviral atual. Brazilian Journal of Infectious DiseaseVol 2 . Nº 1 . Fevereiro 20162- Moura, Maria Lucia Costa de. (2020). Coronavírus e COVID-19. Revista Saúde Coletiva, 53, 10.3- Parente, J. da S.; Azevedo, S. L. de .; Moreira, L. da F. A.; Abreu, L. M. .; Souza, L. V. de. The impact of social isolation on the COVID-19 pandemic on access to HIV treatment and prevention services. Research, Society and Development, [S. l.], v. 10, n. 1, p. e28110111692, 2021.  


2021 ◽  
Author(s):  
Francis Lee ◽  
Daniel Sheeler ◽  
Anna Hotton ◽  
Natascha Del Vecchio ◽  
Rey Flores ◽  
...  

AbstractObjective(s)Young Black men who have sex with men (YBMSM) are a key population identified in the Illinois Getting to Zero (GTZ) initiative who have experienced disproportionate HIV incidence. Rising stimulant use has been determined to impede the effectiveness of ART and pre-exposure prophylaxis for suppressing HIV transmission in populations. This modeling study explores the impact of stimulant use on HIV incidence among YBMSM – given the limited development of dedicated or culturally appropriate interventions for this population – and assesses the impact of these interventions on downstream HIV transmission in the context of achieving GTZ goals.MethodsA previously developed agent-based network model (ABNM), calibrated using data for YBMSM in Illinois, was extended to incorporate the impact of stimulant use (methamphetamines, crack/cocaine, and ecstasy) on sexual networks and engagement in HIV treatment and prevention continua. The model simulated the impact of a residential behavioral intervention (BI) for reducing stimulant dependency and an outpatient biomedical intervention (mirtazapine) for treating methamphetamine dependence on improved engagement in the HIV treatment and prevention continua. The downstream impact of these interventions on population-level HIV incidence was the primary intervention outcome.ResultsBaseline simulated annual HIV incidence in the ABNM was 6.9(95% CI: 6.83,7.04) per 100 person years (py) and 453 (95% CI: 445.9,461.2) new infections annually. A residential targeted to 25% of stimulant users yielded a 27.1% decline in the annual number of new infections. Initiating about 50% of methamphetamine users on mirtazapine reduced the overall HIV incidence by about 11%. A 25% increase in antiretroviral treatment (ART) and preexposure prophylaxis (PrEP) uptake in the non-stimulant using YBMSM population combined with a 25% uptake of BI for stimulant users produces an HIV incidence consistent with HIV elimination targets (about 200 infections/year) identified in the GTZ initiative.ConclusionsTargeted behavioral and biomedical interventions to treat stimulant dependency are likely to provide additive benefits to expanding ART and PrEP uptake for everyone in accomplishing GTZ initiatives for HIV elimination.


2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 225-225
Author(s):  
Bruno Palma Granwehr ◽  
Kelly W. Merriman ◽  
Zeena Shelal ◽  
Hadil Bazerbashi ◽  
Patricia A Brock ◽  
...  

225 Background: HIV is a cancer-associated virus classically associated with KS, NHL, and cervical cancer, but more recently with anal cancer, lung, and head and neck cancers. HIV testing and treatment are important for cancer patients for three reasons: 1) HIV treatment is associated with reduced transmission of a cancer-associated virus. 2) HIV treatment is associated with improved outcomes of cancer therapy in many cancers. 3) HIV testing optimizes quality of care, since testing is recommended by the Centers for Disease Control and Prevention (CDC) and the US Preventive Services Task Force (USPSTF)(A level recommendation) for patients between the ages of 15 and 65 years of age. Since emergency centers (EC’s) commonly provide immunizations and other preventive care, we implemented HIV testing at our cancer center EC. Methods: In our 44 bed cancer center EC with approximately 25,000 annual visits, routine implementation by physician order was implemented in July 2014. EC information technology (IT) assisted in modification of the order sets and facilitated documentation of specific consent for HIV. Educational materials were disseminated to patients and EC providers. A new consent form with integration of HIV consent, including a check box to refuse HIV testing, was implemented on June 19, 2015. Testing results are described through August 2015. Results: HIV testing increased significantly from July 2014 and August 2015. The impact on institutional testing was considerable, increasing from 1.2% of all HIV testing in 2013 to 15.1% to date in 2015. Between July 2014 and August 2015, 1.4% (0.4% incident) of 852 patients screened positive for HIV. Notably, 83% of patients agreed to HIV testing, but less than 20% of patients were actually tested. The highest refusal rate (18.8%) was in patients over age 70 and lowest (9.9%) in those 21-29 years of age. Conclusions: Routine HIV testing is feasible in a comprehensive cancer center ED, but increased awareness is necessary to optimize testing, given the high acceptance rate. Seroprevalence of HIV is comparable to non-cancer center EC’s (0.5-1.2%). These results demonstrate the acceptance by patients of testing for HIV, with implications in reduction of transmission of this cancer-associated virus.


2014 ◽  
Vol 38 (1) ◽  
pp. 145-156 ◽  
Author(s):  
Nicolette Teufel-Shone

Since 1998, the US Congress has funded the Special Diabetes Programs for American Indians and Alaskan Natives (SDPI). These funds are administered by the Indian Health Service (IHS) and have been awarded to more than 330 IHS, tribal, and urban Indian health programs in thirty-five states to build or enhance diabetes mellitus (DM) treatment and prevention programs. Over the past thirteen years, these community-directed programs have emerged as models of intervention creativity, innovation, and persistence, with program staff drawing on their cultural capital to design culturally acceptable and locally relevant strategies. These programs have achieved measurable change in Native peoples' knowledge of the diabetes risk factors, access to much needed DM related services, and in some cases, helped reduce rates of DM-related morbidity and mortality. Yet, perhaps their greatest influence has been in understanding and shaping the context of behavioral change and in promoting normative shifts in food choices, activity patterns, DM screening, and DM self-management. Systematic qualitative data collection has not played a prominent role in the evaluation of the SDPI programs, and subsequently the role of cultural capital and the subtle normative shifts over the course of the SDPI programs have not been documented. This article offers a review of the qualitative accomplishments of the SDPI programs and some methodological suggestions for capturing the impact of cultural capital.


2018 ◽  
Vol 3 (3) ◽  
pp. e000651 ◽  
Author(s):  
Harinder Singh Chahal ◽  
Peter Capella ◽  
Ryan Presto ◽  
Jeffrey S Murray ◽  
Martin Shimer ◽  
...  

BackgroundSince 2004, the US Food and Drug Administration’s (USFDA) dedicated drug review process in support of President’s Emergency Plan for AIDS Relief (PEPFAR) has made safe, effective and quality antiretrovirals (ARVs) available for millions of patients. Furthermore, the WHO and Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) can add the USFDA-reviewed products to their respective formularies, through a novel process of ‘one-way reliance’. We assessed the number of ARVs made available through WHO and Global Fund based on the USFDA review.MethodsWe conducted a cross-sectional study of all the USFDA-reviewed PEPFAR drugs between 1 December 2014 and 20 March 2017 to determine 1) the percentage that are included on the WHO and Global Fund formularies; 2) the number of the USFDA ARVs supporting the WHO HIV treatment guidelines, and their uptake by WHO and Global Fund and 3) time between the USFDA review and WHO review of the same ARVs.FindingsOverall, 91% (204/224) of the USFDA products appeared on either the WHO/Prequalification of Medicines Programme (PQP) or the Global Fund ARV lists. Forty-five per cent (100/224) and 83% (184/224) appear on WHO/PQP and Global Fund formularies through one-way reliance, respectively. Forty-one per cent (91/224) of the USFDA products support the WHO-preferred first-line HIV treatment options. Of these 91 products, 38% and 85% of products were adopted by WHO/PQP and Global Fund through one-way reliance, respectively. Sixty-six products that were fully reviewed and registered by WHO (vs one-way reliance) had also undergone the USFDA review; 46 of these were registered by WHO after the USFDA review was complete (median delay of 559 days (IQR 233–798 days)).ConclusionsThe USFDA’s PEPFAR process is making safe and effective ARVs available worldwide, in part because the major global ARV procurement organisations rely on the USFDA registration as proof of quality. There is room for improved information sharing and collaboration to reduce duplication of effort, save resources and further expedite access to ARVs.


2018 ◽  
Vol 43 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Carina Van Rooyen ◽  
Ruth Stewart ◽  
Thea De Wet

Big international development donors such as the UK’s Department for International Development and USAID have recently started using systematic review as a methodology to assess the effectiveness of various development interventions to help them decide what is the ‘best’ intervention to spend money on. Such an approach to evidence-based decision-making has long been practiced in the health sector in the US, UK, and elsewhere but it is relatively new in the development field. In this article we use the case of a systematic review of the impact of microfinance on the poor in sub-Saharan African to indicate how systematic review as a methodology can be used to assess the impact of specific development interventions.


Author(s):  
Aref Emamian

This study examines the impact of monetary and fiscal policies on the stock market in the United States (US), were used. By employing the method of Autoregressive Distributed Lags (ARDL) developed by Pesaran et al. (2001). Annual data from the Federal Reserve, World Bank, and International Monetary Fund, from 1986 to 2017 pertaining to the American economy, the results show that both policies play a significant role in the stock market. We find a significant positive effect of real Gross Domestic Product and the interest rate on the US stock market in the long run and significant negative relationship effect of Consumer Price Index (CPI) and broad money on the US stock market both in the short run and long run. On the other hand, this study only could support the significant positive impact of tax revenue and significant negative impact of real effective exchange rate on the US stock market in the short run while in the long run are insignificant. Keywords: ARDL, monetary policy, fiscal policy, stock market, United States


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