scholarly journals Perceptions dynamics about antiretroviral treatment among HIV patients in Bali

2021 ◽  
Vol 10 (3) ◽  
pp. 500
Author(s):  
Anak Agung Sagung Sawitri ◽  
I Nyoman Sutarsa ◽  
Tuti Parwati Merati ◽  
Made Bakta ◽  
Dewa Nyoman Wirawan
Keyword(s):  
Antiretroviral Treatment ◽  
Continuous Process ◽  
Hiv And Aids ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Chi Square ◽  
Art Initiation ◽  
Living With Hiv ◽  
The Continuum

Perceptions of people living with HIV and AIDS (PLHIV) about antiretroviral treatment (ART) is crucial for improving adherence. This study aims to examine the dynamics of perceptions during the early phase of ART. A longitudinal study involving newly diagnosed PLHIV was conducted. Interviews were carried out at the time of HIV diagnosis and at three months after ART initiation. Data were analyzed by comparing proportion of good perception across the continuum of HIV diagnosis, ART initiation and threemonths follow-up, and were tested using Chi-square. From 170 PLHIV participated in the study, 81.76% had initiated ART and 73.4% remained on ART at three-months of follow-up. Several positive perception items were significantly decreased: ability to take ART at work and ability to continue treatment if experiencing side effects, effectiveness of ART, confidentiality, unwanted disclosure, and level of support from outreach workers. Ability to follow instruction from physician was significantly increased, and negative attitudes toward ART were decreased across the continuum. Adherence to ART is a continuous process, and is influenced by the dynamics perceptions among PLHIV. Understanding these dynamics is crucial to formulate strategies that can promote and maintain positive attitudes toward ART as well as living with HIV more broadly.

scholarly journals Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
First Line ◽  
Hiv Viral Load ◽  
Loss To Follow Up ◽  
History Of ◽  
Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

scholarly journals 1313. Complementary Effects of Medical Follow-up and Virologic Suppression for Reincarcerated Inmates Living with HIV

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S474-S474
Author(s):  
Melissa E Badowski ◽  
R Kane Stafford ◽  
Brian W Drummond ◽  
Thomas D Chiampas ◽  
Sarah M Michienzi ◽  
...  
Keyword(s):  
Hiv Care ◽  
People Living With Hiv ◽  
Virologic Suppression ◽  
Management Support ◽  
Chi Square ◽  
History Of ◽  
Secondary Endpoints ◽  
Living With Hiv ◽  
Hiv 1

Abstract Background Although prison presents an opportunity to achieve virologic suppression (VS) among people living with HIV, continued success is not guaranteed upon release. Methods A retrospective cohort study was performed in reincarcerated Illinois prisoners from January 1, 2016 to July 31, 2018. Patients were included if they were age ≥18 years, carried a diagnosis of HIV/AIDS, on antiretroviral therapy (ART) at the time of release, and had CD4 and HIV-1 RNA labs drawn within 6 months of release and reincarceration. Potential subjects were excluded if reincarcerated within 30 days due to a technical violation and not receiving ART at the time of prison release. Primary and secondary endpoints were percent of patients achieving VS upon reincarceration and percent of patients following at an HIV clinic while released. Statistical analysis included descriptive statistics, chi-square, and paired t-tests. Results Among 505 patients released during the study period, 95 patients were reincarcerated and 80 were included (Figure 1). Demographic information can be found in Table 1. Fifty-one patients (64%) reported follow-up at an HIV clinic while released, whereas 29 (36%) did not. Patients who had VS at the time of prison release were more likely to make their follow-up appointment (90%) compared with those who did not (69%) (P < 0.001). In addition, patients making their follow-up appointment were also more likely to have VS at the time of reincarceration (86% vs. 10%, P < 0.001). Recidivist patients adherent to ART were less likely to experience decreases in mean CD4 count (P = 0.03) (Table 2). Subjects reporting a history of substance use were more likely not to re-engage in post-release HIV care (P = 0.001), but no difference was noted in patients with a documented psychiatric history (P = 0.2). Conclusion Patients failing to meet VS at the time of prison release should be targeted for more intensive re-entry medical and case management support to ensure adherence to follow-up and maintenance of immunologic function. Disclosures All authors: No reported disclosures.

scholarly journals Respons Orang Hidup Dengan HIV AIDS (OHIDHA) Dalam Upaya Penanggulangan HIV AIDS di Kabupaten Sukoharjo dan Grobogan

2017 ◽  
Vol 12 (1) ◽  
pp. 92
Author(s):  
Arrum Firda Ayu Maqfiroch ◽  
Zahroh Shaluhiyah
Keyword(s):  
Univariate Analysis ◽  
Hiv And Aids ◽  
P Value ◽  
People Living With Hiv ◽  
Chi Square ◽  
Cross Sectional ◽  
The Status ◽  
Keywords Aids ◽  
Living With Hiv ◽  
Hiv Aids

ABSTRAKPenanggulangan HIV AIDS membutuhkan keterlibatan dari berbagai pihak. Salah satu pihak yang terlibat adalah OHIDHA. OHIDHA merupakan anggota keluarga yang hidup bersama ODHA dan memberikan dukungan kepada ODHA. Stigma di Kabupaten Sukoharjo dan Grobogan masih tinggi. Penelitian ini bertujuan untuk mengetahui faktor-faktor apakah yang menentukan respons OHIDHA dalam upaya penanggulangan HIV AIDS di Kabupaten Sukoharjo dan Grobogan.Penelitian ini merupakan penelitian kuantitatif dengan pendekatan cross sectional. Teknik pengambilan data kuantitatif melalui wawancara dengan kuesioner. Penelitian ini didukung dengan penelitian kualitatif dengan teknik pengambilan data FGD. Jumlah responden adalah 92 OHIDHA, proporsi 50% dan selang kepercayaan 95%. Analisis data menggunakan analisis univariat dengan distribusi frekuensi, bivariat menggunakan Chi-Square dan multivariat menggunakan regresi logistik.Hasil penelitian menunjukkan bahwa variabel yang berhubungan dengan respons OHIDHA adalah hubungan dengan ODHA (p-value=0,001), lama hidup dengan ODHA (p-value=0,030), lama mengetahui status ODHA (p-value=0,001) dan sikap (p-value=0,005). Hasil analisis multivariat menunjukkan bahwa sikap (p-value=0,006) merupakan variabel yang mempunyai pengaruh paling signifikan dibanding variabel lainnya.Kata Kunci : OHIDHA, respons, Grobogan, Sukoharjo Respons of People Living With HIV AIDS to Control HIV and AIDS in Sukoharjo and Grobogan District; Controlling HIV and AIDS requird the involvement of various sector. One of the sector involved is People Living With HIV AIDS (PLWHA).  PLWHA is a family member who lives with people living with HIV and provide support to people living with HIV. Stigma in Sukoharjo and Grobogan still high. This study aims to determine the factors that determine whether the PLWHA response in control to HIV and AIDS in Sukoharjo Grobogan. This research was a quantitative study with cross sectional approach. Quantitative data collection techniques through interviews with questionnaires . This research was supported by qualitative research with FGD. The number of respondents was 92 PLWHA, the proportion of 50% and 95% confidence interval . Analysis of the data using univariate analysis with frequency distribution, bivariate using Chi-Square and multivariate using logistic regression. The results showed that the variables related to the PLWHA response is a relationship with people living with HIV ( p = 0,001 ) , long life with people living with HIV ( p = 0.030 ) , longer know the status of PLWHA ( 0.001 ) and attitude ( p = 0.005 ). Multivariate analysis showed that the attitude (p value = 0,006) was a variable that has the most significant effect compared to other variables .Keywords : AIDS , response , Grobogan , Sukoharjo

scholarly journals Circulating microparticles are increased amongst people presenting with HIV and advanced immune suppression in Malawi and correlate closely with arterial stiffness: a nested case control study

2021 ◽  
Vol 6 ◽  
pp. 264
Author(s):  
Christine Kelly ◽  
Rijan Gurung ◽  
Raphael Kamng'ona ◽  
Irene Sheha ◽  
Mishek Chammudzi ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Immune Suppression ◽  
Endothelial Damage ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Art Initiation ◽  
Immunodeficiency Virus ◽  
Circulating Microparticles ◽  
Living With Hiv ◽  
Nested Case Control

Background: We aimed to investigate whether circulating microparticle (CMPs) subsets were raised amongst people presenting with human immunodeficiency virus (HIV) and advanced immune suppression in Malawi, and whether they associated with arterial stiffness. Methods: Antiretroviral therapy (ART)-naïve adults with a new HIV diagnosis and CD4 <100 cells/µL had microparticle characterisation and carotid femoral Pulse Wave Velocity (cfPWV) at 2 weeks post ART initiation. HIV uninfected controls were matched on age, systolic blood pressure (BP) and diastolic BP in a 1:1 ratio.  Circulating microparticles were identified from platelet poor plasma and stained for endothelial, leucocyte, monocyte and platelet markers. Results: The median (IQ) total CMP count for 71 participants was 1 log higher in HIV compared to those without (p<0.0001) and was associated with arterial stiffness (spearman rho 0.47, p<0.001). In adjusted analysis, every log increase in circulating particles showed a 20% increase in cfPWV (95% confidence interval [CI] 4 – 40%, p=0.02). In terms of subsets, endothelial and platelet derived microparticles were most strongly associated with HIV. Endothelial derived E-selectin+ CMPs were 1.3log-fold higher and platelet derived CD42a+ CMPs were 1.4log-fold higher (both p<0.0001). Endothelial and platelet derived CMPs also correlated most closely with arterial stiffness (spearman rho: E-selectin+ 0.57 and CD42a 0.56, both p<0.0001). Conclusions: Circulating microparticles associate strongly with arterial stiffness among people living with HIV in Malawi. Endothelial damage and platelet microparticles are the predominant cell origin types and future translational studies could consider prioritising these pathways.

scholarly journals Consequences of the COVID-19 pandemic on the continuum of the care in a cohort of people living with HIV followed in a single center of Northern Italy

2020 ◽  
Author(s):  
Eugenia Quiros-Roldan ◽  
Paola Magro ◽  
Canio Carriero ◽  
Annacarla Chiesa ◽  
Issa El Hamad ◽  
...  
Keyword(s):  
Antiretroviral Drugs ◽  
Hiv Care ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Continuous Variables ◽  
Hiv Diagnosis ◽  
Missed Visits ◽  
Hiv Continuum Of Care ◽  
Living With Hiv ◽  
The Continuum

Abstract Introduction: During the COVID-19 pandemic, hospitals faced increasing pressure, where people living with HIV risked to either acquire SARS-CoV-2 and to interrupt the HIV continuum of care.Methods: this is a retrospective, observational study. We compared the numbers of medical visits performed, antiretroviral drugs dispensed and the number of new HIV diagnosis and of hospitalizations in a cohort of people living with HIV (PLWH) followed by the Spedali Civili of Brescia between the bimester of the COVID-19 pandemic peak and the bimester of October-November 2019. Data were retrieved from administrative files and from paper and electronic clinical charts. Categorical variables were described using frequencies and percentages, while continuous variables were described using mean, median, and interquartile range (IQR) values. Means for continuous variables were compared using Student’s t-tests and the Mann-Whitney test. Proportions for categorical variables were compared using the χ2 test.Results: As of December 31st, 2019, a total of 3875 PLWH were followed in our clinic. Mean age was 51,4 ±13 years old, where 28% were females and 18.8% non-Italian. Overall, 98.9% were on ART (n=3834), 93% were viro-suppressed. A total of 1217 and 1162 patients had their visit scheduled at our out-patient HIV clinic during the two bimesters of 2019 and 2020, respectively. Comparing the two periods, we observed a raise of missed visits from 5% to 8% (p<0.01), a reduction in the number of new HIV diagnosis from 6.4 in 2019 to 2.5 per month in 2020 (p=0.01), a drop in ART dispensation and an increase of hospitalized HIV patients due to COVID-19. ART regimens including protease inhibitors (PIs) had a smaller average drop than ART not including PIs (16,6% vs 21,6%, p<0.05). Whether this may be due to the perception of a possible efficacy of PIs on COVID19 is not known. Conclusions: Our experience highlights the importance of a resilient healthcare system and the need to implement new strategies in order to guarantee the continuum of HIV care even in the context of emergency.

scholarly journals Determinants of AIDS and non-AIDS related mortality among people living with HIV in Shiraz, southern Iran: a 20-year retrospective follow-up study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zahra Gheibi ◽  
Zahra Shayan ◽  
Hassan Joulaei ◽  
Mohammad Fararouei ◽  
Shohreh Beheshti ◽  
...  
Keyword(s):  
Immune Deficiency Syndrome ◽  
Older Age ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Mena Region ◽  
Infected People ◽  
Clinical Stages ◽  
Living With Hiv ◽  
Related Mortality

Abstract Background Human Immunodeficiency Virus (HIV) infection has become a global concern. Determining the factors leading to death among HIV patients helps controlling Acquired Immune Deficiency Syndrome (AIDS) epidemic. Up to now, little is known about mortality and its determinants among people living with HIV in the Middle East and North Africa (MENA) region, including Iran. The purpose of this study was to assess the risk factors of AIDS-Related Mortality (ARM) and Non-AIDS-Related Mortality (NARM) among people with HIV in Iran. Methods This 20-year retrospective study was conducted on 1160 people with HIV whose data were collected from 1997 to 2017. The association of the study outcomes (ARM and NARM) with various study variables, including demographic status at the time of diagnosis and clinical indexes during the follow-up were examined to define the predictors of mortality among the patients. Regarding, Cox proportional hazard and competing risk models were fitted and Adjusted Hazard Ratios (AHR), Sub-distribution Hazard Ratio (SHR) and the 95% Confidence Intervals (CI) were reported. Results during the follow-up period, 391 individuals (33.7%) died with 86,375 person-years of follow-up. Of the total deaths, 251 (64.2%) and 140 (35.8%) were ARM and NARM, respectively. Rates of the mortality caused by AIDS and non-AIDS were 3.2 and 4.5 per 1000 person-months, respectively. Responding to combined Antiretroviral Treatment (cART) 6 months after initiation, receiving Pneumocystis Pneumonia (PCP) prophylaxis, and higher CD4 count at diagnosis, reduced the hazard of ARM and NARM. However, older age, late HIV diagnosis, and last HIV clinical stages increased the hazard of AIDS related to mortality. Additionally, male gender, older age, incarceration history, and last HIV clinical stages increased the non-AIDS mortality. Conclusions Mortality caused by AIDS and non-AIDS remains high among people with HIV in Iran, particularly among males and those with late diagnosis. It seems that applying effective strategies to identify infected individuals at earlier stage of the infection, and targeting individuals with higher risk of mortality can decrease the mortality rate among HIV infected people.

Factors that can influence feelings towards and interactions with people living with HIV/AIDS in rural Central Kenya

2016 ◽  
Vol 28 (9) ◽  
pp. 910-919 ◽  
Author(s):  
Caroline Kingori ◽  
Zelalem T Haile ◽  
Peter Ngatia ◽  
Ruth Nderitu
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Hiv And Aids ◽  
People Living With Hiv ◽  
Hiv Knowledge ◽  
Chi Square ◽  
Hiv Prevention Strategies ◽  
Living With Hiv ◽  
Central Kenya ◽  
Hiv Aids

Background In Kenya, HIV incidence and prevalence have declined. HIV rates are lower in rural areas than in urban areas. However, HIV infection is reported higher in men in rural areas (4.5%) compared to those in urban areas (3.7%). Objectives This study examined HIV knowledge, feelings, and interactions towards HIV-infected from 302 participants in rural Central Kenya. Methods Chi square tests and multivariable logistic regression analyzed variables of interest. Results Most participants exhibited positive feelings in their interaction with people living with HIV and AIDS (PLWHA). Association between HIV knowledge and socio-demographic characteristics revealed that the proportion of participants with a correct response differed by gender, age, level of education, and marital status ( p < 0.05). Compared to those with inadequate knowledge of HIV/AIDS, participants with adequate HIV/AIDS knowledge were nearly three times as likely to disagree that PLWHA should be legally separated from others to protect public health (adjusted odds ratio: aOR (95% CI) (2.76 (1.12, 6.80). Conclusions HIV stigma continues to impact HIV prevention strategies particularly in rural Central Kenya. Culturally, appropriate interventions addressing HIV knowledge among those with lower levels of education, single, older, and male are warranted. Review of HIV policies separating high-risk populations from the general population is needed to reduce stigma.

scholarly journals A Conceptual Analysis of Metaphors Engendering HIV and AIDS-Related Stigma and Discrimination in Kisii County, Kenya

2020 ◽  
Vol 14 (2) ◽  
pp. 137-147
Author(s):  
Geoffrey Mokua Maroko ◽  
Gladys Nyamoita Mokua ◽  
Augustus Onchari Nyakundi ◽  
Meshack Ondora Onyambu
Keyword(s):  
Hiv And Aids ◽  
People Living With Hiv ◽  
Language Management ◽  
Group Discussions ◽  
Support Providers ◽  
Stigma And Discrimination ◽  
Success Stories ◽  
Related Stigma ◽  
Living With Hiv

Metaphors are mapped across two conceptual domains where A is B. Metaphorical expressionsare defined by dimensions including novelty, conventionality, abstractness and concreteness. The AbaGusii of Western Kenya is a highly conservative community of Bantu speakers of Western part of Kenya. They view HIV and Aids as taboo that cannot be the subject of discussion in public. Hence, People Living with HIV (hereafter PLHIV) are stigmatized and discriminated. The purpose of this paper is to analyse the metaphorical words and concepts that engender HIV and Aids-related stigma and discrimination in Kisii County. Descriptive narratives were elicited from HIV support providers using focus group discussions and follow-up interviews. The narratives were analysed in terms of five attributes of stigma and discrimination within the conceptual metaphor theory. Results revealed some culturally ingrained metaphors that evoke stigma and discrimination. The paper advocates for language management efforts using success stories in HIV and Aids management to construct positive messages to counter the negative metaphors.

scholarly journals The PARTIAL ACHIEVEMENT OF THE 90-90-90 UNAIDS TARGET IN A COHORT OF HIV INFECTED PATIENTS FROM CENTRAL ITALY.

2020 ◽  
Vol 12 (1) ◽  
pp. e2020017 ◽  
Author(s):  
Elisabetta Schiaroli
Keyword(s):  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Central Italy ◽  
Linkage To Care ◽  
People Living With Hiv ◽  
Engagement In Care ◽  
Hiv Test ◽  
Rapid Tests ◽  
Living With Hiv ◽  
The Continuum

Despite progress in the prevention and treatment of HIV, persistent issues concerning the evaluation of continuum in care from the serological diagnosis to virologic success remain. Considering the UNAIDS target 90-90-90 for 2020 for treatment and viral suppression of people living with HIV (PLVH), our purpose was to verify if, starting from diagnosis, the viral suppression rate of our cohort of new PLWH satisfied the above targets. The aim of this retrospective study was to compare 2005-2017 data collected at the Perugia Infectious Diseases Clinic with the 2020 UNAIDS 90 targets and to identify risk factors that could be associated with failure to reach these targets. Methods:  We included all patients aged ≥15 undergoing HIV test at our clinic between January 2005 and December 2017. We evaluated the unclaimed tests, linkage to care, retention in ART and the viral suppression at 1 and 2 years from starting ART. Data were analyzed between Italians and foreigners. Results: We observed 592 new diagnoses for HIV infection: 61.4% on Italian-natives, 38.5% on foreigners. Considering the continuum of care from diagnosis, 88 (15%) PLWHIV were lost to engagement in care: 55 (9.2%) patients didn’t withdraw the test and 33 (5.5%)  didn’t link to care. An antiretroviral treatment was started only on 78.8% of the new diagnoses (467/592) and a viral suppression was obtained at 2 years on 82% of PLWH who had started ART (383/467) namely only 64.7% of the new diagnoses instead of the hoped-for 81% of the UNAIDS target. We found no significant differences between Italians and foreigners Conclusions UNAIDS goal was very far to be reached. The main challenges were unreturned tests as well as the retention in ART. Rapid tests for a test-treat strategy and frequent phone communications in the first ART years could facilitate UNAIDS target achievement.

scholarly journals Antiretroviral therapy among patients with HIV in Almaty, Kazakhstan: the implication for HIV-associated tuberculosis control

2020 ◽  
Vol 14 (11.1) ◽  
pp. 128S-132S
Author(s):  
Alfiya Denebayeva ◽  
Arpine Abrahamyan ◽  
Aelita Sargsyan ◽  
Karine Kentenyants ◽  
Ainur Zhandybayeva ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Guideline ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Preventive Strategy ◽  
Hiv Diagnosis ◽  
Art Initiation ◽  
Living With Hiv ◽  
And Control ◽  
The Impact

Introduction: Antiretroviral therapy (ART) is an effective preventive strategy against tuberculosis (TB) in people living with HIV (PLWH). In Kazakhstan, according to the revised HIV treatment guideline (2017), ART should be initiated immediately after HIV diagnosis established, regardless of CD4+ count. Aim: To evaluate the impact of early initiation of ART on TB infection in PLWH registered in the Center of Prevention and Control of AIDS, Almaty, Kazakhstan, between 2008 and 2018. Methodology: A retrospective cohort study was conducted using the data of 4,053 patients from electronic HIV case management system (2008-2018) (EHCMS). Results: The study revealed low rates (12.6%) of rapid ART (≤ 1 month after HIV diagnosis). Patients in the rapid ART initiation group were less likely to develop TB compared with those who started treatment >1 month after the HIV detection (odds ratio 1.6; 95% confidence interval [1.1, 2.2]; p = 0.00799). Interestingly, the risk for developing TB among patients receiving ART ≥ 1 month after HIV diagnosis was significantly higher compared with those not taking any treatment. The latter was explained by several confounding not addressed during the analysis, since ART was prescribed to patients with primarily deeper immunodeficiency, while the patients not receiving ART were less immunocompromised. Conclusion: Despite the recently changed HIV treatment guideline in Kazakhstan, ART is still initiated based on the disease severity. In 2018, the initiation of ART during the first month after HIV diagnosis increased by 50%. However, it is necessary to reduce the time to initiation of ART for all patients.

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