scholarly journals The HIV treatment cascade in people living with HIV in Iran in 2014: Mixed-method study to measure losses and reasons

2019 ◽  
Vol 30 (13) ◽  
pp. 1257-1264 ◽  
Author(s):  
Nima Ghalehkhani ◽  
Behnam Farhoudi ◽  
Mohammad Mehdi Gouya ◽  
Hamid Sharifi ◽  
SeyedAhmad SeyedAlinaghi ◽  
...  
Keyword(s):  
Cell Count ◽  
Hiv Treatment ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Treatment Cascade ◽  
Cascade Analysis ◽  
Hiv Treatment Cascade ◽  
Living With Hiv ◽  
Cd4 Cell

The study assessed the HIV treatment cascade of people living with HIV (PLWH) in Iran and the reasons for gaps in HIV services in 2014. We did the cascade analysis using the WHO HIV test–treat–retain cascade analysis tool (2014). To measure the gaps, we checked the records for all PLWH reported to the national HIV surveillance till September 2014 to define how many were alive, linked to HIV care, assessed for CD4 cell count, started antiretroviral therapy (ART), and reported to be alive up to five years after ART. To assess the reasons for gaps in the cascade, we ran desk review, four focus group discussions and 51 in-depth interviews with key informants including PLWH. Spectrum model estimated 75,700 PLWH in Iran, of whom only 22,647 people (%30) were diagnosed. Of those who were diagnosed with HIV, 16,266 people (%72) had enrolled in HIV care. About 13% of all PLWH were retained in HIV care and only 9% (6745 people) had ever been tested for CD4 cell count. Only 8% (6018 people) of all PLWH had received ART by September 2014. We found the biggest gap in the HIV treatment cascade to be HIV diagnosis as only 30% of PLWH have been diagnosed. Innovative strategies to improve HIV testing, particularly those that work best for key populations, are critical to reach the 90–90-90 targets.

scholarly journals Problematizing transitions in relation to correctional centres for people living with HIV: Unpacking the taken for granted.

2021 ◽  
Vol 3 (2) ◽  
pp. 47-63
Author(s):  
Morgan Wadams
Keyword(s):  
Healthcare Providers ◽  
Hiv Treatment ◽  
Knowledge Generation ◽  
Hiv Care ◽  
Correctional Facilities ◽  
People Living With Hiv ◽  
Treatment Cascade ◽  
Hiv Treatment Cascade ◽  
Care Practices ◽  
Living With Hiv

Transitions into and out of correctional facilities for people living with HIV are a pivotal point in the HIV treatment cascade where adherence metrics are significantly affected. In this paper I use Alvesson and Sandberg’s problematization method of literature analysis to critique and understand the taken-for-granted assumptions underpinning how knowledge is generated within the intersecting fields of HIV, transitions, and corrections. Utilizing problematization, two assumptions underpinning knowledge generation are identified: the linearity of the HIV care continuum model and the tendency to create and perpetuate spatially segregating metaphors of transitions inside versus outside correctional facilities for people living with HIV. These assumptions are discussed in the context of how they shape dominant ways of thinking and practicing in the field. An alternative way to understand transitions for people living with HIV is proposed along with recommendations to guide the HIV care practices of nurses and other healthcare providers.

scholarly journals The THE SPECTRUM OF OPPORTUNISTIC INFECTIONS AND ASSOCIATED FACTORS AMONG PEOPLE LIVING WITH HIV/AIDS ON HIGHLY ACTIVE ANTI-RETROVIRAL THERAPY AT MERPATI CLINIC, BALI, INDONESIA: A RETROSPECTIVE STUDY

2020 ◽  
pp. 68-71
Author(s):  
NOVIANA JOENPUTRI ◽  
KETUT SURYANA
Keyword(s):  
Retrospective Study ◽  
Marital Status ◽  
Cell Count ◽  
Associated Factors ◽  
Opportunistic Infections ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Living With Hiv ◽  
Cd4 Cell

Objective: Infections contributed to higher morbidity and mortality in people living with HIV/AIDS (PLWHA) in both developed and developing countries. This study aimed to describe the spectrum of opportunistic infections (OIs) and associated factors among PLWHA on highly active antiretroviral therapy (HAART) at Merpati Clinic, Wangaya Regional General Hospital in Denpasar, Bali. Methods: This was a retrospective study. All of PLWHA, who still receiving HAART at Merpati Clinic from January 2018 to January 2020, who met inclusion and exclusion criteria, were included as subjects in this study. All data were collected through a review of the complete medical record of patients. Results: The prevalence of OIs in this study was 43.4%. Most PLWHA who experienced OIs were male (68.8%), age ≤40 y old with a median of age 36 y old, educational status senior high school (57.7%), married (62.1%), employed (89.7%), CD4 cell count ≥ 200 cells/µl (67.6%) and transmission route of HIV non-Intravenous (IV) drug user (99.2%). Sex, age, marital status, and CD4 cell count were significantly associated with OIs, p=0.000, p=0.005, p=0.005, and p=0.000, respectively. Conclusion: The commonest OI in this study was pulmonary tuberculosis. The presence of OIs was associated with sex, age of HIV diagnosis, marital status, and CD4 cell count. With the knowledge of OIs spectrum, clinicians are expected to be able to prevent, diagnose and treat OIs promptly to decrease the morbidity and mortality caused by OIs efficiently.

scholarly journals Retention in Care among Patients with Early HIV Disease in Haiti

2017 ◽  
Vol 16 (6) ◽  
pp. 523-526 ◽  
Author(s):  
Kelly A. Hennessey ◽  
Taina Dadaille Leger ◽  
Vanessa R. Rivera ◽  
Adias Marcelin ◽  
Margaret L. McNairy ◽  
...  
Keyword(s):  
Cell Count ◽  
Retention In Care ◽  
Hiv Treatment ◽  
World Health ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Hiv Test ◽  
Lost To Follow Up ◽  
Cd4 Cell

In September 2015, the World Health Organization updated their guidelines to recommend antiretroviral therapy (ART) for all people living with HIV. Countries are now in the process of implementing strategies to provide universal HIV treatment. We analyzed the rate of retention and time to ART eligibility (according to 2013 WHO guidelines) among 3,345 adult patients receiving positive HIV test results between February 1, 2003 and March 31, 2013 at the GHESKIO Clinic in Haiti, with WHO stage 1 or 2 disease and initial CD4 cell count >500 cells/mm3. Among the 3,345 patients, 2,423 (72%) were female, the median age was 33 years, 3,089 (92%) lived in Port-au-Prince, and 1,944 (58%) had attended no school or primary school only. The median initial CD4 cell count was 668 cells/mm3 (IQR: 572-834); over the subsequent 2 years, 1,485 patients (44%) were lost to follow-up and 7 (<1%) died pre-ART, 1,041 (31%) were retained in pre-ART care, and 819 (24%) initiated ART. In multivariate analysis, secondary education (aOR 1.27; 95% CI: 1.10-1.47), female gender (aOR: 1.28; 95% CI: 1.09-1.50), co-habitation (aOR: 1.31; 95% CI: 1.09-1.57), and residence in Port-au-Prince (aOR: 1.43; 95% CI: 1.09-1.88) were associated with retention in care. The median time from baseline CD4 count to ART eligibility was 1.7 years. Prior to the implementation of universal treatment, pre-ART attrition was high among patients who did not qualify for ART at presentation. Though implementing WHO recommendations for universal ART will require service expansion, it will likely result in improved retention for those at risk of being lost to follow-up.

scholarly journals CD4+ cell count stratification to guide tuberculosis preventive therapy for people living with HIV

AIDS ◽  
2020 ◽  
Vol 34 (1) ◽  
pp. 139-147 ◽  
Author(s):  
Lelia H. Chaisson ◽  
Valeria Saraceni ◽  
Silvia Cohn ◽  
Dena Seabrook ◽  
Solange C. Cavalcante ◽  
...  
Keyword(s):  
Cell Count ◽  
Preventive Therapy ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Living With Hiv ◽  
Cd4 Cell

scholarly journals People living with HIV in Estonia: engagement in HIV care in 2013

2016 ◽  
Vol 21 (43) ◽  
Author(s):  
Kaja-Triin Laisaar ◽  
Mait Raag ◽  
Irja Lutsar ◽  
Anneli Uusküla
Keyword(s):  
Medical Care ◽  
Universal Access ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Administrative Databases ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
The European Union ◽  
Treatment Cascade ◽  
Living With Hiv

Estonia had the highest rate of newly diagnosed human immunodeficiency virus (HIV) cases in the European Union (24.6/100,000) and an estimated adult HIV prevalence of 1.3% in 2013. HIV medical care, including antiretroviral therapy (ART), is free of charge for people living with HIV (PLHIV). To maximise the health benefits of HIV treatment, universal access should be achieved. Using data from surveillance and administrative databases and the treatment cascade model, we assessed the number of people infected with HIV, diagnosed with HIV, linked to HIV care, retained in HIV care, on ART, and with suppressed viral load (HIV-RNA: < 200 copies/mL). We identified that about one quarter of the 8,628 HIV-positive people estimated to live in Estonia in 2013 had not been diagnosed with HIV, and another quarter, although aware of their HIV-positive serostatus, had not accessed HIV medical care. Although altogether only 12–15% of all PLHIV in Estonia had achieved viral suppression, the main gap in HIV care in Estonia were the 58% of PLHIV who had accessed HIV medical care at least once after diagnosis but were not retained in care in 2013.

Progressive phasing out of baseline CD4 cell count testing for people living with HIV in Kinshasa, DRC

AIDS ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nadine Mayasi Ngongo ◽  
Hippolyte Situakibanza Nani-Tuma ◽  
Marcel Mbula Mambimbi ◽  
Murielle Longokolo Mashi ◽  
Ben Bepouka Izizag ◽  
...  
Keyword(s):  
Cell Count ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Living With Hiv ◽  
Cd4 Cell

scholarly journals A comparative study: long and short term effect of a nutrition sensitive approach to delay the progression of HIV to AIDS among people living with HIV (PLWH) in Nigeria

2016 ◽  
Vol 6 (2) ◽  
pp. 79
Author(s):  
Abraham Mainaji Amlogu ◽  
Sundus Tewfik ◽  
Charles Wambebe ◽  
Ihab Tewfik
Keyword(s):  
Cell Count ◽  
Negative Impact ◽  
Scale Up ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Biochemical Indices ◽  
Nutrition Sensitive ◽  
Living With Hiv ◽  
Cd4 Cell

ABSTRACTBackground: Malnutrition has a negative impact on optimal immune function, thus increasing susceptibility to morbidity and mortality among HIV positive patients. Evidence indicates that the prevalence of macro and micronutrient deficiencies (particularly magnesium, selenium, zinc, and vitamin C) has a negative impact on optimal immune function, through the progressive depletion of CD4 T-lymphocyte cells, which thereby increases susceptibility to morbidity and mortality among PLWH. Objective: To assess the effectiveness of a nutrition sensitive intervention to delay the progression of human immune-deficiency virus (HIV) to AIDS among people living with HIV in Abuja, Nigeria.Methods: A randomised control trial was carried out on 400 PLWH (adult, male and female of different religious background) in Abuja, Nigeria between January and December, 2012. Out of these 400 participants, 100 were randomly selected for the six months pilot study (January to June, 2012). The participants in the pilot study overlapped to form part of the scale-up participants (n 400) monitored from June to December, 2012. The comparative effect of daily consumed 354.92 kcal/d optimised meal for six and twelve months was ascertained through the nutritional status and biochemical indices of the study participants (n 100 pilot and n 400 scale-up interventions) who were/were not taking the intervention meal. The meal consisted of: Glycine max 50g; Pennisetum americanum 20g; Moringa oleifera 15g; Daucus carota spp.sativa 15g.Results: At the end of six months of the scale-up intervention, mean CD4 cell count (cell/mm3) for Pre-ART and ART Test groups increased by 6.31% and 12.12% respectively. Mean mid upper arm circumference (MUAC) for Pre-ART and ART Test groups increased by 2.72% and 2.52% within the same period (n 400). Comparatively, participants who overlapped from pilot to scale-up intervention (Long term use, n 100) were assessed for 12 months. Mean CD4 cell count (cell/mm3) for Pre-ART and ART Test groups increased by 2.21% and 12.14%. Mean MUAC for Pre-ART and ART Test groups increased by 2.08% and 3.95% respectively. Moreover, Student’s t-test analysis suggests a strong association between the intervention meal,  MUAC and CD4 count on long term use of optimised meal in the group of participants on antiretroviral therapy (ART) (P<0.05). Conclusion: Although the achieved results take the form of specific technology, it suggests that a prolong consumption of the intervention meal will be suitable to sustain the gained improvements in the anthropometric and biochemical indices of PLWHIV in Nigeria. Keywords: HIV; AIDS; Nutrition-sensitive approach; CD4 cell count; Macro and Micronutrients; ART; Tailored Functional Recipe - TFR.

scholarly journals Immunologic Restoration of People Living with Human Immunodeficiency Virus on Highly Active Anti-retroviral Therapy in Ethiopia: The Focus of Chronic Non-Communicable Disease Co-Morbidities

2019 ◽  
Vol 13 (1) ◽  
pp. 36-48 ◽  
Author(s):  
Tsegaye Melaku ◽  
Girma Mamo ◽  
Legese Chelkeba ◽  
Tesfahun Chanie
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Highly Active Antiretroviral Therapy ◽  
Communicable Disease ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Living With Hiv ◽  
Cd4 Cell ◽  
Non Communicable Disease

Background: The life expectancy of people living with Human Immunodeficiency Virus (HIV) has dramatically improved with the much-increased access to antiretroviral therapy. Consequently, a larger number of people living with HIV are living longer and facing the increased burden of non-communicable diseases. This study assessed the effect of chronic non-communicable disease(s) and co-morbidities on the immunologic restoration of HIV infected patients on highly active antiretroviral therapy. Methods: A nested case-control study was conducted among people living with HIV at Jimma University Medical Center from February 20 to August 20, 2016. Cases were HIV infected patients living with chronic non-communicable diseases and controls were people living with HIV only. Patient-specific data were collected using a structured data collection tool to identify relevant information. Data were analyzed using the Statistical Package for Social Science version 20.0. Logistic regressions were used to identify factors associated with outcome. Statistical significance was considered at p-value <0.05. A patient's written informed consent was obtained after explaining the purpose of the study. Results: A total of 240 participants (120 cases and 120 controls) were included in the analysis. Prevalence of hypertension was 12.50%, and diabetes was 10.84%. About 10.42% of study participants were living with multi-morbidity. At baseline, the mean (±SD) age of cases was 42.32±10.69 years, whereas it was 38.41±8.23 years among controls. The median baseline CD4+ cell count was 184.50 cells/µL (IQR: 98.50 - 284.00 cells/µL) for cases and 177.0 cells/µL (IQR: 103.75 - 257.25 cells/µL) for controls. Post-6-months of highly active antiretroviral therapy initiation, about 29.17% of cases and 16.67% of controls had poor immunologic restoration. An average increase of CD4+ cell count was 6.4cells/µL per month among cases and 7.6 cells/µL per month among controls. Male sex [AOR, 3.51; 95% CI, 1.496 to 8.24; p=0.004], smoking history [AOR, 2.81; 95% CI, 1.072, to 7.342; p=0.036] and co-morbidity with chronic non-communicable disease(s) [AOR, 3.99; 95% CI, 1.604 to 9.916; p=0.003)] were independent predictors of poor immunologic restoration. Conclusions: Chronic non-communicable disease(s) have negative effects on the kinetics of CD4+ cell count among HIV-infected patients who initiated antiretroviral therapy. So the integration of chronic non-communicable disease-HIV collaborative activities will strengthen battle to control the double burden of chronic illnesses.

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