Evaluation of the impact of human immunodeficiency virus pre-exposure prophylaxis on new human immunodeficiency virus diagnoses during the COVID-19 pandemic

2021 ◽  
pp. 095646242110545
Author(s):  
A Keane ◽  
SO Regan ◽  
L Quinn ◽  
D Murphy ◽  
BO Kelly ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Sexual Practices ◽  
First Year ◽  
Hiv Diagnosis ◽  
Eligibility Criteria ◽  
Global Pandemic ◽  
Immunodeficiency Virus ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
The Impact

Aims The national PrEP programme launched in Ireland in November 2019 with tenofovir/emtricitabine free to those meeting eligibility criteria. We assessed the impact of the first year of the PrEP programme on new HIV diagnoses in the largest sexual health and HIV service in Ireland. Methods A free PrEP service was established in November 2019. We reviewed the number of new diagnoses of HIV between November 2018–2019, before the introduction of the national PrEP programme and compared this with the number of new HIV diagnosis between November 2019–2020. Results There were 95 new HIV diagnoses (63.3% MSM) between November 2018 and 2019 and 73 new HIV diagnoses (65.7% MSM) between November 2019 and 2020. There was a statistically significant decline in new HIV diagnoses between the 2 years ( P = 0.0003). 546 patients were prescribed PrEP as of December 2020.106 patients (19.4%) changed their PrEP dosing regimen due to lockdown. 178 individuals (32.6%) had a rectal infection diagnosed. Conclusion There has been a reduction in new HIV diagnoses in our cohort (although this has occurred during a global pandemic). It is too early to say if PrEP reduces late presentations of HIV based on our findings. A significant number of rectal infections were identified in the PrEP clinic suggesting ongoing risk despite pandemic restrictions. Further research into sexual practices during COVID-19 is needed to assess if this had an impact on the lower rates of HIV acquisition.

scholarly journals Use of Intrauterine Devices and Risk of Human Immunodeficiency Virus Acquisition Among Insured Women in the United States

2019 ◽  
Vol 70 (10) ◽  
pp. 2221-2223
Author(s):  
Julia L Marcus ◽  
Jonathan M Snowden ◽  
Mara E Murray Horwitz ◽  
Sengwee Toh ◽  
Casie Horgan ◽  
...  
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Intrauterine Device ◽  
The United States ◽  
Hiv Diagnosis ◽  
Health Insurance Data ◽  
Virus Acquisition ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
Hiv Acquisition

Abstract Concerns have been raised about progestin-containing contraceptives and the risk of human immunodeficiency virus (HIV) acquisition. Based on health insurance data from women in the United States with intrauterine device (IUD) insertions during 2011–2018, there was no increased risk of incident HIV diagnosis for levonorgestrel-releasing IUDs versus copper IUDs.

scholarly journals FCGR2A and FCGR3A Genotypes in Human Immunodeficiency Virus Mother-to-Child Transmission

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Caitlin Milligan ◽  
Barbra A. Richardson ◽  
Grace John-Stewart ◽  
Ruth Nduati ◽  
Julie Overbaugh
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Disease Progression ◽  
Transmission Risk ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Immunodeficiency Virus ◽  
Hiv Acquisition ◽  
The Impact ◽  
Mother To Child

Abstract Background.  Fc-mediated effector functions have been suggested to influence human immunodeficiency virus (HIV) acquisition and disease progression. Analyzing the role of host Fc gamma receptor (FcγR) polymorphisms on HIV outcome in mother-to-child transmission (MTCT) will increase our understanding of how host genetics may alter immune responses in prevention, therapy, and disease. This study analyzed the impact of FCGR2A and FCGR3A genotypes on MTCT in a cohort in which Fc-mediated antibody functions are predictive of infant HIV outcome. Methods.  Human immunodeficiency virus-positive mothers and their infants from a historical MTCT cohort were genotyped for FCGR2A and FCGR3A. We assessed the impact of these genotypes on transmission and acquisition of HIV and disease progression using χ2 tests, survival analyses, and logistic regression. Results.  Among 379 mother-infant pairs, infant FCGR2A and FCGR3A genotypes were not associated with infant HIV infection or disease progression. Maternal FCGR2A was not associated with transmission, but there was a trend between maternal FCGR3A genotype and transmission (P = .07). When dichotomizing mothers into FCGR3A homozygotes and heterozygotes, heterozygotes had a 64.5% higher risk of transmission compared with homozygotes (P = .02). This risk was most evident in the early breastfeeding window, but a trend was only observed when restricting analyses to breastfeeding mothers (hazards ratio, 1.64; P = .064). Conclusions.  Infant FCGR2A and FCGR3A genotypes were not associated with HIV infection or disease progression, and, thus, host FcγR genotype may not significantly impact vaccination or therapeutic regimens that depend on Fc-mediated antibody functions. Maternal FCGR3A genotype may influence early breastfeeding transmission risk, but more studies should be conducted to clarify this association and its mechanism.

scholarly journals Minimum dataset for monitoring national human immunodeficiency virus pre-exposure prophylaxis (HIV PrEP) programmes: a five-nation consensus, 2019

2021 ◽  
Vol 26 (23) ◽  
Author(s):  
John Saunders ◽  
O Noel Gill ◽  
Valerie Delpech ◽  
Claudia Estcourt ◽  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Health Planning ◽  
Monitoring And Evaluation ◽  
World Health ◽  
Surveillance Systems ◽  
Combination Prevention ◽  
Immunodeficiency Virus ◽  
Health Organization ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), the use of antiretroviral medication to prevent HIV acquisition, is a highly effective biomedical prevention tool. The World Health Organization (WHO) recommends PrEP for people at substantial risk of HIV infection, as part of combination prevention, and highlights the need for robust evaluation of PrEP programmes. Based on suggested WHO core indicators, we created a concise set of HIV PrEP-related dataset variables, to harmonise the monitoring and evaluation of PrEP programmes across five closely related nations (England, Northern Ireland, Ireland, Scotland and Wales). The dataset is based on the PrEP cascade and is intended to represent the minimum variables needed for reporting and comparison of meaningful data at national and multinational level. The dataset can be modified for settings with different health and surveillance systems. It is intended for public health, academic, clinical and health planning, and public audiences. Here we describe the dataset and illustrate its use with data from the first year of the Scottish National PrEP programme.

scholarly journals Acceptability and Feasibility of a Pharmacist-Led Human Immunodeficiency Virus Pre-Exposure Prophylaxis Program in the Midwestern United States

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Joshua P Havens ◽  
Kimberly K Scarsi ◽  
Harlan Sayles ◽  
Donald G Klepser ◽  
Susan Swindells ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Patient Satisfaction ◽  
Point Of Care ◽  
College Education ◽  
Retention In Care ◽  
Care Process ◽  
Collaborative Practice Agreement ◽  
Immunodeficiency Virus ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Abstract Background Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) substantially reduces the risk of HIV acquisition, yet significant barriers exist to its prescription and use. Incorporating pharmacists in the PrEP care process may help increase access to PrEP services. Methods Our pharmacist-led PrEP program (P-PrEP) included pharmacists from a university-based HIV clinic, a community pharmacy, and 2 community-based clinics. Through a collaborative practice agreement, pharmacists conducted PrEP visits with potential candidates for PrEP, according to the recommended Centers for Disease Control and Prevention guidelines, and authorized emtricitabine-tenofovir disoproxil fumarate prescriptions. Demographics and retention in care over 12 months were summarized, and participant satisfaction and pharmacist acceptability with the P-PrEP program were assessed by Likert-scale questionnaires. Results Sixty patients enrolled in the P-PrEP program between January and June 2017 completing 139 visits. The mean age was 34 years (range, 20–61 years), and 88% identified as men who have sex with men, 91.7% were men, 83.3% were white, 80% were commercially insured, and 89.8% had completed some college education or higher. Participant retention at 3, 6, 9, and 12 months was 73%, 58%, 43%, and 28%, respectively. To date, no participant has seroconverted. One hundred percent of the participants who completed the patient satisfaction questionnaire would recommend the P-PrEP program. Pharmacists reported feeling comfortable performing point-of-care testing and rarely reported feeling uncomfortable during PrEP visits (3 occasions, 2.2%) or experiencing workflow disruption (1 occasion, 0.7%). Conclusions Implementation of a pharmacist-led PrEP program is feasible and associated with high rates of patient satisfaction and pharmacist acceptability.

scholarly journals Estimates of the Time From Seroconversion to Antiretroviral Therapy Initiation Among People Newly Diagnosed With Human Immunodeficiency Virus From 2006 to 2015, New York City

2019 ◽  
Vol 71 (8) ◽  
pp. e308-e315
Author(s):  
McKaylee M Robertson ◽  
Sarah L Braunstein ◽  
Donald R Hoover ◽  
Sheng Li ◽  
Denis Nash
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Hiv Testing ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Population Based ◽  
Cd4 Count ◽  
Hiv Diagnosis ◽  
Art Initiation ◽  
Immunodeficiency Virus

Abstract Background We estimated the time from human immunodeficiency virus (HIV) seroconversion to antiretroviral therapy (ART) initiation during an era of expanding HIV testing and treatment efforts. Methods Applying CD4 depletion parameters from seroconverter cohort data to our population-based sample, we related the square root of the first pretreatment CD4 count to time of seroconversion through a linear mixed model and estimated the time from seroconversion. Results Among 28 162 people diagnosed with HIV during 2006–2015, 89% initiated ART by June 2017. The median CD4 count at diagnosis increased from 326 (interquartile range [IQR], 132–504) cells/µL to 390 (IQR, 216–571) cells/µL from 2006 to 2015. The median time from estimated seroconversion to ART initiation decreased by 42% from 6.4 (IQR, 3.3–11.4) years in 2006 to 3.7 (IQR, 0.5–8.3) years in 2015. The time from estimated seroconversion to diagnosis decreased by 28%, from a median of 4.6 (IQR, 0.5–10.5) years to 3.3 (IQR, 0–8.1) years from 2006 to 2015, and the time from diagnosis to ART initiation reduced by 60%, from a median of 0.5 (IQR, 0.2–2.1) years to 0.2 (IQR, 0.1–0.3) years from 2006 to 2015. Conclusions The estimated time from seroconversion to ART initiation was reduced in tandem with expanded HIV testing and treatment efforts. While the time from diagnosis to ART initiation decreased to 0.2 years, the time from seroconversion to diagnosis was 3.3 years among people diagnosed in 2015, highlighting the need for more effective strategies for earlier HIV diagnosis.

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