scholarly journals HIV continuum of care: expanding scope beyond a cross-sectional view to include time analysis: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Georgia Vourli ◽  
Ioannis Katsarolis ◽  
Nikos Pantazis ◽  
Giota Touloumi
Keyword(s):  
Risk Estimation ◽  
Estimation Method ◽  
Continuum Of Care ◽  
Hiv Care ◽  
Cross Sectional ◽  
Effective Response ◽  
Factors Affecting ◽  
Modelling Studies ◽  
The Cross ◽  
Hiv Continuum Of Care

Abstract Introduction The continuum of care (CoC) model has been used to describe the main pillars of HIV care. This study aims to systematically review methods and elucidate gaps in the CoC analyses, especially in terms of the timing of the progression through steps, recognized nowadays as a critical parameter for an effective response to the epidemic. Methods A PubMed and EMBASE databases search up to December 2019 resulted in 1918 articles, of which 209 were included in this review; 84 studies presented in major HIV conferences were also included. Studies that did not provide explicit definitions, modelling studies and those reporting only on metrics for subpopulations or factors affecting a CoC stage were excluded. Included articles reported results on 1 to 6 CoC stages. Results Percentage treated and virally suppressed was reported in 78%, percentage diagnosed and retained in care in 58%, percentage linked to care in 54% and PLHIV in 36% of the articles. Information for all stages was provided in 23 studies. Only 6 articles use novel CoC estimates: One presents a dynamic CoC based on multistate analysis techniques, two base their time-to-next-stage estimates on a risk estimation method based on the cumulative incidence function, weighted for confounding and censoring and three studies estimated the HIV infection time based on mathematical modelling. Conclusion A limited number of studies provide elaborated time analyses of the CoC. Although time analyses lack the straightforward interpretation of the cross-sectional CoC, they provide valuable insights for the timely response to the HIV epidemic. A future goal would be to develop a model that retains the simplicity of the cross-sectional CoC but also incorporates timing between stages.

scholarly journals A modified HIV continuum of care: A six-year evaluation of a viral load cascade at a hospital-based clinic in Kingston, Jamaica

2019 ◽  
Vol 30 (8) ◽  
pp. 748-755 ◽  
Author(s):  
Geoffrey J Barrow ◽  
Margaret L Brandeau
Keyword(s):  
Viral Load ◽  
Statistical Analysis ◽  
Viral Suppression ◽  
Care Delivery ◽  
Continuum Of Care ◽  
Hiv Care ◽  
Viral Load Suppression ◽  
Outcome Indicators ◽  
Care Continuum ◽  
Hiv Continuum Of Care

To achieve the goal of HIV viral suppression, provision of medication alone is not sufficient. Concomitant frameworks to evaluate HIV care delivery programmes are needed. This study examined the care continuum at a hospital-based HIV clinic in Kingston, Jamaica using a modified HIV continuum of care, with an increased focus on viral load indicators (viral load samples taken, results returned and viral suppression). A statistical analysis of patient flow through the care continuum to identify gaps in programme delivery was performed. Key programmatic areas for process improvement and the utility of this approach for viral load suppression interpretation were identified. Between 2010 and 2015, more than 1600 patients had been registered for care and more than 1000 had accessed antiretroviral therapy at this location. Consistent trends in programme performance were seen from 2010 to 2012. Although declines in the proportion of viral load samples taken and results returned occurred because of laboratory failures in 2013, the trend of increasing numbers and proportions of virally suppressed patients continued. Statistical analysis indicated that improvements in laboratory quality (fraction of viral load samples returned with accurate test results) could increase viral load suppression among patients at the clinic by up to 17%. Refining care delivery processes can significantly improve HIV viral load suppression rates. Expanding monitoring frameworks to include all of the essential processes that affect final outcome indicators can provide valuable insight into trends of outcome indicators and programme performance.

scholarly journals Hair Structures Affecting Hair Appearance

Cosmetics ◽  
2019 ◽  
Vol 6 (3) ◽  
pp. 43 ◽  
Author(s):  
Nagase
Keyword(s):  
Light Scattering ◽  
Total Reflection ◽  
Hair Length ◽  
Cross Sectional ◽  
Elliptical Cross ◽  
Factors Affecting ◽  
Hair Fiber ◽  
The Cross ◽  
Sectional Shape ◽  
Multiple Fibers

Optical factors affecting hair appearance are reviewed based on hair structures from macroscopic to microscopic viewpoints. Hair appearance is the result of optical events, such as reflection, refraction, scattering, and absorption. The effects of hair structures on such optical events are summarized and structural conditions for hair appearance are considered. Hair structures are classified into the following: the alignment of multiple hair fibers, the cross-sectional shape of the hair fiber, and the microstructures of hair fiber (cuticle, cortex, and medulla). The alignment of multiple hair fibers is easily affected by the existence of meandering fibers and their alignment along hair length becomes less-synchronized. The less-synchronized orientation of multiple fibers causes the broadening of the apparent reflection and luster-less dull impression. The cross-sectional shape of hair fiber affects light reflection behavior. Hair fibers with elliptical cross-section show glittering colored light based on total reflection in the hair. The scaly structures of cuticles at the surface of hair are often uplifted and cause light scattering, and then affect hair luster. The porous structure of the cortex and medulla in hair fiber can cause light scattering and affect hair luster and color. The above phenomena suggest that important factors for hair appearance are the alignment of multiple hair fibers, appropriate cross-sectional shape, ordered scaly structure, and pore-less internal structure.

scholarly journals Continuous Retention and Viral Suppression Provide Further Insights Into the HIV Care Continuum Compared to the Cross-sectional HIV Care Cascade

2015 ◽  
Vol 62 (5) ◽  
pp. 648-654 ◽  
Author(s):  
Jonathan Colasanti ◽  
Jane Kelly ◽  
Eugene Pennisi ◽  
Yi-Juan Hu ◽  
Christin Root ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Cross Sectional ◽  
Care Continuum ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
The Cross

scholarly journals Persons living with HIV who do not smoke cigarettes: A comparison of ex-smokers and never smokers

2021 ◽  
Vol 14 ◽  
pp. 1179173X2110533
Author(s):  
Jonathan Shuter ◽  
H. Dean Hosgood ◽  
Shaundell Nardin ◽  
Andrea H. Weinberger
Keyword(s):  
Smoking Status ◽  
Care Center ◽  
Current Smoker ◽  
Hiv Care ◽  
Computer Assisted ◽  
Cross Sectional ◽  
Effective Response ◽  
Persons Living With Hiv ◽  
Never Smokers ◽  
Living With Hiv

Background and Aims Approximately half of persons living with HIV (PLWH) in the US smoke cigarettes. Large surveys show that 16.9%–37.3% of PLWH are never smokers compared to 57.5% of US adults. Similar proportions of PLWH and general population adults describe themselves as ex-smokers (20.3% vs 21.9% respectively). Little research has been done to characterize PLWH non-smokers. In this study, we compared a group of well characterized PLWH ex-smokers (i.e., no cigarettes for at least 5 years) to PLWH never smokers with the aim of developing a clearer understanding of the characteristics of these groups and the differences between them. Design Cross-sectional interview study employing audio computer-assisted self-interview (ACASI). Setting Comprehensive HIV care center in New York City. Participants In 2018–2019, we recruited a sample of PLWH never smokers (N = 54) and long-term ex-smokers (no cigarettes for at least 5 years, N = 36). Non-smoking status of participants was verified by exhaled carbon monoxide. Measurements We collected a range of sociodemographic, historical, clinical, and psychobehavioral data pertaining to tobacco use. Results Compared to never smokers, ex-smokers were older, more likely to have heterosexually acquired HIV and less likely to have same-sex-acquired infection, more likely to have parents and/or siblings who smoked, more likely to have current smoker/s in their households, and more likely to have ever used marijuana, cocaine, and/or heroin. Conclusions We describe important demographic and sociobehavioral differences between PLWH never smokers and ex-smokers that may be useful in crafting an effective response to the cigarette smoking epidemic in US PLWH.

scholarly journals Multi-Level Factors Affecting Entry into and Engagement in the HIV Continuum of Care in Iringa, Tanzania

PLoS ONE ◽  
2014 ◽  
Vol 9 (8) ◽  
pp. e104961 ◽  
Author(s):  
Erica H. Layer ◽  
Caitlin E. Kennedy ◽  
Sarah W. Beckham ◽  
Jessie K. Mbwambo ◽  
Samuel Likindikoki ◽  
...  
Keyword(s):  
Continuum Of Care ◽  
Factors Affecting ◽  
Multi Level ◽  
Hiv Continuum Of Care

scholarly journals Research on the Cross Section Forming Quality of Three-Dimensional Multipoint Stretch Forming Parts

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jiaqi Yu ◽  
Yi Li ◽  
Fei Teng ◽  
Jicai Liang ◽  
Xiangfeng Lin ◽  
...  
Keyword(s):  
Cross Section ◽  
Three Dimensional ◽  
Bending Test ◽  
Stretch Forming ◽  
Forming Process ◽  
Cross Sectional ◽  
Forming Quality ◽  
Factors Affecting ◽  
Forming Parameters ◽  
The Cross

This paper introduced the basic principle and main influencing factors of the three-dimensional multipoint stretch forming process and investigated the optimized scheme of the cross section forming quality. The main factors affecting the stretch forming process were studied by the orthogonal test through the numerical simulation technique. In the case of a good target shape, the best combination of forming parameters was established by using the range method. The cross-sectional distortion of the formed profile is the smallest when the prestretching amount is 1% of the profile length, the poststretching amount is 0.8% of the profile length, the number of the die heads is 12, and the friction coefficient is 0.15. The optimal combination of forming parameters was verified by the multipoint bending test.

scholarly journals Estimating Atherosclerosis Cardiovascular Disease Risk of 10-year with the Systemic Coronary Risk Estimation Method and Statin Use Recommendation

2020 ◽  
Vol 5 (3) ◽  
pp. 115
Author(s):  
Nurmainah - Nurmainah ◽  
Syarifah Yanti
Keyword(s):  
Cardiovascular Disease ◽  
Disease Risk ◽  
Risk Estimation ◽  
Blood Pressure Measurement ◽  
Cardiovascular Disease Risk ◽  
Estimation Method ◽  
Risk Category ◽  
Coronary Risk ◽  
Cross Sectional ◽  
Score Method

Stroke and heart disease belong to atherosclerotic cardiovascular diseases (ASCVD), which is one of the death causes in Indonesia. This study aimed to estimate the risk of atherosclerosis cardiovascular disease in the next 10 years using the Systemic Coronary Risk Estimation (SCORE) method. This research was an observational study with descriptive cross-sectional study design. Respondent data collection was taken prospectively which means directs data was collected through interviews, blood pressure measurement, and peripheral blood sampling. The results showed that respondents who were involved in this study were those with an average age of 49.70 ± 7.1 years. Respondents were more dominated by women (76.1%); BMI of respondents showed in the non-obese group 27.14 ± 4.6 kg/m2; total cholesterol, LDL, TG, and HDL levels respectively had an average of 152.17 ± 39.5 mg/dL; 91.28 ± 40.9 mg/dL; 117.24 ± 96.9 mg/dL; and 30.87 ± 8.8. The number of respondents who smoke was 17.39% and that of those who have undergone physical activity in the form of sports was 60.87%. Based on the results of risk estimation using the SCORE method, it was found that the number of people who were in the low-risk category was 54.35% and the moderate risk category was 45.65%. This study concludes that the risk of ASCVD for the next 10 years in the community is at low and moderate levels. Non-pharmacological treatment is more recommended at this level and statins can be given to individuals if there is no improvement in cholesterol levels.

scholarly journals HIV Continuum of Care Among People Who Inject Drugs in Iran

2021 ◽  
Author(s):  
Nima Ghalekhani ◽  
Ali Mirzazadeh ◽  
Fatemeh Tavakoli ◽  
Ghazal Mousavian ◽  
Mehrdad Khezri ◽  
...  
Keyword(s):  
People Who Inject Drugs ◽  
Care Service ◽  
Continuum Of Care ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Art Programs ◽  
Treatment Services ◽  
Care Outcomes ◽  
Linkage To Hiv Care ◽  
Hiv Continuum Of Care

Abstract Background:People who inject drugs (PWID) are at higher risk for HIV and may have lower access to care and treatment services when infected. We aimed to assess the HIV continuum of care among PWID in Iran. Methods:We collected data from 2,663 PWIDwho self-reported injection drug use at least once during the past 12 months. They were recruited via respondent-driven sampling to a national bio-behavioral surveillance survey from 11 cities of Iran between June 2019 and March 2020. For participants who were tested positive for HIV in the survey, we asked questions to calculate the proportionwho were 1) aware of their HIV status, 2) linkage to HIV care, 3) initiated an HIV treatment anti-retroviral therapy (ART), 4) retention on ART and 5) virally suppressed (< 1000 copies/mL).Results:Out of 95 PWID were tested positive for HIV, 100% (95% Confidence Intervals (CI): 96,100%) reported that they were aware of their HIV positive status, 57% (95% CI: 46, 66%) were linked to an HIV care service and initiated ART, 49% (95% CI: 39, 59%) retained on ART and only 15% (95% CI: 8, 23%) had viral load less than 1000 cp/ml.Conclusion:Our results indicated that about half of the PWID diagnosed with HIVever started ART, and less than one in six were virally suppressed.Strategies to improve linkage to ART programs, and to improve ART retention and adherence may improve HIV care outcomes among PWID in Iran.

scholarly journals Acceptance of Couples’ HIV Counseling and Testing among Pregnant Women Attending Antenatal Clinic in Likoni sub-County, Mombasa County, Kenya

2021 ◽  
Vol 1 (2) ◽  
pp. 23-35
Author(s):  
Jeniffer Makena Mwongera ◽  
Shadrack Ayieko Yonge ◽  
Joseph Baya Msanzu ◽  
Rahma Udu Yussuf
Keyword(s):  
Pregnant Women ◽  
Opportunistic Infections ◽  
Hiv Risk Behavior ◽  
Hiv Care ◽  
Cost Of Transport ◽  
Cross Sectional ◽  
Effective Response ◽  
Hiv Counseling And Testing ◽  
Hiv Counseling ◽  
Counseling And Testing

Couples’ HIV Counseling and Testing (CHCT) is an essential component of an effective response to AIDS pandemic worldwide and serves as an entry point to HIV care and support. However, it has become increasingly apparent that couples have overlooked the services yet they are too at risk of HIV infection. This study sought to determine level of acceptance of CHCT among pregnant women attending antenatal care services in Likoni sub-County, Mombasa County, Kenya. A descriptive cross-sectional study design was used with structured questionnaires and an observation checklist to collect data from couples while an interview schedule was used to solicit data from health care workers. Results showed uptake of CHCT in the study area was relatively low (33.5%). Statistically significant associations were found between CHCT and demographic factors such as education (χ2 = 29.54; p = 0.005), marital status (χ2 = 12.41; p = 0.010), occupation (χ2 = 18.18; p < 0.001), income (χ2 = 23.02; p < 0.001). In operation factors, statistically significant associations were found between CHCT and distance to health facility (χ2 = 8.31; p = 0.040), means of transport (χ2 = 10.28, p = 0.040), cost of transport (χ2 = 10.92; p = 0.010), appropriateness and convenience of time allocated (χ2 = 11.88, p <, 0.001), an individual’s working hours per day (χ2 = 14.46; p < 0.001), and education/information on CHCT (χ2 = 5.97; p = 0.020). In HIV related knowledge, attitude and practice of couples on HIV risk behavior, significant associations were found between CHCT and prevention of discordant partners from contracting HIV (χ2 = 53.71; p < 0.001), helping couples adhere to ART (χ2 = 43.34; p  < 0.001), helping to reduce morbidity and mortality due to HIV and other opportunistic infections (χ2 = 48.66; p < 0.001), increasing trust among partners (χ2 = 45.16; p < 0.001), and increasing marital cohesion among partners (χ2 = 65.78; p < 0.001). Logistic regression revealed that determinants of CHCT were significant for married status (p < 0.001), unemployed (p = 0.020), that CHCT increases trust among partners (p = 0.020), and that CHCT increases marital cohesion among partners (p = 0.001). Based on these findings, there is need to improve awareness on CHCT to enhance positive attitudes towards couples testing.

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