scholarly journals Adoption and uptake of the lateral flow urine LAM test in countries with high tuberculosis and HIV/AIDS burden: current landscape and barriers

2020 ◽  
Vol 4 ◽  
pp. 24 ◽  
Author(s):  
Diane N. Singhroy ◽  
Emily MacLean ◽  
Mikashmi Kohli ◽  
Erica Lessem ◽  
David Branigan ◽  
...  
Keyword(s):  
Scale Up ◽  
Lateral Flow ◽  
World Health ◽  
People Living With Hiv ◽  
Risk Of Death ◽  
Country Level ◽  
Adoption And Implementation ◽  
Testing Algorithms ◽  
Health Organization ◽  
Hiv Aids

Background: Since 2015, the World Health Organization (WHO) has recommended a commercially available lateral-flow urine LAM test (Alere-LAM) to assist in the diagnosis of tuberculosis (TB) in severely ill people living with HIV (PLHIV). The test can rapidly detect TB in severely ill PLHIV and can identify PLHIV most at-risk of death, leading to mortality reductions. However, its uptake in countries with high burdens of TB and HIV has been slow. To assess the current use landscape and identify barriers to the adoption of Alere-LAM, we conducted a questionnaire-based study in 31 high TB and HIV/AIDS burden countries. Methods: Between November 2018 and December 2019, we collected responses to a semi-structured questionnaire that had been emailed to staff and affiliates of National TB Programs or HIV/AIDS Programs, Ministries of Health, and TB or HIV institutes of 31 high TB/HIV burden countries. Questions concerned country policies, adoption, and current use of Alere-LAM testing, as well as testing algorithms and barriers preventing Alere-LAM uptake. Results: We received questionnaire responses from 24 out of 31 (77%) high TB/HIV burden countries. Of these 24 countries, 11 (46%) had adopted Alere-LAM policies, with only five (21%) countries currently using Alere-LAM testing. Testing algorithms were generally aligned with WHO recommendations. Fifteen countries (63%) said they were planning to implement Alere-LAM testing in the near future. The most commonly cited constraint to adoption and implementation was budget limitations. Additional barriers to Alere-LAM implementation included lack of country-specific data and piloting, administrative hurdles such as regulatory agency approval, lack of coordination between National TB and HIV programs, and small perceived patient population. Conclusion: Responses to our questionnaire demonstrate the persistent gap between country-level policy and real-world use of Alere-LAM, as well as specific barriers that must be addressed to scale-up testing in PLHIV.

scholarly journals Adoption and uptake of the lateral flow urine LAM test in countries with high tuberculosis and HIV/AIDS burden: current landscape and barriers

2020 ◽  
Vol 4 ◽  
pp. 24
Author(s):  
Diane N. Singhroy ◽  
Emily MacLean ◽  
Mikashmi Kohli ◽  
Erica Lessem ◽  
David Branigan ◽  
...  
Keyword(s):  
Scale Up ◽  
Lateral Flow ◽  
World Health ◽  
People Living With Hiv ◽  
Risk Of Death ◽  
Country Level ◽  
Adoption And Implementation ◽  
Testing Algorithms ◽  
Health Organization ◽  
Hiv Aids

Background: Since 2015, the World Health Organization (WHO) has recommended a commercially available lateral-flow urine LAM test (Alere-LAM) to assist in the diagnosis of tuberculosis (TB) in severely ill people living with HIV (PLHIV). The test can rapidly detect TB in severely ill PLHIV and can identify PLHIV most at-risk of death, leading to mortality reductions. However, its uptake in countries with high burdens of TB and HIV has been slow. To assess the current use landscape and identify barriers to the adoption of Alere-LAM, we conducted a questionnaire-based study in 31 high TB and HIV/AIDS burden countries. Methods: Between November 2018 and December 2019, we collected responses to a semi-structured questionnaire that had been emailed to staff and affiliates of National TB Programs or HIV/AIDS Programs, Ministries of Health, and TB or HIV institutes of 31 high TB/HIV burden countries. Questions concerned country policies, adoption, and current use of Alere-LAM testing, as well as testing algorithms and barriers preventing Alere-LAM uptake. Results: We received questionnaire responses from 24 out of 31 (77%) high TB/HIV burden countries. Of these 24 countries, 11 (46%) had adopted Alere-LAM policies, with only five (21%) countries currently using Alere-LAM testing. Testing algorithms were generally aligned with WHO recommendations. Fifteen countries (63%) said they were planning to implement Alere-LAM testing in the near future. The most commonly cited constraint to adoption and implementation was budget limitations. Additional barriers to Alere-LAM implementation included lack of country-specific data and piloting, administrative hurdles such as regulatory agency approval, lack of coordination between National TB and HIV programs, and small perceived patient population. Conclusion: Responses to our questionnaire demonstrate the persistent gap between country-level policy and real-world use of Alere-LAM, as well as specific barriers that must be addressed to scale-up testing in PLHIV.

scholarly journals Kondisi Psikologi, Sosial, dan Spiritual pada Orang dengan HIV/AIDS Selama Pengobatan Antiretroviral di Komisi Penanggulangan AIDS Kota Bogor Tahun 2019

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Ervan Meidan Ariatama ◽  
Titik Respati ◽  
Eka Nurhayati
Keyword(s):  
Aids Prevention ◽  
World Health ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
World Health Organization Quality ◽  
Organization Quality ◽  
Health Organization ◽  
Living With Hiv ◽  
Hiv Aids

Penyakit HIV/AIDS selain mengakibatkan dampak kesehatan dapat juga mengakibatkan dampak negatif terhadap psikologi, sosial, dan spiritual pada kualitas hidup orang dengan HIV/AIDS (ODHA). Antiretroviral (ARV) merupakan obat penghambat proses replikasi HIV yang merupakan solusi untuk meningkatkan kualitas hidup dan harapan hidup penderita. Tujuan penelitian ini adalah menggambarkan kondisi psikologi, sosial, dan spiritual ODHA selama menjalani pengobatan ARV di Komisi Penanggulangan AIDS (KPA) Kota Bogor periode bulan Agustus–September 2019. Penelitian ini dilakukan menggunakan metode observasi analitik dengan pendekatan cross sectional. Data diambil menggunakan kuesioner World Health Organization Quality of Life-HIV Instrument (WHOQOL-HIV Instrument) yang terdiri atas 120 pertanyaan dan terbagi menjadi 6 domain (psikologi, sosial, spiritual, fisik, lingkungan hidup, dan tingkat kebebasan). Pada penelitian ini hanya diambil 3 domain, yaitu psikologi, sosial, dan spiritual dengan jumlah pertanyaan 52 butir yang dibagikan kepada 80 responden dan dilaksanakan selama bulan Agustus sampai bulan September 2019. Teknik pengambilan sampel menggunakan non-probability sampling jenis consecutive sampling berdasar atas rumus besar estimasi proporsi dengan presisi absolut. Hasil menunjukkan mayoritas kondisi psikologi, sosial, dan spiritual ODHA selama pengobatan antiretroviral di KPA Kota Bogor tahun 2019 dalam kondisi baik dengan persentase kondisi psikologi 96%, sosial 99%, dan spiritual 70%. Simpulan penelitian ini adalah kondisi psikologi, sosial, dan spiritual pada ODHA di Komisi Penanggulangan AIDS Kota Bogor tahun 2019 mayoritas dalam kondisi baik, walaupun kondisi spiritual ODHA masih terdapat hasil kurang baik. PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL CONDITIONS IN PEOPLE LIVING WITH HIV/AIDS DURING ANTIRETROVIRAL TREATMENT AT THE AIDS PREVENTION COMMISSION AT BOGOR CITY IN 2019Apart from having an impact on health, HIV/AIDS can also have a negative psychological, social, and spiritual impact on people living with HIV/AIDS (PLWHA). Antiretroviral (ARV) as drugs that inhibits the process of replication of HIV, which is a solution to improve the quality of life and life expectancy of patients. The purpose of this study was to describe the psychological, social, and spiritual conditions of PLWHA during ARV treatment at the AIDS Prevention Commission in Bogor City in August to September 2019. The study was a cross-sectional study. The research material consisted of primary data taken using the World Health Organization-Quality Instrument HIV questionnaire (WHOQOL-HIV Instrument) consisting of 120 questions and divided into six domains (psychological, social, spiritual, physical, environment, degree of freedom). However, in this study, only three domains studied, which are psychological, social, and spiritual, with 52 questions and then distributed to 80 respondents and carried out from August to September. The sampling technique uses non-probability sampling type consecutive sampling based on large formula of proportion estimation with absolute precision. Results showed the psychological, social, and spiritual condition of PLWHA during antiretroviral treatment at the Bogor City AIDS Commission in 2019 shows a good condition. The majority of good psychological, social, and spiritual domain experienced by 96%, 99%, and 70% of respondents, respectively. The conclusion of this research is the psychological, social, and spiritual conditions of PLWHA in the Bogor AIDS prevention commission in 2019 in the good conditions, even though there was a spiritual condition of ODHA that was still not good.

scholarly journals Rolling out Xpert MTB/RIF® for tuberculosis detection in HIV-positive populations: An opportunity for systems strengthening

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Ishani Pathmanathan ◽  
Anand Date ◽  
William L. Coggin ◽  
John Nkengasong ◽  
Amy S. Piatek ◽  
...  
Keyword(s):  
Scale Up ◽  
World Health ◽  
People Living With Hiv ◽  
Successful Implementation ◽  
High Expectations ◽  
Resource Limited ◽  
Health Organization ◽  
Living With Hiv ◽  
And Control ◽  
Monitoring Treatment

Background: To eliminate preventable deaths, disease and suffering due to tuberculosis ,improved diagnostic capacity is critical. The Cepheid Xpert MTB/RIF® assay is recommended by the World Health Organization as the initial diagnostic test for people with suspected HIV associatedtuberculosis. However, despite high expectations, its scale-up in real-world settings has faced challenges, often due to the systems that support it.Opportunities for System Strengthening: In this commentary, we discuss needs and opportunities for systems strengthening to support widespread scale-up of Xpert MTB/RIF as they relate to each step within the tuberculosis diagnostic cascade, from finding presumptive patients, to collecting, transporting and testing sputum specimens, to reporting and receiving results, to initiating and monitoring treatment and, ultimately, to ensuring successful and timely treatment and cure. Investments in evidence-based interventions at each step along the cascade and within the system as a whole will augment not only the utility of Xpert MTB/RIF, but also the successful implementation of future diagnostic tests.Conclusion: Xpert MTB/RIF will only improve patient outcomes if optimally implemented within the context of strong tuberculosis programmes and systems. Roll-out of this technology to people living with HIV and others in resource-limited settings offers the opportunity to leverage current tuberculosis and HIV laboratory, diagnostic and programmatic investments, while also addressing challenges and strengthening coordination between laboratory systems, laboratory-programme interfaces, and tuberculosis-HIV programme interfaces. If successful, the benefits of this tool could extend beyond progress toward global End TB Strategy goals, to improve system-wide capacity for global disease detection and control.

scholarly journals Internet-based HIV self-testing program to increase HIV testing uptake for men who have sex with men in Brazil (Preprint)

2019 ◽  
Author(s):  
Raquel Brandini De Boni ◽  
Valdilea Gonçalves Veloso ◽  
Nilo M Fernandes ◽  
Flavia Lessa ◽  
Renato Girade Correa ◽  
...  
Keyword(s):  
Scale Up ◽  
Integrated System ◽  
World Health ◽  
People Living With Hiv ◽  
System P ◽  
Self Testing ◽  
Testing Uptake ◽  
Sex With Men ◽  
Health Organization ◽  
Living With Hiv

BACKGROUND Approximately 30% of people living with HIV worldwide are estimated to be unaware of their infection. HIV self-testing (HIVST) is a strategy recommended by the World Health Organization which increases access to and uptake of testing among key populations who are at high risk for HIV infection. OBJECTIVE To describe the development and feasibility of a free, anonymous, Internet-based HIV self-testing (HIVST) strategy designed for men who have sex with men (MSM) in Curitiba, Brazil (E-testing). METHODS The project was developed under the scope of the “A Hora é Agora” (Time is now) program. Individuals aiming to request an HIVST package (2 tests each) answered an anonymous 5-minute questionnaire regarding inclusion criteria and sexual risk behavior. Eligible individuals could receive one package every 6 months for free. Website analytics, response to online questionnaires, packages distribution, and return of test results were monitored via a platform-integrated system. RESULTS Between February 2015 and January 2016, the website documented 17,786 unique visitors with 3,218 provided complete answers to the online questionnaires. Most individuals self-reported being white (77%), young (median age was 25 years, interquartile range 22-31), educated (87.3% complete secondary education or more), and had previously tested for HIV (62.5%). Overall, 2,526 HIVST packages were delivered; of those, 542 (21.4%) reported a result online or by mail (23 reactive and 11 invalid). During the study period, 37 individuals reporting to have used E-testing visited the pre-specified health facility for confirmatory testing (30 positive; 7 negative). CONCLUSIONS E-testing proved highly feasible and acceptable in this study, thus supporting scale-up to additional MSM population centers in Brazil.

scholarly journals Factors associated with undernourishment among people 20 years old or over with HIV/AIDS, attending public health services in the São Paulo municipality, Brazil

2014 ◽  
Vol 30 (12) ◽  
pp. 2578-2586 ◽  
Author(s):  
Katia Cristina Bassichetto ◽  
Denise Pimentel Bergamaschi ◽  
Vania Regina Salles Garcia ◽  
Maria Amélia de Sousa Mascena Veras
Keyword(s):  
Nutritional Status ◽  
Health Department ◽  
Nutritional Risk ◽  
World Health ◽  
People Living With Hiv ◽  
Public Health Services ◽  
Health Organization ◽  
Living With Hiv ◽  
Municipal Health ◽  
Hiv Aids

The study evaluated the nutritional status of 629 people living with HIV/AIDS attended at 12 specialized services of São Paulo's Municipal Health Department, Brazil. Data were obtained from medical records and through interviews during nutritional consultation. We used the classification criteria established by World Health Organization to assess malnourished individuals, a BMI < 18.5kg/m2. The prevalence of malnutrition in people with AIDS is 3.12 times that observed among people with HIV, and among people with co-infection it is 3.41 times that obtained among people without co-infection. This indicates how these conditions can harm the maintenance of the nutritional status, and shows that they demand a comprehensive understanding of the mechanisms involved in this phenomenon, as well as the development of strategies to improve the health care of individuals at nutritional risk.

scholarly journals An Internet-Based HIV Self-Testing Program to Increase HIV Testing Uptake Among Men Who Have Sex With Men in Brazil: Descriptive Cross-Sectional Analysis

10.2196/14145 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e14145 ◽  
Author(s):  
Raquel Brandini De Boni ◽  
Valdilea Gonçalves Veloso ◽  
Nilo Martinez Fernandes ◽  
Flavia Lessa ◽  
Renato Girade Corrêa ◽  
...  
Keyword(s):  
Scale Up ◽  
Integrated System ◽  
World Health ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Self Testing ◽  
Testing Uptake ◽  
Sex With Men ◽  
Health Organization ◽  
Living With Hiv

BackgroundApproximately 30% of people living with HIV worldwide are estimated to be unaware of their infection. HIV self-testing (HIVST) is a strategy recommended by the World Health Organization to increase access to and uptake of testing among key populations who are at high risk for HIV infection.ObjectiveThis study aimed to describe the development and feasibility of a free, anonymous, internet-based HIVST strategy designed for men who have sex with men in Curitiba, Brazil (electronic testing [e-testing]).MethodsThe project was developed under the scope of the “A Hora é Agora” (The Time is Now) program. Individuals aiming to request an HIVST package (two tests each) answered an anonymous 5-minute questionnaire regarding inclusion criteria and sexual risk behavior. Eligible individuals could receive one package every 6 months for free. Website analytics, response to online questionnaires, package distribution, and return of test results were monitored via a platform-integrated system.ResultsBetween February 2015 and January 2016, the website documented 17,786 unique visitors and 3218 completed online questionnaires. Most individuals self-reported being white (77.0%), young (median age: 25 years, interquartile range: 22-31 years), educated (87.3% completed secondary education or more), and previously tested for HIV (62.5%). Overall, 2526 HIVST packages were delivered; of those, 542 (21.4%) reported a result online or by mail (23 reactive and 11 invalid). During the study period, 37 individuals who reported using e-testing visited the prespecified health facility for confirmatory testing (30 positive, 7 negative).ConclusionsE-testing proved highly feasible and acceptable in this study, thus supporting scale-up to additional centers for men who have sex with men in Brazil.

scholarly journals Integrating mental health in global initiatives for HIV/AIDS

2005 ◽  
Vol 187 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Melvyn C. Freeman ◽  
Vikram Patel ◽  
Pamela Y. Collins ◽  
Jose M. Bertolote
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Psychosocial Interventions ◽  
World Health ◽  
People Living With Hiv ◽  
Infected People ◽  
Mental Health Interventions ◽  
Health Organization ◽  
Living With Hiv ◽  
Hiv Aids

SummaryA more prominent role is needed for mental health interventions in global HIV/AIDS initiatives – such as the World Health Organization ‘3 by 5’ Initiative. Significant numbers of infected people have, or develop, mental health problems, and this often adversely impacts on HIV/AIDS treatment and adherence. Integrating psychiatric and psychosocial interventions should benefit both the mental and the physical health of people living with HIV/AIDS.

scholarly journals EXPECTING THE RETURN OF UIN SUMATERA UTARA'S latHIVa IN THE PREVENTION OF HIV AND AIDS IN NORTH SUMATERA

2021 ◽  
Vol 27 (2) ◽  
Author(s):  
Achmad Ramadhan
Keyword(s):  
National Level ◽  
Hiv And Aids ◽  
World Health ◽  
People Living With Hiv ◽  
Aids Epidemic ◽  
Health Organization ◽  
Living With Hiv ◽  
North Sumatra ◽  
Prevention Of Hiv ◽  
Hiv Aids

<p>As a reflection, when latHIVa was established as a non-structural institution at UIN Sumatera Utara (UiN SU) to tackle HIV and AIDS, the discovery of HIV and AIDS cases at the international level were around 34.3 million people living with HIV, while in 2019 it was estimated that 36.9 million people living with HIV. The cases of HIV and AIDS at the national level in 2000 were 1500 people living with HIV / AIDS (PLWHA) while in 2019 there were 349,882 PLWHA in North Sumatra, and in 2000 there were 30 people living with HIV, while the cases of HIV / AIDS at the level of North Sumatra Province up to August 2019 were 9362 PLWHA. The description of the HIV and AIDS case above describes the epidemic process since the formation of the UIN Sumatera Utara's latHIVa until August 2019. The HIV and AIDS epidemic is like an iceberg phenomenon, which means the numbers of HIV and AIDS cases found above are not the actual numbers. HIV and AIDS do exist. Therefore, WHO (World Health Organization) has formulated that to find out the real numbers, the numbers obtained must be multiplied by 100-200. Thus, if 9362 cases of HIV and AIDS in North Sumatra is  multiplied by 100, then there might be 936,200 cases of PLWHA in North Sumatra. Thus, there are around 900 thousand PLWHA who have not been found in North Sumatra.</p>

scholarly journals Pulmonary tuberculosis screening in anti-retroviral treated adults living with HIV in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill K. Gersh ◽  
Ruanne V. Barnabas ◽  
Daniel Matemo ◽  
John Kinuthia ◽  
Zachary Feldman ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Preventive Therapy ◽  
World Health ◽  
People Living With Hiv ◽  
Tuberculosis Screening ◽  
Hiv Positive Adults ◽  
Health Organization ◽  
A Prospective Study ◽  
Living With Hiv ◽  
Tuberculosis Prevalence

Abstract Background People living with HIV (PLHIV) who reside in high tuberculosis burden settings remain at risk for tuberculosis disease despite treatment with anti-retroviral therapy and isoniazid preventive therapy (IPT). The performance of the World Health Organization (WHO) symptom screen for tuberculosis in PLHIV receiving anti-retroviral therapy is sub-optimal and alternative screening strategies are needed. Methods We enrolled HIV-positive adults into a prospective study in western Kenya. Individuals who were IPT-naïve or had completed IPT > 6 months prior to enrollment were eligible. We evaluated tuberculosis prevalence overall and by IPT status. We assessed the accuracy of the WHO symptom screen, GeneXpert MTB/RIF (Xpert), and candidate biomarkers including C-reactive protein (CRP), hemoglobin, erythrocyte sedimentation rate (ESR), and monocyte-to-lymphocyte ratio for identifying pulmonary tuberculosis. Some participants were evaluated at 6 months post-enrollment for tuberculosis. Results The study included 383 PLHIV, of whom > 99% were on antiretrovirals and 88% had received IPT, completed a median of 1.1 years (IQR 0.8–1.55) prior to enrollment. The prevalence of pulmonary tuberculosis at enrollment was 1.3% (n = 5, 95% CI 0.4–3.0%): 4.3% (0.5–14.5%) among IPT-naïve and 0.9% (0.2–2.6%) among IPT-treated participants. The sensitivity of the WHO symptom screen was 0% (0–52%) and specificity 87% (83–90%). Xpert and candidate biomarkers had poor to moderate sensitivity; the most accurate biomarker was CRP ≥ 3.3 mg/L (sensitivity 80% (28–100) and specificity 72% (67–77)). Six months after enrollment, the incidence rate of pulmonary tuberculosis following IPT completion was 0.84 per 100 person-years (95% CI, 0.31–2.23). Conclusions In Kenyan PLHIV treated with IPT, tuberculosis prevalence was low at a median of 1.4 years after IPT completion. WHO symptoms screening, Xpert, and candidate biomarkers were insensitive for identifying pulmonary tuberculosis in antiretroviral-treated PLHIV.

scholarly journals Scaling Up Information Sharing on HIV-Associated Neurocognitive Disorder: Raising Awareness and Knowledge Among Key Stakeholders

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110168
Author(s):  
Renato M. Liboro ◽  
Paul A. Shuper ◽  
Lori E. Ross
Keyword(s):  
Health Care ◽  
Information Sharing ◽  
Service Providers ◽  
Scale Up ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Public Health Informatics ◽  
Raising Awareness ◽  
Hiv Associated Neurocognitive Disorder ◽  
Hiv Aids

Although the majority of specialists and researchers in the field of HIV/AIDS are aware and knowledgeable about HIV-associated neurocognitive disorder (HAND) as a condition that affects as much as 50% of people living with HIV/AIDS (PLWH), research has documented that many health care and service providers who work directly with PLWH are either unaware of HAND or believe they do not know enough information about HAND to effectively support their clients experiencing neurocognitive challenges. Based on the findings of a qualitative study that interviewed 33 health care and service providers in HIV/AIDS services to identify and examine their awareness and knowledge on HAND, this article argues for utilizing a combination of Public Health Informatics principles; communication techniques, propagation strategies, and recognized approaches from Implementation and Dissemination Science; and social media and online discussion platforms, in addition to traditional Knowledge Mobilization strategies, to scale up information sharing on HAND among all relevant stakeholders. Increasing information sharing among stakeholders would be an important step to raising awareness and knowledge on HAND, and consequently, improving care, services, and support for PLWH and neurocognitive issues.

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