scholarly journals Stigma and discrimination: Barrier for ending AIDS by 2030 and achieving the 90-90-90 targets by 2020

2019 ◽  
Vol 7 (1) ◽  
pp. 1 ◽  
Author(s):  
Dewa Nyoman Wirawan
Keyword(s):  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Hiv Epidemic ◽  
Nations Programme ◽  
United Nations Programme ◽  
Public Health Threat ◽  
Living With Hiv

The Joint United Nations Programme on HIV-AIDS (UNAIDS) put forward an ambitious vision of  “three zero” which consisted of zero new HIV infections, zero discrimination and zero AIDS-related deaths. In other words, it is envisaged there will be no new HIV infections, no more discrimination towards people living with HIV and no more AIDS-related deaths. UNAIDS also set the target of  “ending AIDS” as a public health threat by 2030. In order to end the HIV epidemic by 2030, in 2014 UNAIDS established a fast tract strategy namely "90-90-90" which means by 2020, 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained access to antiretroviral therapy (ART) and 90% of all people receiving antiretroviral therapy will achieve viral suppression. If this target of "90-90-90" is achieved, it is estimated that by 2020 at least 73% of all people living with HIV worldwide will experience viral suppression; further modeling suggests that if this target is achieved this will bring about the “end of AIDS” by 2030.

scholarly journals Estimates of the Number of People Living with HIV in Italy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Laura Camoni ◽  
Vincenza Regine ◽  
Karen Stanecki ◽  
Maria Cristina Salfa ◽  
Mariangela Raimondo ◽  
...  
Keyword(s):  
United Nations ◽  
Hiv Infections ◽  
Hiv Prevalence ◽  
People Living With Hiv ◽  
Joint United Nations Programme ◽  
Need Of Care ◽  
Nations Programme ◽  
United Nations Programme ◽  
Living With Hiv ◽  
Hiv Aids

Objective. To estimate the HIV prevalence and the number of people living with HIV (PLHIV) in Italy with a projection for 2020.Methods. Two methods elaborated by Joint United Nations Programme on HIV/AIDS (UNAIDS) were used: Estimate and Projection Package and Spectrum.Results. A total of 123,000 (115,000–145,000) individuals aged 15 or more were estimated to be living with HIV in Italy at the end of 2012 and the estimated HIV prevalence was 0.28 (0.24–0.32) per 100 residents aged 15 or more. In 2012, the estimated number of new HIV infections among adults was 3,000 (2,700–4,000), and the number of adults in need for ART was 93,000 (80,000–110,000). The projection estimates that 130,000 (110,000–150,000) adults will live with HIV/AIDS in 2020 in Italy.Conclusion. Estimates of PLHIV in Italy stress the high number of PLHIV in need of care and treatment, as well as the need for more information and prevention campaigns.

scholarly journals New action points in the fight against HIV/AIDS in Europe and Central Asia

2004 ◽  
Vol 8 (39) ◽  
Author(s):  
Keyword(s):  
European Union ◽  
United Nations ◽  
Central Asia ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
The European Union ◽  
Nations Programme ◽  
United Nations Programme ◽  
Living With Hiv ◽  
Hiv Aids

As numbers of new HIV infections increase across the European Union, and figures from the Joint United Nations Programme on HIV/AIDS (UNAIDS) show over 1.8 million people living with HIV in Europe and Central Asia, the European Commission wants attention refocused on the problem

scholarly journals Antiretroviral Drugs Impact Autophagy with Toxic Outcomes

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 909
Author(s):  
Laura Cheney ◽  
John M. Barbaro ◽  
Joan W. Berman
Keyword(s):  
Quality Control ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Viral Suppression ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Foreign Material ◽  
Complete Understanding ◽  
Living With Hiv ◽  
Target Effects

Antiretroviral drugs have dramatically improved the morbidity and mortality of people living with HIV (PLWH). While current antiretroviral therapy (ART) regimens are generally well-tolerated, risks for side effects and toxicity remain as PLWH must take life-long medications. Antiretroviral drugs impact autophagy, an intracellular proteolytic process that eliminates debris and foreign material, provides nutrients for metabolism, and performs quality control to maintain cell homeostasis. Toxicity and adverse events associated with antiretrovirals may be due, in part, to their impacts on autophagy. A more complete understanding of the effects on autophagy is essential for developing antiretroviral drugs with decreased off target effects, meaning those unrelated to viral suppression, to minimize toxicity for PLWH. This review summarizes the findings and highlights the gaps in our knowledge of the impacts of antiretroviral drugs on autophagy.

scholarly journals Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression Amongst HIV-infected Prisoners in South Ethiopia: A Prospective Cohort Study

2021 ◽  
Author(s):  
Terefe Gone Fuge ◽  
George Tsourtos ◽  
Emma R Miller
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
South Ethiopia ◽  
Pharmacy Refill ◽  
Living With Hiv ◽  
Optimal Adherence

Abstract ObjectivesMaintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of treatment adherence and viral suppression in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors amongst prisoners in South Ethiopia. MethodsA prospective cohort study was conducted between June 1, 2019 and May 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information (including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration related characteristics) was collected using a structured questionnaire. Adherence was determined based on the participants’ self-report and pharmacy refill records. Plasma viral load measurements undertaken within the study period were prospectively extracted to determine viral suppression. Univariate and multivariate regression models were used to analyse data. ResultsWhile prisoners had a significantly higher pharmacy refill adherence compared to non-incarcerated PLWHA (89% vs 75%), they had a slightly lower dose adherence (81% vs 83%). The prevalence of viral failure (VF) was also slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31to 35 years and in those who experienced social stigma, regardless of their incarceration status. ConclusionsThis study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to ART doses and to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors were found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

scholarly journals Can we talk about price with patients when choosing antiretroviral therapy? A survey with people living with HIV and prescribers in France

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e046212
Author(s):  
Emmanuelle Papot ◽  
Nikos Kalampalikis ◽  
Marjolaine Doumergue ◽  
Fabrice Pilorgé ◽  
Guillemette Quatremère ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The North ◽  
Hiv Epidemic ◽  
Voluntary Response ◽  
History Of ◽  
Using Data ◽  
Living With Hiv

ObjectiveThe aim of this study was to evaluate people living with HIV (PLWH) and HIV specialist prescribers’ perception of discussing antiretroviral therapy (ART) price in PLWH’s care and the acceptability of choosing or switching to various types of less expensive ARTs.DesignCross-sectional surveys (one in a convenience sample of PLWH and one in a voluntary response sample of HIV specialist prescribers).Setting and participantsThe surveys were conducted among PLHW attending an HIV clinic in the North of Paris (cohort of 4922 PLWH in 2016), and HIV specialists working in French HIV clinics (210 across 12 districts/28), between January and June 2016.MethodSelf-administered questionnaires were constructed using data collected during focus groups with PLWH and prescribers. Pretests were carried out to select the questions and items. Descriptive analyses of the 129 complete questionnaires of PLWH and 79 of prescribers are presented.ResultsAmong PLWH, 128/129 were on ART and 54% (69/128) gave a fair estimation of the price of their current regimen. Among prescribers, 24% (19/79) thought that their patients knew this price. Taking into account the price of ART was not perceived as a negative step in the history of French response to HIV epidemic for 53% (68/129) of PLWH and 82% (65/79) of prescribers. Seventy-seven PLWH (60%) would agree to switch to less expensive antiretroviral regimens (as effective and with similar adverse events) if pills were bigger; 42 (33%) if there were more daily doses, and 37 (29%) if there were more pills per dose; prescribers were more circumspect.ConclusionA high proportion of PLWH gave a fair estimate of their ART price and this seemed unexpected by HIV specialists. Consideration of drug prices when choosing ART was perceived as conceivable by PLWH and prescribers if effectiveness and tolerance were also considered.

scholarly journals Assessing the interaction between depressive symptoms and alcohol use prior to antiretroviral therapy on viral suppression among people living with HIV in Rural Uganda

AIDS Care ◽  
2020 ◽  
Vol 32 (10) ◽  
pp. 1251-1257
Author(s):  
Jacklyn D. Foley ◽  
Alan Sheinfil ◽  
Sarah E. Woolf-King ◽  
Robin Fatch ◽  
Nneka I. Emenyonu ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Antiretroviral Therapy ◽  
Alcohol Use ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Living With Hiv

Predicting the population impact of increased HIV testing and treatment in Australia

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 146 ◽  
Author(s):  
James Jansson ◽  
Cliff C. Kerr ◽  
David P. Wilson
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infections ◽  
Transmission Risk ◽  
Risk Compensation ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Risk Levels ◽  
Sex With Men ◽  
Living With Hiv ◽  
The Impact

Introduction The treatment as prevention strategy has gained popularity as a way to reduce the incidence of HIV by suppressing viral load such that transmission risk is decreased. The effectiveness of the strategy also requires early diagnosis. Methods: Informed by data on the influence of diagnosis and treatment on reducing transmission risk, a model simulated the impact of increasing testing and treatment rates on the expected incidence of HIV in Australia under varying assumptions of treatment efficacy and risk compensation. The model utilises Australia’s National HIV Registry data, and simulates disease progression, testing, treatment, transmission and mortality. Results: Decreasing the average time between infection and diagnosis by 30% is expected to reduce population incidence by 12% (~126 cases per year, 95% confidence interval (CI): 82–198). Treatment of all people living with HIV with CD4 counts <500 cells μL–1 is expected to reduce new infections by 30.9% (95% CI: 15.9–37.6%) at 96% efficacy if no risk compensation occurs. The number of infections could increase up to 12.9% (95% CI: 20.1–7.4%) at 26% efficacy if a return to prediagnosis risk levels occur. Conclusion: Treatment as prevention has the potential to prevent HIV infections but its effectiveness depends on the efficacy outside trial settings among men who have sex with men and the level of risk compensation. If antiretroviral therapy has high efficacy, risk compensation will not greatly change the number of infections. If the efficacy of antiretroviral therapy is low, risk compensation could lead to increased infections.

scholarly journals Law, criminalisation and HIV in the world: have countries that criminalise achieved more or less successful pandemic response?

2021 ◽  
Vol 6 (8) ◽  
pp. e006315
Author(s):  
Matthew M Kavanagh ◽  
Schadrac C Agbla ◽  
Marissa Joy ◽  
Kashish Aneja ◽  
Mara Pillinger ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Transmission ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Gender Based Violence ◽  
Hiv Virus ◽  
The World ◽  
Gender Based ◽  
And Gender ◽  
Living With Hiv

How do choices in criminal law and rights protections affect disease-fighting efforts? This long-standing question facing governments around the world is acute in the context of pandemics like HIV and COVID-19. The Global AIDS Strategy of the last 5 years sought to prevent mortality and HIV transmission in part through ensuring people living with HIV (PLHIV) knew their HIV status and could suppress the HIV virus through antiretroviral treatment. This article presents a cross-national ecological analysis of the relative success of national AIDS responses under this strategy, where laws were characterised by more or less criminalisation and with varying rights protections. In countries where same-sex sexual acts were criminalised, the portion of PLHIV who knew their HIV status was 11% lower and viral suppression levels 8% lower. Sex work criminalisation was associated with 10% lower knowledge of status and 6% lower viral suppression. Drug use criminalisation was associated with 14% lower levels of both. Criminalising all three of these areas was associated with approximately 18%–24% worse outcomes. Meanwhile, national laws on non-discrimination, independent human rights institutions and gender-based violence were associated with significantly higher knowledge of HIV status and higher viral suppression among PLHIV. Since most countries did not achieve 2020 HIV goals, this ecological evidence suggests that law reform may be an important tool in speeding momentum to halt the pandemic.

scholarly journals Factors associated with viremia in people living with HIV on antiretroviral therapy in Guatemala

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Dean W. Ortíz ◽  
Olivia Roberts-Sano ◽  
Hugo E. Marroquin ◽  
Lindsey Larson ◽  
Katherine B. Franco ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Clinical Factors ◽  
Factors Associated ◽  
Hiv Rna ◽  
Prior Art ◽  
Treatment Interruptions ◽  
Perceived Difficulty ◽  
Living With Hiv

Abstract Introduction Viral suppression prevents HIV transmission and disease progression, but socio-economic and clinical factors can hinder the goal of suppression. We evaluated factors associated with viral non suppression (VNS) and persistent viremia (PV) in people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in Guatemala. Methods We conducted a cross sectional analysis using data from an ongoing cohort of PLHIV attending the largest HIV clinic in Guatemala. Univariable and multivariable analyses were conducted between PLHIV with viral suppression and detectable viremia. VNS was defined as most recent HIV RNA ≥ 200 copies/ml and PV as two consecutive HIV RNA ≥ 200 copies/ml. Results Of 664 participants, 13.3% had VNS and 7.1% had PV. In univariable analysis disaggregated by gender, low income, poor education, perceived difficulty attending healthcare, and alcohol use were associated with VNS in men while low CD4 at diagnosis, multiple prior ART regimens and treatment interruptions were significant in both genders. Multiple prior ART regimens (adjusted Odds Ratio (aOR) 2.82, [95% confidence interval (CI) 1.59, 4.99], p < 0.01), treatment interruptions (aOR 4.51, [95% CI 2.13, 9.58], p < 0.01), excessive alcohol consumption (aOR 2.56, [95% CI 1.18, 5.54], p < 0.05) perceived difficulty attending healthcare (aOR 2.07, [ 95% CI 1.25, 3.42], p < 0.01) and low CD4 at diagnosis (aOR 2.34, 95% [CI 1.30, 4.20], p < 0.01) were independently associated with VNS on multivariable regression. Conclusions We conclude that socio-economic and clinical factors influence viral suppression in our cohort and vary between men and women. Gender specific approaches are necessary to achieve the 90% suppression goal.

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