scholarly journals HIV Care Continuum from diagnosis in a Counseling and Testing Center

2020 ◽  
Vol 73 (6) ◽  
Author(s):  
Angélica da Mata Rossi ◽  
Silvia Paulino Ribeiro Albanese ◽  
Ingridt Hildegard Vogler ◽  
Flávia Meneguetti Pieri ◽  
Edvilson Cristiano Lentine ◽  
...  
Keyword(s):  
Viral Load ◽  
Retention In Care ◽  
Late Diagnosis ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Viral Load Suppression ◽  
Care Continuum ◽  
Counseling And Testing ◽  
Testing Center ◽  
Hiv Aids

ABSTRACT Objective: To analyze the HIV care continuum from the diagnosis in an HIV/AIDS Counseling and Testing Center (CTC), and the sociodemographic, clinical, and laboratory characteristics related to gender. Method: Epidemiological study, conducted with data of individuals assisted at a Counseling and Testing Center, and followed in an outpatient clinic for HIV/AIDS. Pearson’s Chi-square test and binary logistic regression were used to obtain odds ratios, considering alpha value <0.05. Results: The prevalence of HIV among 5,229 users was 5%. The highest chance of positive results was among men, aged 14 to 33 years old, who were not in a domestic partnership. In the analysis of TCD4+ lymphocytes and viral load (VL) of 238 cases, 56.1% had a late diagnosis. We have identified gaps in the care cascade, especially linkage to the care, retention in care, and viral load suppression. Conclusion: The results suggest a late diagnosis for both genders, as well as difficulty in reaching the viral suppression goal.

Importance of HIV Care Continuum

2020 ◽  
pp. 50-67
Author(s):  
Simon George Taukeni ◽  
Eveline Ndinelao Kalomo
Keyword(s):  
Viral Load ◽  
Research Direction ◽  
Cultural Barriers ◽  
Hiv Care ◽  
Future Research ◽  
Hiv Care Continuum ◽  
Viral Load Suppression ◽  
Hiv Counseling ◽  
Care Continuum ◽  
Counseling And Testing

This chapter seeks to create further awareness and public health education on the importance of the human immunodeficiency virus (HIV) care continuum as one of the key policy focal areas to significantly reduce the HIV epidemic. Specific efforts were directed into the need to implement comprehensive HIV care continuum. The chapter argues that rolling out HIV counseling and testing, enrolled and linked patients to care, prescribing antiretroviral therapy, viral load testing and monitoring are key to achieve viral load suppression. Recommendations and future research direction have put much emphasis on an effort to address psychosocial factors such as stigma, inadequate healthcare facilities, laboratory testing equipment, social and cultural barriers to testing and treatment, to improve access and overall implementation of HIV care continuum.

scholarly journals High Rates of Retention and Viral Suppression in the US HIV Safety Net System: HIV Care Continuum in the Ryan White HIV/AIDS Program, 2011

2014 ◽  
Vol 60 (1) ◽  
pp. 117-125 ◽  
Author(s):  
R. K. Doshi ◽  
J. Milberg ◽  
D. Isenberg ◽  
T. Matthews ◽  
F. Malitz ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Safety Net ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Ryan White ◽  
The Us ◽  
Aids Program ◽  
Hiv Aids

scholarly journals 1322. A Mobile Technology-Based Intervention Improves HIV Care Continuum for Young People Living with HIV

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S478-S478
Author(s):  
Ping Du ◽  
John Zurlo ◽  
Tarek Eshak ◽  
Tonya Crook ◽  
Cynthia Whitener
Keyword(s):  
Mobile Technology ◽  
Viral Suppression ◽  
Retention In Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Hiv Viral Suppression ◽  
Study Participants ◽  
Living With Hiv

Abstract Background Young people living with HIV (YPLWH) have lower rates of retention in care and HIV viral suppression. Multiple barriers exist to engage YPLWH in care. As nearly all YPLWH use their mobile phones to access health information and to communicate with other people, we implemented a mobile technology-based intervention with the goal to improve HIV care continuum in YPLWH. Methods YPLWH were eligible for this study if they were: (1) aged 18–34 years; (2) newly diagnosed with HIV; (3) having a history of being out of care; or (4) not virally suppressed. We recruited YPLWH during January 2017-May 2018 and followed them every 6 months. We developed a HIPAA-compliant mobile application, “OPT-In For Life,” and let participants use this app to manage their HIV care. The app integrated multiple features that enabled users to communicate with the HIV treatment team via a secure messaging function, to access laboratory results and HIV prevention resources, and to set up appointment or medication reminders. We obtained participants’ demographics, app-usage data, and medical records to evaluate if this mobile technology-based intervention would improve HIV care continuum among YPLWH. We used a quasi-experiment study design to compare the rates of retention in care and HIV viral suppression every 6 months between study participants and YPLWH who were eligible but not enrolled in the study. Results 92 YPLWH participated in this study (70% male, 56% Hispanics or Blacks, 54% retained in care, and 66% virally suppressed at baseline). On average study participants used the app 1–2 times/week to discuss various health issues and supportive services with HIV providers, to access HIV-related health information, and to manage their HIV care. At the 6-month evaluation, compared with 88 eligible YPLWH who were not enrolled in this intervention, study participants had increased rates of retention in care (baseline-to-6-month between participants and nonparticipants: 54%–84% vs. 26%–25%) and HIV viral suppression (66%–80% vs. 56%–60%). Conclusion Our study demonstrates using a HIPAA-compliant mobile app as an effective intervention to engage YPLWH in care. This intervention can be adapted by other HIV programs to improve HIV care continuum for YPLWH or broader HIV populations. Disclosures All authors: No reported disclosures.

scholarly journals Care Facilitation Advances Movement Along The Hepatitis C Care Continuum For Persons With Hiv, Hepatitis C And Substance Use: A Randomized Clinical Trial (Ctn-0064)

2021 ◽  
Author(s):  
Lisa R Metsch ◽  
Daniel J Feaster ◽  
Lauren K Gooden ◽  
Carmen Masson ◽  
David C Perlman ◽  
...  
Keyword(s):  
Substance Use ◽  
Viral Load ◽  
Hepatitis C ◽  
Controlled Trial ◽  
Sustained Viral Response ◽  
Hiv Care ◽  
Control Group ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Viral Response

Abstract Background Direct-acting antivirals can cure HCV. Persons with HCV/HIV and living with substance use are disadvantaged in benefitting from advances in HCV treatment. Methods In this randomized controlled trial, participants with HCV/HIV were randomized between February 2016 and January 2017 to either care facilitation or control. Twelve-month follow-up assessments completed in January 2018. Care facilitation group participants received motivation and strengths-based case-management addressing retrieval of HCV load results, engagement in HCV/HIV care and medication adherence. Control group participants received referral to HCV evaluation and an offer of assistance in making care appointments. Primary outcome was number of steps achieved along a series of 8 clinical steps (e.g., receiving HCV results, initiating treatment, sustained viral response) of the HCV/HIV care continuum over 12 months post-randomization. Results Three hundred and eighty-one individuals were screened and 113 randomized. Median age was 51 years; 58.4% male and 72.6% Black/African American. Median HIV-1 viral load was 27,209 copies/ml with 69% having a detectable viral load. Mean number of steps completed was statistically significantly higher in the intervention (2.44 steps) vs. control group (1.68 steps) [χ 2(1)=7.36, p=0.0067]. Men in the intervention (vs. control) group completed a statistically significantly higher number of steps. Eleven participants achieved sustained viral response with no difference by treatment group. Conclusions The care facilitation intervention increased progress along the HCV/HIV care continuum, as observed for men and not women. Study findings also highlight the continued challenges to achieve individual patient sustained viral responses and population level HCV elimination.

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 New York City HIV Care Continuum Dashboards: Using Surveillance Data to Improve HIV Care Among People Living With HIV in New York City (Preprint)

2018 ◽  
Author(s):  
Sarah L Braunstein ◽  
Karen Coeytaux ◽  
Charulata J Sabharwal ◽  
Qiang Xia ◽  
Rebekkah S Robbins ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Surveillance Data ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Viral Load Suppression ◽  
Care Continuum ◽  
Hiv Surveillance

BACKGROUND HIV surveillance data can be used to improve patient outcomes. OBJECTIVE This study aimed to describe and present findings from the HIV care continuum dashboards (CCDs) initiative, which uses surveillance data to quantify and track outcomes for HIV patients at major clinical institutions in New York City. METHODS HIV surveillance data collected since 2011 were used to provide high-volume New York City clinical facilities with their performance on two key outcomes: linkage to care (LTC), among patients newly diagnosed with HIV and viral load suppression (VLS), among patients in HIV care. RESULTS The initiative included 21 facilities covering 33.78% (1135/3360) of new HIV diagnoses and 46.34% (28,405/61,298) of patients in HIV care in New York City in 2011 and was extended to a total of 47 sites covering 44.23% (1008/2279) of new diagnoses and 69.59% (43,897/63,083) of New York City patients in care in 2016. Since feedback of outcomes to providers began, aggregate LTC has improved by 1 percentage point and VLS by 16 percentage points. CONCLUSIONS Disseminating information on key facility–level HIV outcomes promotes collaboration between public health and the clinical community to end the HIV epidemic. Similar initiatives can be adopted by other jurisdictions with mature surveillance systems and supportive laws and policies.

scholarly journals 896. Examining the Impact of the COVID-19 Pandemic on Delivery of HIV Care and Prevention Services Among Patients in a Ryan White Clinic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S539-S539
Author(s):  
Michelle Zhang ◽  
Sharlay Butler ◽  
Jason Kennedy ◽  
Molly McKune ◽  
Ghady Haidar ◽  
...  
Keyword(s):  
Viral Load ◽  
Viral Suppression ◽  
Retention In Care ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Viral Load Suppression ◽  
Sti Prevention ◽  
Prevention Services ◽  
The Impact ◽  
Non Parametric

Abstract Background We sought to characterize the impact of the COVID-19 pandemic on HIV-related outcomes in a cohort of patients by examining rates of viral load (VL) suppression, retention-in-care, PrEP access, and STIs. Methods This was a single center, retrospective study of adults receiving HIV treatment or HIV/STI prevention services from 01/2019 - 12/2020. HIV outpatient visits were identified through HRSA’s CareWARE. Visits (in-person, telehealth) only included HIV primary care. HRSA core performance measures were utilized (Table 1). STI positivity rates and descriptive characteristics were calculated. New and refill PrEP prescriptions were tabulated. Chi-square tests compared unmatched non-parametric variables; McNemar’s test matched non-parametric variables. Multivariable logistic regression identified variables associated with retention in care and viral suppression. Results 1721 patients received care; 1234 were seen in both years, 334 only in 2019, 153 only in 2020. The number of telehealth visits increased significantly: video (0% to 31%, &lt; 0.001), phone (0% to 0.4%, p &lt; 0.001). Though the proportion of kept appointments increased (57.2% vs 61.2%), the annual retention in care rate decreased from 74.5% to 70.9% (p = 0.002). Overall, 9.7% of patients had detectable VLs at any point. Compared to 2019, a lower proportion of patients maintained VL suppression in 2020, (91.6% vs 83.5% p = 0.075). More patients did not have a VL drawn in 2020 than in 2019 (10.3% vs 2.0 %, p &lt; 0.001). Patients with detectable VLs in 2019 were more likely than those who were undetectable to have detectable VLs in 2020 (OR 18.2, 95% CI 9.91-33.42). Black race was associated with higher likelihood of lack of VL suppression (OR = 2.0; 95% CI 1.10-3.66). There were no significant differences between gender or age groups in rates of viral suppression, number screened for bacterial STIs or positive results. Visits for new and refill PrEP prescriptions decreased by 59% and 7%, respectively. Conclusion Rates of viral load suppression and retention in care decreased in 2020 compared to 2019. The proportion of clinic visits attended increased after the integration of telemedicine in 2020. These data may be used to inform evidence-based interventions to improve the HIV continuum of care through telehealth. Disclosures Ghady Haidar, MD, Karuys (Grant/Research Support)

scholarly journals The impact of COVID-19 pandemic on HIV care continuum in Jiangsu, China

2021 ◽  
Author(s):  
Lingen Shi ◽  
Weiming Tang ◽  
Haiyang Hu ◽  
Tao Qiu ◽  
Gifty Marley ◽  
...  
Keyword(s):  
Negative Impact ◽  
Information Management System ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Public Health Services ◽  
Cd4 Cell Count ◽  
Care Continuum ◽  
Confirmatory Tests ◽  
The Impact ◽  
Hiv Aids

Abstract Background The COVID-19 pandemic seriously threatens general public health services globally. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV care continuum in Jiangsu province, China. Methods Data for analysis was retrieved from the web-based Comprehensive Response Information Management System (CRIMS) for HIV/AIDS in China. We used time series model of seasonal autoregressive integrated moving average (SARIMA) and Exponential smoothing to predict the amount of HIV care services during the COVID-19 measures, and Chi-square were performed to assess subgroup differences. Results Overall, the testing rated decreased 49.0% (919,938) decrease in the first three months during the COVID-19 measures, as compared with the estimated number. Although an estimated of 1555 confirmatory tests were expected in the first three months during the COVID-19 measures, only 48.7% (757) confirmed HIV/AIDS cases were actually recorded. In the actual data during the first period of COVID-19, 980 clients received confirmatory tests, only 71.4% (700) were reportedly linked to care. Only 49.5% (235) out of the expected 475 estimated number of clients received CD4 cell count test services. Meanwhile 91.23% (208) had initiated antiretroviral therapy (ART) which compared to 227 the estimated number of initiated ART. Compared with the same period during 2016 to 2019, PLWHIV who were less than 30, migrants were more likely to be influenced by the COVID-19 policies. Conclusions The COVID-19 pandemic had a negative impact on the HIV healthcare systems in Jiangsu, China. Further measures that can encounter the impact of the pandemic are needed, in order to maintain HIV care continuum.

scholarly journals Challenges Across the HIV Care Continuum for Patients With HIV/TB Co-infection in Atlanta, GA

2018 ◽  
Vol 5 (4) ◽  
Author(s):  
Marcos C Schechter ◽  
Destani Bizune ◽  
Michelle Kagei ◽  
David P Holland ◽  
Carlos del Rio ◽  
...  
Keyword(s):  
Inner City ◽  
Viral Suppression ◽  
Retention In Care ◽  
The United States ◽  
Hiv Care ◽  
City Hospital ◽  
Hiv Care Continuum ◽  
Sequential Art ◽  
Care Continuum ◽  
Tb Treatment

Abstract Background Antiretroviral therapy (ART) for persons with HIV infection prevents tuberculosis (TB) disease. Additionally, sequential ART after initiation of TB treatment improves outcomes. We examined ART use, retention in care, and viral suppression (VS) before, during, and 3 years following TB treatment for an inner-city cohort in the United States. Methods Retrospective cohort study among persons treated for culture-confirmed TB between 2008 and 2015 at an inner-city hospital. Results Among 274 persons with culture-confirmed TB, 96 (35%) had HIV co-infection, including 23 (24%) new HIV diagnoses and 73 (76%) previous diagnoses. Among those with known HIV prior to TB, the median time of known HIV was 6 years, and only 10 (14%) were on ART at the time of TB diagnosis. The median CD4 at TB diagnosis was 87 cells/uL. Seventy-four (81%) patients received ART during treatment for TB, and 47 (52%) has VS at the end of TB treatment. Only 32% of patients had continuous VS 3 years after completing TB treatment. There were 3 TB recurrences and 3 deaths post–TB treatment; none of these patients had retention or VS after TB treatment. Conclusions Among persons with active TB co-infected with HIV, we found that the majority had known HIV and were not on ART prior to TB diagnosis, and retention in care and VS post–TB treatment were very low. Strengthening the HIV care continuum is needed to improve HIV outcomes and further reduce rates of active TB/HIV co-infection in our and similar settings.

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