scholarly journals SWTICH DE ESQUEMAS ANTIRRETROVIRAIS DURANTE A PANDEMIA DE COVID-19 EM UM CENTRO DE REFERÊNCIA DA AMÉRICA LATINA

RAHIS ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 168-169
Author(s):  
Dirce Inês Silva ◽  
Isabela Estrela Santos ◽  
Jaqueline Xavier Oliveira
Keyword(s):  
Research Society ◽  
Hiv Treatment ◽  
Services Research ◽  
Prevention Services ◽  
Treatment And Prevention ◽  
The Social ◽  
America Latina ◽  
Terapia Antirretroviral ◽  
The Impact ◽  
Brazilian Journal

INTRODUÇÃO : O tratamento da infecção pelo vírus da imunodeficiência humana (HIV) é realizado por meio da terapia antirretroviral (TARV) e vem apresentando avanços importantes no decorrer dos anos. Ocorreu a introdução de novas drogas e classes que ampliaram de modo significativo as opções para o tratamento da infecção pelo HIV-1. Existem razões para a troca (Swtich) da TARV, são eles : manutenção da supressão viral, resistência, probabilidade de maior adesão ao tratamento, eventos adversos, interações medicamentosas (1). Durante a pandemia de Covid-19 que vivenciamos desde março de 2020 no Brasil muitas dificuldades ocorreram nos serviços de saúde, principalmente para as pessoas que vivem com HIV como : acesso aos serviços, diagnóstico, tratamento e acompanhamento (2.3). OBJETIVO: Avaliar a prevalência de trocas de esquemas em um centro de referência da América Latina no período de Janeiro de 2020 a 31 de Julho de 2021.METODOLOGIA : Realizamos um estudo transversal no período de 2020 a 2021 , utilizando o sistema de informação : Sistema de Controle Logístico de Medicamentos (SICLOM) do Ministério da Saúde . Os dados foram analisados no Statistical Package for the Social Science(SPSS® ) 22.RESULTADOS : No período do estudo foram detectadas 473 trocas. Em 2020 ocorreram 283 trocas, 83 em mulheres e 200 em homens. E 2021 até o dia 31/07/2021 foram detectadas 190 trocas, 76 ocorreram em mulheres e 114 em homens. As trocas ocorreram devido : resistência, reações adversas, gestação , tratamento concomitante da tuberculose e simplificação do tratamento ( Figura 1 e 2)).   Figura 1 – Ocorências de Swtich de esquemas antirretroviraisFigura 2- Razões de Trocas de Esquemas Antiretrovirais CONCLUSÃO : Swtich dos esquemas antirretrovirais em utilização pode ser uma estratégia de simplificação da TARV, melhoria da adesão, e em muitos casos a redução de eventos adversos. O arsenal terapêutico no contexto brasileiro é diversificado permitindo uma troca com segurança e sem risco de perda da eficácia virológica. Sendo uma estratégia para enfrentamento da infecção pelo HIV mesmo em tempos de pandemia do COVID19. REFERÊNCIAS:1-Brites, Carlos. Terapia antirretroviral atual: tendências e desafios. Estratégias de troca (switch) naterapia antirretroviral atual. Brazilian Journal of Infectious DiseaseVol 2 . Nº 1 . Fevereiro 20162- Moura, Maria Lucia Costa de. (2020). Coronavírus e COVID-19. Revista Saúde Coletiva, 53, 10.3- Parente, J. da S.; Azevedo, S. L. de .; Moreira, L. da F. A.; Abreu, L. M. .; Souza, L. V. de. The impact of social isolation on the COVID-19 pandemic on access to HIV treatment and prevention services. Research, Society and Development, [S. l.], v. 10, n. 1, p. e28110111692, 2021.  

scholarly journals SimpactCyan 1.0: An Open-source Simulator for Individual-Based Models in HIV Epidemiology with R and Python Interfaces

2018 ◽  
Author(s):  
Jori Liesenborgs ◽  
Diana M Hendrickx ◽  
Elise Kuylen ◽  
David Niyukuri ◽  
Niel Hens ◽  
...  
Keyword(s):  
Open Source ◽  
Hiv Infections ◽  
Hiv Treatment ◽  
Model Parameters ◽  
Eligibility Criteria ◽  
Hiv Epidemiology ◽  
Treatment And Prevention ◽  
Individual Based Models ◽  
Prevention Programmes ◽  
The Impact

ABSTRACTSimpactCyan is an open-source simulator for individual-based models in HIV epidemiology. Its core algorithm is written in C++ for computational efficiency, while the R and Python interfaces aim to make the tool accessible to the fast-growing community of R and Python users. Transmission, treatment and prevention of HIV infections in dynamic sexual networks are simulated by discrete events. A generic “intervention” event allows model parameters to be changed over time, and can be used to model medical and behavioural HIV prevention programmes. First, we describe a more efficient variant of the modified Next Reaction Method that drives our continuous-time simulator. Next, we outline key built-in features and assumptions of individual-based models formulated in SimpactCyan, and provide code snippets for how to formulate, execute and analyse models in SimpactCyan through its R and Python interfaces. Lastly, we give two examples of applications in HIV epidemiology: the first demonstrates how the software can be used to estimate the impact of progressive changes to the eligibility criteria for HIV treatment on HIV incidence. The second example illustrates the use of SimpactCyan as a data-generating tool for assessing the performance of a phylodynamic inference framework.

Shadow of HIV exceptionalism 40 years later

2021 ◽  
pp. medethics-2020-106908
Author(s):  
Michela Blain ◽  
Stephaun E Wallace ◽  
Courtney Tuegel
Keyword(s):  
Implicit Bias ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Medical Community ◽  
Aids Epidemic ◽  
Treatment And Prevention ◽  
The Social ◽  
Hiv Exceptionalism ◽  
Medical Advances

During the AIDS epidemic in the 1980s, it was crucial that providers take steps to protect patients by managing HIV with the perspective of ‘HIV exceptionalism’. However, in 2020, the social and historical barriers erected by this concept, as demonstrated in this patient’s case, are considerably impeding progress to end the epidemic. With significant medical advances in HIV treatment and prevention, the policies informed by HIV exceptionalism now paradoxically perpetuate stigma and inequities, particularly for people of colour. To improve overall HIV care, the medical community must move past HIV exceptionalism by liberalising diagnostics, instituting clinician implicit bias training and advocating to fully decriminalise HIV non-disclosure.

Training in HIV Psychiatry

2017 ◽  
Author(s):  
David M. Stoff ◽  
Mary Ann Cohen ◽  
Marshall Forstein ◽  
Anna L. Dickerman ◽  
Daena L. Petersen
Keyword(s):  
Diversity Training ◽  
Research Training ◽  
Hiv Treatment ◽  
Aids Education ◽  
Hiv Education ◽  
Prevention Services ◽  
Treatment And Prevention ◽  
Research Workforce ◽  
Living With Hiv ◽  
Hiv Aids

HIV education and training can improve HIV treatment and prevention services, improve HIV-related education, and increase the number of clinicians and investigators working with persons at risk for and living with HIV/AIDS. This chapter presents a biopsychosocial, integrated model of HIV/AIDS education for psychiatry trainees, relevant curriculum and content areas of HIV/AIDS education, and related areas, such as teaching treatment approaches and implementation of training curricula. HIV education is enriched through a balanced approach that emphasizes the importance of diversity training as well as research training. National Institutes of Health (NIH) research training and career development opportunities are highlighted, as are diversity issues in HIV psychiatry for the training of a diverse research workforce.

scholarly journals Stimulant Use Interventions May Strengthen ‘Getting to Zero’ Initiatives in Illinois: Insights from a Modeling Study

2021 ◽  
Author(s):  
Francis Lee ◽  
Daniel Sheeler ◽  
Anna Hotton ◽  
Natascha Del Vecchio ◽  
Rey Flores ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Crack Cocaine ◽  
Hiv Treatment ◽  
Annual Number ◽  
Hiv Incidence ◽  
Stimulant Use ◽  
Treatment And Prevention ◽  
Biomedical Intervention ◽  
The Impact ◽  
Modeling Study

AbstractObjective(s)Young Black men who have sex with men (YBMSM) are a key population identified in the Illinois Getting to Zero (GTZ) initiative who have experienced disproportionate HIV incidence. Rising stimulant use has been determined to impede the effectiveness of ART and pre-exposure prophylaxis for suppressing HIV transmission in populations. This modeling study explores the impact of stimulant use on HIV incidence among YBMSM – given the limited development of dedicated or culturally appropriate interventions for this population – and assesses the impact of these interventions on downstream HIV transmission in the context of achieving GTZ goals.MethodsA previously developed agent-based network model (ABNM), calibrated using data for YBMSM in Illinois, was extended to incorporate the impact of stimulant use (methamphetamines, crack/cocaine, and ecstasy) on sexual networks and engagement in HIV treatment and prevention continua. The model simulated the impact of a residential behavioral intervention (BI) for reducing stimulant dependency and an outpatient biomedical intervention (mirtazapine) for treating methamphetamine dependence on improved engagement in the HIV treatment and prevention continua. The downstream impact of these interventions on population-level HIV incidence was the primary intervention outcome.ResultsBaseline simulated annual HIV incidence in the ABNM was 6.9(95% CI: 6.83,7.04) per 100 person years (py) and 453 (95% CI: 445.9,461.2) new infections annually. A residential targeted to 25% of stimulant users yielded a 27.1% decline in the annual number of new infections. Initiating about 50% of methamphetamine users on mirtazapine reduced the overall HIV incidence by about 11%. A 25% increase in antiretroviral treatment (ART) and preexposure prophylaxis (PrEP) uptake in the non-stimulant using YBMSM population combined with a 25% uptake of BI for stimulant users produces an HIV incidence consistent with HIV elimination targets (about 200 infections/year) identified in the GTZ initiative.ConclusionsTargeted behavioral and biomedical interventions to treat stimulant dependency are likely to provide additive benefits to expanding ART and PrEP uptake for everyone in accomplishing GTZ initiatives for HIV elimination.

scholarly journals Lessons from a publicly funded tier 2 healthy weight programme in Cornwall, UK

2019 ◽  
Author(s):  
A J Williams ◽  
T Barter ◽  
R A Sharpe
Keyword(s):  
Statistical Tests ◽  
Evidence Base ◽  
Lessons Learned ◽  
Healthy Weight ◽  
Anthropometric Measures ◽  
Prevention Services ◽  
Treatment And Prevention ◽  
Weight Management Programme ◽  
The Uk ◽  
The Impact

Abstract Background The UK has one of the highest prevalence rates of obesity worldwide. Public health departments have a duty to provide some obesity treatment and prevention services. With evidence of effective programmes lacking, we investigate lessons learned from a healthy weight programme in Cornwall, UK. Methods Data from the 12-week multi-component adult healthy weight management programme were obtained for 2012–2016. Descriptive statistics and statistical tests were used to describe participants’ demographics, health status and anthropometric measures to explore the enrolment and retention of the programme as well as the impact. Results A total of 1872 adults were referred into the programme. Overall, 646 completed the programme and, 48.8% achieved the programme’s aim of a >3% reduction in weight. Those who completed and met the programme aim tended to have had healthier outcomes at baseline. Conclusions For those who engage with the programme the impact can be meaningful. However, <1% of the population of Cornwall with overweight or obesity enroled in the programme, and those who benefitted most might have been in least need. Providing services that meet the needs of the population is challenging when a variety of services is needed, and the evidence base is poor.

scholarly journals “But I Gathered My Courage”: HIV Self-Testing as a Pathway of Empowerment Among Ugandan Female Sex Workers

2021 ◽  
Vol 31 (3) ◽  
pp. 443-457
Author(s):  
Jonas Wachinger ◽  
Daniel Kibuuka Musoke ◽  
Catherine E. Oldenburg ◽  
Till Bärnighausen ◽  
Katrina F. Ortblad ◽  
...  
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Sense Of Self ◽  
Qualitative Interviews ◽  
Hiv Treatment ◽  
Prevention Services ◽  
Female Sex ◽  
Treatment And Prevention ◽  
Self Testing ◽  
Framework Approach

HIV self-testing (HIVST) increases HIV testing in diverse populations, but little is known about the experiences of individuals who self-test. We used a five-step framework approach to analyze 62 qualitative interviews with 33 female sex workers (FSWs) participating in an HIVST trial in urban Uganda. Notions of empowerment emerged from the data, and findings were interpreted based on Kabeer’s empowerment framework of resources, agency, and achievements. We found that access to HIVST bolstered empowerment because it increased participant’s time and money (resources), control of testing circumstances and status disclosure (agency), and sense of competency (achievements). In addition, we found that knowledge of HIV status empowered participants to better control HIV-related behaviors (agency) and recognize a new sense of self (achievements). This suggests that the availability of HIVST can facilitate feelings of empowerment, meriting a higher awareness for benefits outside of linkage to HIV treatment and prevention services.

scholarly journals When to start ART in adults? The results of HPTN 052 move us closer to a test-and-treat policy

2011 ◽  
Vol 12 (3) ◽  
pp. 9 ◽  
Author(s):  
Nathan Geffen
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
World Health ◽  
Hiv Positive ◽  
Who Guidelines ◽  
Test And Treat ◽  
Prevention Services ◽  
Treatment And Prevention ◽  
Health Organization

When is the best time to initiate antiretroviral therapy (ART) in adults? This is a vital question in HIV treatment and prevention services. More specifically, is the 350 cells/µl CD4 count threshold recommended by current World Health Organization (WHO) guidelines sufficient, or should we move to a ‘test-and-treat’ approach in which anyone who tests HIV-positive is offered ART, irrespective of their CD4 count? The recently announced results of the HPTN 052 trial take us closer, but not all the way, to a test-and-treat approach.

Estimating the impact of the US President's Emergency Plan for AIDS Relief on HIV treatment and prevention programmes in Africa

2015 ◽  
Vol 91 (8) ◽  
pp. 615-620 ◽  
Author(s):  
Laura M Heaton ◽  
Paul D Bouey ◽  
Joe Fu ◽  
John Stover ◽  
Timothy B Fowler ◽  
...  
Keyword(s):  
Hiv Treatment ◽  
Emergency Plan ◽  
Treatment And Prevention ◽  
The Us ◽  
Prevention Programmes ◽  
The Impact

Progress countering HIV/AIDS in Africa may be at risk

2017 ◽  
Keyword(s):  
At Risk ◽  
Hiv Treatment ◽  
Hiv And Aids ◽  
Sub Saharan Africa ◽  
Content Type ◽  
Prevention Services ◽  
Treatment And Prevention ◽  
Budget Support ◽  
Sub Saharan ◽  
Hiv Aids

Significance HIV and AIDS have slipped from the public radar in recent years but nonetheless remains a serious health challenge across sub-Saharan Africa (SSA). Efforts to control the epidemic may well be put at risk following recent US policy announcements that are likely to undermine prevention efforts. Impacts The US Mexico City Policy will damage HIV/AIDS programming through its effects on critical sexual and reproductive health (SRH) services. Growing drug resistance to HIV treatment will impair both treatment and prevention services, leading to increased deaths and new infections. Weak health systems and lack of domestic support jeopardises the sustainability of HIV services. Emerging health crises may divert donor attention and budget support from HIV/AIDS organisations at a time when momentum is needed.

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