scholarly journals Trends in Care and Treatment for Persons Aged ≥13 Years with HIV Infection 17 U.S. Jurisdictions, 2012-2015

2018 ◽  
Vol 12 (1) ◽  
pp. 90-105 ◽  
Author(s):  
Debra L. Karch ◽  
Xueyuan Dong ◽  
Jing Shi ◽  
H. I. Hall
Keyword(s):  
Hiv Infection ◽  
Viral Suppression ◽  
Linkage To Care ◽  
Risk Groups ◽  
Sexual Contact ◽  
Hiv Diagnosis ◽  
Annual Percent Change ◽  
Hiv Surveillance ◽  
High Risk Populations ◽  
National Trends

Background: Care and viral suppression national goals for HIV infection are not being met for many at-risk groups. Assessment of the trends in national outcomes for linkage to care, receipt of care, and viral suppression among these groups is necessary to reduce transmission. Methods: Data reported to the National HIV Surveillance System by December 2016 were used to identify cases of HIV infection among persons aged 13 years and older in one of 17 identified jurisdictions with complete laboratory reporting. We estimated national trends in HIV-related linkage to care, receipt of care and viral suppression using estimated annual percent change from 2012-2015 for various characteristics of interest, overall and stratified by sex and race/ethnicity. Results: Overall, trends in linkage to and receipt of care and viral suppression increased from 2012-2015. Generally, linkage to and receipt of care increased among young black and Hispanic/Latino males, those with infection attributed to male-to-male sexual contact, and those not in stage 3 [AIDS] at HIV diagnosis. All sub-groups showed improvement in viral suppression. Within years, there remains a substantial disparity in receipt of care and viral suppression among racial/ethnic groups. Conclusion: While trends are encouraging, scientifically proven prevention programs targeted to high-risk populations are the foundation for stopping transmission of HIV infection. Frequent testing to support early diagnosis and prompt linkage to medical care, particularly among young men who have male to male sexual contact, black and Hispanic/Latino populations, are key to reducing transmission at all stages of disease.

scholarly journals HIV Infection-Related Care Outcomes among U.S.-Born and Non-U.S.-Born Blacks with Diagnosed HIV in 40 U.S. Areas: The National HIV Surveillance System, 2016

2018 ◽  
Vol 15 (11) ◽  
pp. 2404 ◽  
Author(s):  
Hanna Demeke ◽  
Anna Johnson ◽  
Hong Zhu ◽  
Zanetta Gant ◽  
Wayne Duffus ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Late Stage ◽  
Surveillance System ◽  
Viral Suppression ◽  
Hiv Infections ◽  
Retention In Care ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Hiv Surveillance ◽  
Care Outcomes

HIV care outcomes must be improved to reduce new human immunodeficiency virus (HIV) infections and health disparities. HIV infection-related care outcome measures were examined for U.S.-born and non-U.S.-born black persons aged ≥13 years by using National HIV Surveillance System data from 40 U.S. areas. These measures include late-stage HIV diagnosis, timing of linkage to medical care after HIV diagnosis, retention in care, and viral suppression. Ninety-five percent of non-U.S.-born blacks had been born in Africa or the Caribbean. Compared with U.S.-born blacks, higher percentages of non-U.S.-born blacks with HIV infection diagnosed during 2016 received a late-stage diagnoses (28.3% versus 19.1%) and were linked to care in ≤1 month after HIV infection diagnosis (76.8% versus 71.3%). Among persons with HIV diagnosed in 2014 and who were alive at year-end 2015, a higher percentage of non-U.S.-born blacks were retained in care (67.8% versus 61.1%) and achieved viral suppression (68.7% versus 57.8%). Care outcomes varied between African- and Caribbean-born blacks. Non-U.S.-born blacks achieved higher care outcomes than U.S.-born blacks, despite delayed entry to care. Possible explanations include a late-stage presentation that requires immediate linkage and optimal treatment and care provided through government-funded programs.

scholarly journals HIV Infection Care and Viral Suppression Among People Who Inject Drugs, 28 U.S. Jurisdictions, 2012-2013

2016 ◽  
Vol 10 (1) ◽  
pp. 127-135 ◽  
Author(s):  
Debra L. Karch ◽  
Kristen Mahle Gray ◽  
Jing Shi ◽  
H. Irene Hall
Keyword(s):  
Young People ◽  
Hiv Infection ◽  
Viral Suppression ◽  
People Who Inject Drugs ◽  
Early Stage ◽  
Linkage To Care ◽  
Retention In Care ◽  
Infected People ◽  
Hiv Surveillance ◽  
Stage Infection

Objectives: Assess outcomes along the care continuum for HIV-infected people who inject drugs (PWID), by type of facility and stage of infection at diagnosis. Methods: Data reported by 28 jurisdictions to the National HIV Surveillance System by December 2014 were used to identify PWID aged ≥13 years, diagnosed with HIV infection before December 31, 2013. Analyses used the CDC definition of linkage to care (LTC), retention in care (RIC), and viral suppression (VS), and are stratified by age, sex, race/ethnicity, and type of facility and stage of HIV infection at diagnosis. Results: Of 1,409 PWID diagnosed with HIV in 2013, 1,116 (79.2%) were LTC with the lowest percentages among males (78.4%); blacks (77.5%) ages 13-24 years (69.0%); those diagnosed in early stage infection (71.6%); and at screening, diagnostic, or referral agencies (60.0%). Of 80,958 PWID living with HIV in 2012, 40,234 (49.7%) were RIC and 34,665 (42.8%) achieved VS. The lowest percentages for RIC and VS were among males (47.1% and 41.3% respectively); those diagnosed with late stage disease (47.1% and 42.4%); and young people. Whites had the lowest RIC (47.0%) while blacks had the lowest VS (41.1%). Conclusion: Enhanced LTC activities are needed for PWID diagnosed at screening, diagnostic or referral agencies versus those diagnosed at inpatient or outpatient settings, especially among young people and blacks diagnosed in early stage infection. Less than half of PWID are retained in care or reach viral suppression indicating the need for continued engagement and return to care activities over the long term.

HIV INFECTION AND SOME RELATED FACTORS IN FEMALE MASSAGE THERAPISTS IN QUANG NGAI PROVINCE

2015 ◽  
pp. 57-60
Author(s):  
Xuan Chuong Tran ◽  
Thi Thanh Hoa Le ◽  
Ngoc Van Nguyen ◽  
Thanh Nguyen
Keyword(s):  
Hiv Infection ◽  
Urban Areas ◽  
Risk Groups ◽  
Sexual Contact ◽  
Related Factor ◽  
Related Factors ◽  
Cross Sectional ◽  
Keywords Hiv ◽  
Study Results ◽  
Massage Therapists

Background: HIV/AIDS is still a dangerous infection in Vietnam and in the world. Studying of HIV infection and related factors in high risk groups, including female massage therapists is therefore very important. Aims: 1. To study the HIV infection in female massage therapists in Quang Ngai province. 2. To fine some related factors to HIV infection. Patients and methods: Female massage therapists working in Quang Ngai province. Cross-sectional, descriptive study. Results: The rate of HIV infection was 0.99%. Group older than 22 years old had higher rate of infection than group under 22 years old (1.80% vs 0.69%). The girls from urban areas or not using condom had higher rate of infection than group from rural or not using condom (1.57% vs 0.47% and 7.32% vs. 0.57%). Most of HIV infected belong to single or divorce groups. Conclusions: The rate of HIV infection in female massage therapists in Quang Ngai province was 0.99%. The HIV infection related factor was not using condom in sexual contact. Keywords: HIV, female massage therapists, Quang Ngai

scholarly journals Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Wei Ang ◽  
Carmen Low ◽  
Chen Seong Wong ◽  
Irving Charles Boudville ◽  
Matthias Paul Han Sim Toh ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Risk Groups ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Voluntary Testing ◽  
Recent Hiv Infection

AbstractBackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.

scholarly journals Decreased Time to Viral Suppression After Implementation of Targeted Testing and Immediate Initiation of Treatment of Acute Human Immunodeficiency Virus Infection Among Men Who Have Sex With Men in Amsterdam

2020 ◽  
Author(s):  
Maartje Dijkstra ◽  
Martijn S van Rooijen ◽  
Mariska M Hillebregt ◽  
Ard van Sighem ◽  
Colette Smit ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Viral Suppression ◽  
Standard Of Care ◽  
Combination Antiretroviral Therapy ◽  
Hiv Diagnosis ◽  
Cart Initiation ◽  
Immunodeficiency Virus ◽  
Targeted Testing ◽  
Sex With Men

Abstract Background Men who have sex with men (MSM) with acute human immunodeficiency virus (HIV) infection (AHI) are a key source of new infections. To curb transmission, we implemented a strategy for rapid AHI diagnosis and immediate initiation of combination antiretroviral therapy (cART) in Amsterdam MSM. We assessed its effectiveness in diagnosing AHI and decreasing the time to viral suppression. Methods We included 63 278 HIV testing visits in 2008–2017, during which 1013 MSM were diagnosed. Standard of care (SOC) included HIV diagnosis confirmation in < 1 week and cART initiation in < 1 month. The AHI strategy comprised same-visit diagnosis confirmation and immediate cART. Time from diagnosis to viral suppression was assessed for 3 cART initiation periods: (1) 2008–2011: cART initiation if CD4 < 500 cells/μL (SOC); (2) January 2012–July 2015: cART initiation if CD4 < 500 cells/μL, or if AHI or early HIV infection (SOC); and (3a) August 2015–June 2017: universal cART initiation (SOC) or (3b) August 2015–June 2017 (the AHI strategy). Results Before implementation of the AHI strategy, the proportion of AHI among HIV diagnoses was 0.6% (5/876); after implementation this was 11.0% (15/137). Median time (in days) to viral suppression during periods 1, 2, 3a, and 3b was 584 (interquartile range [IQR], 267–1065), 230 (IQR, 132–480), 95 (IQR, 63–136), and 55 (IQR, 31–72), respectively (P < .001). Conclusions Implementing the AHI strategy was successful in diagnosing AHI and significantly decreasing the time between HIV diagnosis and viral suppression.

scholarly journals Use of HIV Case Surveillance System to Design and Evaluate Site-Randomized Interventions in an HIV Prevention Study: HPTN 065

2012 ◽  
Vol 6 (1) ◽  
pp. 122-130 ◽  
Author(s):  
Deborah J Donnell ◽  
H Irene Hall ◽  
Theresa Gamble ◽  
Geetha Beauchamp ◽  
Angelique B Griffin ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Surveillance System ◽  
Viral Suppression ◽  
Laboratory Data ◽  
Linkage To Care ◽  
Baseline Data ◽  
Surveillance Data ◽  
Hiv Care ◽  
Hiv Surveillance ◽  
Hiv Test

Introduction:Modeling studies suggest intensified HIV testing, linkage-to-care and antiretroviral treatment to achieve viral suppression may reduce HIV transmission and lead to control of the epidemic. To study implementation of strategy, population-level data are needed to monitor outcomes of these interventions. US HIV surveillance systems are a potential source of these data.Methods:HPTN065 (TLC-Plus) Study is evaluating the feasibility of a test, linkage-to-care, and treat strategy for HIV prevention in two intervention communities - the Bronx, NY, and Washington, DC. Routinely collected laboratory data on diagnosed HIV cases in the national HIV surveillance system were used to select and randomize sites, and will be used to assess trial outcomes.Results:To inform study randomization, baseline data on site-aggregated study outcomes was provided from HIV surveillance data by New York City and Washington D.C. Departments of Health. The median site rate of linkage-to-care for newly diagnosed cases was 69% (IQR 50%-86%) in the Bronx and 54% (IQR 33%-71%) in Washington, D.C. In participating HIV care sites, the median site percent of patients with viral suppression (<400 copies/mL) was 57% (IQR 53%-61%) in the Bronx and 64% (IQR 55%-72%) in Washington, D.C.Conclusions:In a novel use of site-aggregated surveillance data, baseline data was used to design and evaluate site randomized studies for both HIV test and HIV care sites. Surveillance data have the potential to inform and monitor sitelevel health outcomes in HIV-infected patients.

scholarly journals Implementing Rapid Initiation of Antiretroviral Therapy for Acute HIV Infection Within a Routine Testing and Linkage to Care Program in Chicago

2020 ◽  
Vol 19 ◽  
pp. 232595822093975
Author(s):  
Moira McNulty ◽  
Jessica Schmitt ◽  
Eleanor Friedman ◽  
Bijou Hunt ◽  
Audra Tobin ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Viral Suppression ◽  
Linkage To Care ◽  
Care Program ◽  
Acute Hiv Infection ◽  
Screening Programs ◽  
Acute Hiv ◽  
Therapy Clients

Growing evidence suggests that rapid initiation of antiretroviral therapy for HIV improves care continuum outcomes. We evaluated process and clinical outcomes for rapid initiation in acute HIV infection within a multisite health care–based HIV testing and linkage to care program in Chicago. Through retrospective analysis of HIV testing data (2016-2017), we assessed linkage to care, initiation of antiretroviral therapy, and viral suppression. Of 334 new HIV diagnoses, 33 (9.9%) individuals had acute HIV infection. Median time to linkage was 11 (interquartile range [IQR]: 5-19.5) days, with 15 days (IQR 5-27) to initiation of antiretroviral therapy. Clients achieved viral suppression at a median of 131 (IQR: 54-188) days. Of all, 69.7% were retained in care, all of whom were virally suppressed. Sites required few additional resources to incorporate rapid initiation into existing processes. Integration of rapid initiation of antiretroviral therapy into existing HIV screening programs is a promising strategy for scaling up this important intervention.

scholarly journals Timing of Linkage to Care After HIV Diagnosis and Time to Viral Suppression

2016 ◽  
Vol 72 (2) ◽  
pp. e57-e60 ◽  
Author(s):  
H. Irene Hall ◽  
Tian Tang ◽  
Anna S. Johnson ◽  
Lorena Espinoza ◽  
Norma Harris ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Linkage To Care ◽  
Hiv Diagnosis

scholarly journals Predictors of Linkage to and Retention in HIV Care Following Release from Connecticut Jails and Prisons

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S38-S38
Author(s):  
Kelsey B Loeliger ◽  
Frederick L Altice ◽  
Mayur M Desai ◽  
Maria M Ciarleglio ◽  
Colleen Gallagher ◽  
...  
Keyword(s):  
Case Management ◽  
Viral Suppression ◽  
Linkage To Care ◽  
Retention In Care ◽  
Hiv Treatment ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Surveillance ◽  
Targeted Interventions ◽  
Retention In Hiv Care

Abstract Background One in six people living with HIV (PLH) in the USA transition through prison or jail annually. During incarceration, people may engage in HIV care, but transition to the community remains challenging. Linkage to care (LTC) post-release and retention in care (RIC) are necessary to optimizing HIV outcomes, but have been incompletely assessed in prior observational studies. Methods We created a retrospective cohort of all PLH released from a Connecticut jail or prison (2007–2014) by linking Department of Correction demographic, pharmacy, and custody databases with Department of Public Health HIV surveillance monitoring and case management data. We assessed time to LTC, defined as time from release to first community HIV-1 RNA test, and viral suppression status at time of linkage. We used generalized estimating equations to identify correlates of LTC within 14 or 30 days after release. We also described RIC over three years following an initial release, comparing recidivists to non-recidivists. Results Among 3,302 incarceration periods from 1,350 unique PLH, 21% and 34% had LTC within 14 and 30 days, respectively, of which &gt;25% had detectable viremia at time of linkage. Independent correlates of LTC at 14 days included incarceration periods &gt;30 days (adjusted odds ratio [AOR] = 1.6; P &lt; 0.001), higher medical comorbidity (AOR = 1.8; P &lt; 0.001), antiretrovirals prescribed before release (AOR = 1.5; P = 0.001), transitional case management (AOR = 1.5; P &lt; 0.001), re-incarceration (AOR = 0.7; P = 0.002) and conditional release (AOR = 0.6; P &lt; 0.001). The 30-day model additionally included psychiatric comorbidity (AOR = 1.3; P = 0.016) and release on bond (AOR = 0.7; P = 0.033). Among 1,094 PLH eligible for 3-year follow-up, RIC after release declined over 1 year (67%), 2 years (51%) and 3 years (42%). Recidivists were more likely than nonrecidivists to have RIC but, among those retained, were less likely to be virally suppressed (Figure 1). Conclusion For incarcerated PLH, both LTC and RIC as well as viral suppression are suboptimal after release. PLH who receive case management are more likely to have timely LTC. Targeted interventions and integrated programming aligning health and criminal justice goals may improve post-release HIV treatment outcomes. Disclosures All authors: No reported disclosures.

scholarly journals Reduction in undiagnosed HIV infection in the European Union/European Economic Area, 2012 to 2016

2017 ◽  
Vol 22 (48) ◽  
Author(s):  
Ard van Sighem ◽  
Anastasia Pharris ◽  
Chantal Quinten ◽  
Teymur Noori ◽  
Andrew J Amato-Gauci ◽  
...  
Keyword(s):  
European Union ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Linkage To Care ◽  
European Economic Area ◽  
The European Union ◽  
Hiv Diagnosis ◽  
European Economic ◽  
Economic Area ◽  
Undiagnosed Hiv

It is well-documented that early HIV diagnosis and linkage to care reduces morbidity and mortality as well as HIV transmission. We estimated the median time from HIV infection to diagnosis in the European Union/European Economic Area (EU/EEA) at 2.9 years in 2016, with regional variation. Despite evidence of a decline in the number of people living with undiagnosed HIV in the EU/EEA, many remain undiagnosed, including 33% with more advanced HIV infection (CD4 < 350 cells/mm3).

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