ART policy in Belgium: a bioethical paradise?: Nathalie Schiffino and Frédéric Varone

2004 ◽  
pp. 41-61
Keyword(s):  
Art Policy

scholarly journals Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marwân-al-Qays Bousmah ◽  
Marie Libérée Nishimwe ◽  
Christopher Kuaban ◽  
Sylvie Boyer
Keyword(s):  
Socioeconomic Status ◽  
Health Expenditure ◽  
Antiretroviral Treatment ◽  
Catastrophic Health Expenditure ◽  
Hiv Care ◽  
Free Access ◽  
People Living With Hiv ◽  
Art Policy ◽  
Living With Hiv ◽  
The Impact

Abstract Background To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon’s free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country’s treatment access program. Methods Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006–2007 and 2014 (i.e., before and after the policy’s implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy’s implementation. Conclusions Our findings suggest that Cameroon’s free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.

scholarly journals Understanding the Reasons for Deferring ART Among Patients Diagnosed Under the Same-Day-ART Policy in Johannesburg, South Africa

2021 ◽  
Author(s):  
Dorina Onoya ◽  
Tembeka Sineke ◽  
Idah Mokhele ◽  
Jacob Bor ◽  
Matthew P. Fox ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Self Report ◽  
Hiv Diagnosis ◽  
Adjusted Risk ◽  
Art Initiation ◽  
Art Policy ◽  
Universal Test And Treat ◽  
Post Test ◽  
Treat All

AbstractWe aimed to examine the correlates of antiretroviral therapy (ART) deferral to inform ART demand creation and retention interventions for patients diagnosed with HIV during the Universal Test and Treat (UTT) policy in South Africa. We conducted a cohort study enrolling newly diagnosed HIV-positive adults (≥ 18 years), at four primary healthcare clinics in Johannesburg between October 2017 and August 2018. Patients were interviewed immediately after HIV diagnosis, and ART initiation was determined through medical record review up to six-months post-test. ART deferral was defined as not starting ART six months after HIV diagnosis. Participants who were not on ART six-months post-test were traced and interviewed telephonically to determine reasons for ART deferral. Modified Poisson regression was used to evaluate correlates of six-months ART deferral. We adjusted for baseline demographic and clinical factors. We present crude and adjusted risk ratios (aRR) associated with ART deferral. Overall, 99/652 (15.2%) had deferred ART by six months, 20.5% men and 12.2% women. Baseline predictors of ART deferral were older age at diagnosis (adjusted risk ratio (aRR) 1.5 for 30–39.9 vs 18–29.9 years, 95% confidence intervals (CI): 1.0–2.2), disclosure of intentions to test for HIV (aRR 2.2 non-disclosure vs disclosure to a partner/spouse, 95% CI: 1.4–3.6) and HIV testing history (aRR 1.7 for  > 12 months vs < 12 months/no prior test, 95% CI: 1.0–2.8). Additionally, having a primary house in another country (aRR 2.1 vs current house, 95% CI: 1.4–3.1) and testing alone (RR 4.6 vs partner/spouse support, 95% CI: 1.2–18.3) predicted ART deferral among men. Among the 43/99 six-months interviews, women (71.4%) were more likely to self-report ART initiation than men (RR 0.4, 95% CI: 0.2–0.8) and participants who relocated within SA (RR 2.1 vs not relocated, 95% CI: 1.2–3.5) were more likely to still not be on ART. Under the treat-all ART policy, nearly 15.2% of study participants deferred ART initiation up to six months after the HIV diagnosis. Our analysis highlighted the need to pay particular attention to patients who show little social preparation for HIV testing and mobile populations.

Art Policy: Pooling Resources

Circa ◽  
1995 ◽  
pp. 30
Author(s):  
Gemma Tipton
Keyword(s):  
Art Policy

From Barbara to Bia: Art, policy and science dialoguing with rights and health of lesbians in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M G Lima ◽  
C Sandroni ◽  
L P B Medina
Keyword(s):  
Government Policies ◽  
Military Government ◽  
Lgbt Rights ◽  
Art Policy ◽  
Pubmed Database ◽  
Lesbian Health ◽  
Lesbian Couple ◽  
A Minor ◽  
Policy And Science ◽  
Lgbt Movement

Abstract Issue Discrimination and homophobia are latent and can affect health. Chico Buarque composed at least three songs about lesbian love: Barbara (with Ruy Guerra - 1972), Sea and Moon (1980) and Blues for Bia (2017). Problem Beginning with the view that art can manifest itself as narrative, this paper analyzes the alignment of the content of the three songs mentioned above with Brazilian policies ensuring LGBT rights and the trend of studies on lesbian health in Brazil from 1970 to 2019. The results can assist the promotion of discussions in other places. We performed 1) a search of governmental policies aimed at protecting the rights of the LGBT population; 2) a systematic search for studies on lesbian health in PUBMED; 3) a musical analysis of the songs. Results The 1970s was marked by a military government when the love addressed in the song 'Barbara' was closeted and sad. The song (composed in a minor tone) uses half-step intervals, generating melancholy feelings. In the 1980s, still under a dictatorial government, several social movements initiated a militant stance for the LGBT movement and the song “Sea and Moon” addressed the suicide of a lesbian couple. We found no government actions in this period or studies conducted in Brazil in the PUBMED database up to 1998. Government policies emerged in the 2000s, especially through the program entitled 'Brazil without Homophobia' in 2004. Other policies followed and intensified in the 2010s. The number of studies increased from seven up to the year 2009 to 105 from 2010 onward. “Blues for Bia” addresses sexual freedom with lightheartedness. Lessons The increase in policies for the rights of the LGBT population was aligned with a trend in studies on lesbian health and with the three songs analyzed. Songs began with sad, negative tones until finally arriving at issues of autonomy and freedom, suggesting the importance of the maintenance of these actions that can alleviate problems related to LGBT rights and health. Key messages Policies for LGBT rights and studies on lesbian health have increased in Brazil since 2000s, especially after 2010. The tone of the songs studied changed from pain to lightness, in line with increase of the research and policies, emphasizing the importance of such actions.

scholarly journals Hindsight Trust Region Policy Optimization

2021 ◽  
Author(s):  
Hanbo Zhang ◽  
Site Bai ◽  
Xuguang Lan ◽  
David Hsu ◽  
Nanning Zheng
Keyword(s):  
Robot Control ◽  
State Of The Art ◽  
Convergence Property ◽  
Trust Region ◽  
Gradient Algorithm ◽  
Learning Performance ◽  
Kl Divergence ◽  
Art Policy ◽  
Current Task ◽  
Policy Optimization

Reinforcement Learning (RL) with sparse rewards is a major challenge. We pro- pose Hindsight Trust Region Policy Optimization (HTRPO), a new RL algorithm that extends the highly successful TRPO algorithm with hindsight to tackle the challenge of sparse rewards. Hindsight refers to the algorithm’s ability to learn from information across goals, including past goals not intended for the current task. We derive the hindsight form of TRPO, together with QKL, a quadratic approximation to the KL divergence constraint on the trust region. QKL reduces variance in KL divergence estimation and improves stability in policy updates. We show that HTRPO has similar convergence property as TRPO. We also present Hindsight Goal Filtering (HGF), which further improves the learning performance for suitable tasks. HTRPO has been evaluated on various sparse-reward tasks, including Atari games and simulated robot control. Experimental results show that HTRPO consistently outperforms TRPO, as well as HPG, a state-of-the-art policy 14 gradient algorithm for RL with sparse rewards.

Trends in Art Policy: The Dutch Case

1992 ◽  
pp. 67-73
Author(s):  
Pierre Eijgelshoven
Keyword(s):  
Art Policy
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