Abstract:
INTRODUCTION:Antiretroviral therapy (ART) substantially improves the health of people living with HIV and contributes to preventing new infections. While HIV incidence is decreasing in most regions, the epidemic in eastern Europe continues to rise, as new infections currently outnumber the rate of ART initiation. In this study, we assess ART use in Armenia and its impact on the number of AIDS diagnoses and mortality. METHODS:National surveillance data were obtained from the National Centre for AIDS Prevention, Armenia. Cox-proportional hazard models were used to determine the effect of demographic and clinical risk factors, including access to ART, on AIDS and mortality. RESULTS:Among people diagnosed with HIV since 2005, approximately 40% per year were diagnosed with CD4<200 cells per mL. Overall, 232 people (57.1%) with AIDS or a low CD4 count had not received ART by the end of 2010. Mortality was 34.1% among people living with HIV who did not initiate ART, and 0.3% among people who received ART. Among people diagnosed with HIV from 1996 to 2010, age at diagnosis, no use of ART, likely mode of transmission, likely place of transmission, low baseline CD4 count and no STI diagnosis at last contact are significantly associated with death. DISCUSSION:In Armenia, HIV is frequently diagnosed at a late stage of disease, indicating low testing rates. Of people diagnosed with HIV and in need of ART, a large proportion (approximately 60%) either do not provide consent for treatment, or are who migrants who cannot be located. CONCLUSIONS:Globally, the scale-up of ART has resulted in substantial reductions in mortality among individuals initiating therapy. However, in an era of momentum for treatment as prevention, treatment levels are not at adequate levels for preventing morbidities and mortality in some settings. Particular focus should be placed on key at-risk subgroups.
journal_name
J Int AIDS Socjournal_title
Journal of the International AIDS Societyauthors
Mallitt KA,Grigoryan SR,Papoyan AS,Wand HC,Wilson DPdoi
10.7448/IAS.17.1.18795subject
Has Abstractpub_date
2014-08-04 00:00:00pages
18795issn
1758-2652pii
18795journal_volume
17pub_type
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journal_title:Journal of the International AIDS Society
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,多中心研究
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journal_title:Journal of the International AIDS Society
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journal_title:Journal of the International AIDS Society
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
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journal_title:Journal of the International AIDS Society
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pub_type: 杂志文章
doi:10.1186/1758-2652-13-22
更新日期:2010-06-14 00:00:00
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更新日期:2017-03-08 00:00:00
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journal_title:Journal of the International AIDS Society
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doi:10.1186/1758-2652-13-44
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journal_title:Journal of the International AIDS Society
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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更新日期:2019-02-01 00:00:00
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