Abstract:
INTRODUCTION:Current healthcare systems fail to provide adequate HIV services to men. In Zambia, 25% of adult men living with HIV were unaware of their HIV status in 2018, and 12% of those who were unaware of their HIV statu were not receiving antiretroviral therapy (ART) due to pervasive barriers to HIV testing services (HTS) and linkage to ART. To identify men and key and priority populations living with HIV in Zambia, and link them to care and treatment, we implemented the Community Impact to Reach Key and Underserved Individuals for Treatment and Support (CIRKUITS) project. We present HTS and ART linkage results from the first year of CIRKUITS. METHODS:CIRKUITS aimed to reach beneficiaries by training, mentoring, and deploying community health workers to provide index testing services and targeted community HTS. Community leaders and workplace supervisors were engaged to enable workplace HTS for men. To evaluate the effects of these interventions, we collected age- and sex-disaggregated routinely collected programme data for the first 12 months of the project (October 2018 to September 2019) across 37 CIRKUITS-supported facilities in three provinces. We performed descriptive statistics and estimated index cascades for indicators of interest, and used Chi square tests to compare indicators by age, sex, and district strata. RESULTS:Over 12 months, CIRKUITS tested 38,255 persons for HIV, identifying 10,974 (29%) new people living with HIV, of whom 10,239 (93%) were linked to ART. Among men, CIRKUITS tested 18,336 clients and identified 4458 (24%) as HIV positive, linked 4132 (93%) to ART. Men who tested HIV negative were referred to preventative services. Of the men found HIV positive, and 13.0% were aged 15 to 24 years, 60.3% were aged 25 to 39, 20.9% were aged 40 to 49 and 5.8% were ≥50 years old. Index testing services identified 2186 (49%) of HIV-positive men, with a positivity yield of 40% and linkage of 88%. Targeted community testing modalities accounted for 2272 (51%) of HIV-positive men identified, with positivity yield of 17% and linkage of 97%. CONCLUSIONS:Index testing and targeted community-based HTS are effective strategies to identify men living with HIV in Zambia. Index testing results in higher yield, but lower linkage and fewer absolute men identified compared to targeted community-based HTS.
journal_name
J Int AIDS Socjournal_title
Journal of the International AIDS Societyauthors
Mwango LK,Stafford KA,Blanco NC,Lavoie MC,Mujansi M,Nyirongo N,Tembo K,Sakala H,Chipukuma J,Phiri B,Nzangwa C,Mwandila S,Nkwemu KC,Saadani A,Mwila A,Herce ME,Claassen CWdoi
10.1002/jia2.25520subject
Has Abstractpub_date
2020-06-01 00:00:00pages
e25520issn
1758-2652journal_volume
23 Suppl 2pub_type
杂志文章abstract:INTRODUCTION:Policies for rationing antiretroviral therapy (ART) have been subject to on-going ethical debates. Introduced in Malawi in 2011, Option B+ prioritized HIV-positive pregnant women for lifelong ART regardless of the underlying state of their immune system, shifting the logic of allocation away from medical e...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.20.1.21467
更新日期:2017-03-08 00:00:00
abstract:INTRODUCTION:International investment in the response to HIV and AIDS has plateaued and its future level is uncertain. With many countries committed to ending the epidemic, it is essential to allocate available resources efficiently over different response periods to maximize impact. The objective of this study is to p...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.19.1.20627
更新日期:2016-02-23 00:00:00
abstract:INTRODUCTION:Switching to a rilpivirine, tenofovir and emtricitabine (RTE) single-tablet regimen (STR) has been evaluated in a limited number of virologically suppressed patients. The aim of this study was to describe clinical outcomes in HIV-positive patients switched from a suppressive antiretroviral regimen to RTE S...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.1.20037
更新日期:2015-07-30 00:00:00
abstract:INTRODUCTION:Despite significant gains in access to early infant diagnosis (EID) over the past decade, most HIV-exposed infants still do not get tested for HIV in the first two months of life. For those who are tested, the long turnaround time between when the sample is drawn and when the results are returned leads to ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.7448/IAS.18.7.20299
更新日期:2015-12-02 00:00:00
abstract:: With the success of antiretrovirals and increased access to this lifesaving treatment, the life expectancy of people living with HIV has been substantially increased and, in many instances, is comparable to that of the general population. However, HIV infection, as well as its treatment, can cause physical, psycholog...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1186/1758-2652-2-1
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abstract:INTRODUCTION:HIV-1-associated CD4+ T-cell depletion is a consequence of uninfected cell death. Nef is one of the viral factors that trigger apoptosis on bystander cells, though the plasma Nef levels do not correlate with Th lymphocytes counts. The aim of our study was to evaluate whether anti-Nef antibodies were involv...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.1.18790
更新日期:2014-02-14 00:00:00
abstract:INTRODUCTION:Infection with HIV subtype A has been associated with poorer neurocognitive outcomes compared to HIV subtype D in Ugandan children not eligible for antiretroviral therapy (ART). In this study, we sought to determine whether subtype-specific differences are also observed among children receiving ART. MATER...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
doi:10.1002/jia2.25015
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:Although individual HIV rapid diagnostic tests (RDTs) show good performance in evaluations conducted by WHO, reports from several African countries highlight potentially significant performance issues. Despite widespread use of RDTs for HIV diagnosis in resource-constrained settings, there has been no syst...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,多中心研究
doi:10.7448/IAS.20.1.21345
更新日期:2017-03-24 00:00:00
abstract:INTRODUCTION:Global HIV-1 prevalence is 35.3 million [1]; women comprise >50% of those infected. The majority of women may lack regular care and only one-fourth are virologically suppressed [2]. ELLA is a cross-sectional, non-interventional study conducted across Europe, Latin America, Canada and Asia that describes ba...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19616
更新日期:2014-11-02 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25577
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION:Limited data exist on acceptability of candidate pre-exposure prophylaxis (PrEP) regimens among US women. We evaluated PrEP experiences, attitudes and future use intentions among sexually active women who completed the US-based HIV Prevention Trials Network 069/AIDS Clinical Trials Group 5305 study. METHO...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
doi:10.1002/jia2.25247
更新日期:2019-03-01 00:00:00
abstract:INTRODUCTION:As adolescents transition from childhood to adulthood, they experience major physical, social and psychological changes, and are at heightened risk for developing mental health conditions and engaging in health-related risk behaviours. For adolescents living with HIV (ALHIV), these risks may be even more p...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25556
更新日期:2020-09-01 00:00:00
abstract:INTRODUCTION:Nearly 40 years into the HIV epidemic, the persistence of HIV stigma is a matter of grave urgency. Discrimination (i.e. enacted stigma) in healthcare settings is particularly problematic as it deprives people of critical healthcare services while also discouraging preventive care seeking by confirming fear...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.1002/jia2.25553
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION:Globally, young gay, bisexual and other men who have sex with men (gbMSM) continue to experience disproportionately high rates of HIV and other sexually transmitted and blood-borne infections (STBBIs). As such, there are strong public health imperatives to evaluate innovative prevention, treatment and care...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.1002/jia2.25017
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:Most clinical trials for new antiretroviral (ARV) agents are conducted among narrowly defined adult populations. Only after safety and efficacy have been clearly demonstrated among adults living with HIV are trials including adolescents, children and infants conducted. This approach contributes to signific...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25576
更新日期:2020-09-01 00:00:00
abstract:INTRODUCTION:Men who have sex with men (MSM) and transgender women (TGW) are two key populations (KPs) in Thailand at high risk for HIV. Uptake and scale-up of pre-exposure prophylaxis (PrEP) among them has been slow. We used data from Princess PrEP, Thailand's largest KP-led PrEP programme, to operationalize PrEP serv...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25540
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Safer conception strategies minimize HIV risk during condomless sex to become pregnant. Gaps remain in understanding the acceptability, feasibility and choices HIV-serodiscordant couples make when multiple safer conception options are available. METHODS:We conducted a pilot study of a comprehensive safer ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25261
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Every year, approximately 260,000 children are infected with HIV in low- and middle-income countries. The timely initiation and high level of maintenance of antiretroviral therapy (ART) are crucial to reducing the suffering of HIV-positive children. We need to develop a better understanding of the backgrou...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.1.19310
更新日期:2014-12-03 00:00:00
abstract:INTRODUCTION:Almost from the beginning of the HIV epidemic in 1981, an association with tuberculosis (TB) was recognized. This association between HIV and TB co-infection has been particularly evident amongst prisoners. However, despite this, few studies of TB in prisons have stratified results by HIV status. Given the...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.7448/IAS.19.1.20960
更新日期:2016-11-15 00:00:00
abstract:INTRODUCTION:To be used most effectively, pre-exposure prophylaxis (PrEP) should be prioritized to those at high risk of acquisition and would ideally be aligned with time periods of increased exposure. Identifying such time periods is not always straightforward, however. Gaza Province in southern Mozambique is charact...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.4.19946
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abstract:INTRODUCTION:Antiretroviral (ARV)-based pre-exposure prophylaxis (PrEP) is a promising new HIV prevention strategy. However, variable levels of adherence have yielded mixed results across several PrEP trials and populations. It is not clear how taking ARV - traditionally used for HIV treatment - is perceived and how th...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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abstract:INTRODUCTION:Guidelines regarding antiretroviral therapy (ART) initiation in HIV infection have varied over time, with the 2015 World Health Organization recommendation suggesting ART initiation at the time of diagnosis regardless of CD4 T-cell counts. Herein, we investigated the influence of socio-demographic and clin...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:The Amsterdam PrEP project is a prospective, open-label demonstration study at a large sexually transmitted infection (STI) clinic. We examined the uptake of PrEP; the baseline characteristics of men who have sex with men (MSM) and transgender persons initiating PrEP; their choices of daily versus event-dr...
journal_title:Journal of the International AIDS Society
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journal_title:Journal of the International AIDS Society
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更新日期:2020-01-01 00:00:00
abstract:INTRODUCTION:Several factors such as duration of infection, age, male gender, consumption of alcohol, HIV infection and low CD4 count have been associated with fibrosis progression rate. However, it is relatively scarce, the knowledge about the liver fibrosis progression rate in HIV-infected patients with undetectable ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19636
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:To achieve epidemic control of HIV by 2030, countries aim to meet 90-90-90 targets to increase knowledge of HIV-positive status, initiation of antiretroviral therapy (ART) and viral suppression by 2020. We assessed the progress towards these targets from 2014 to 2016 in South Africa as expanded treatment p...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19713
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:Changes in combination antiretroviral therapy (cART) throughout childhood challenge the continuity of paediatric HIV treatment. This study aimed to evaluate the prevalence of treatment interruption (TI), including lamivudine (3TC) monotherapy, and the relationship of TI to virologic and immunologic paramet...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.19.1.20936
更新日期:2016-10-27 00:00:00
abstract:BACKGROUND:Traditional medication adherence measures do not account for the pharmacokinetic (PK) properties of the drugs, potentially misrepresenting true therapeutic exposure. METHODS:In a population of HIV-infected Kenyan children on antiretroviral therapy including nevirapine (NVP), we used a one-compartment model ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.20.1.21157
更新日期:2017-06-15 00:00:00