Current status of HIV treatment in Asia and the Pacific region

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 119 ◽  
Author(s):  
Angsana Phuphuakrat ◽  
Sasisopin Kiertiburanakul ◽  
Somnuek Sungkanuparph
Keyword(s):  
Low Income ◽  
Universal Access ◽  
Scale Up ◽  
Hiv Treatment ◽  
High Income ◽  
Low Income Countries ◽  
Current Status ◽  
People Living With Hiv ◽  
The Pacific ◽  
Living With Hiv

Asia and the Pacific represent a diverse group of nations facing HIV epidemic profiles of differing severity. Compared to other parts of the world, the burden of HIV disease is high in this region because of its large populations. At the end of 2011, 5 million people were living with HIV in Asia and the Pacific. This accounted for 15% of people living with HIV worldwide. The prevalence of people living with HIV, as well as access to HIV treatment and care, varies widely between countries. Differences between high-income economies and the rest of the continent are remarkable. Many high-income countries provide antiretroviral therapy (ART) to their citizens. Middle- and low-income countries have rapid ART scale-up and are dependent on international funding. This may compromise the sustainability of ART availability. In addition, lack of access to second- and third-line therapy remains a problem in many countries. The global goal of achieving universal access to ART by 2015 requires mainly low- and middle-income countries to be targeted. Regional policy should be developed in order to identify new infections in key populations, to start earlier treatment, to retain patients in care and to maintain funding.

scholarly journals Challenges and opportunities to prevent tuberculosis in people living with HIV in low-income countries

2019 ◽  
Vol 23 (2) ◽  
pp. 241-251 ◽  
Author(s):  
A. D. Harries ◽  
V. Schwoebel ◽  
I. Monedero-Recuero ◽  
T. K. Aung ◽  
S. Chadha ◽  
...  
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
People Living With Hiv ◽  
Challenges And Opportunities ◽  
Living With Hiv

scholarly journals People living with HIV in Estonia: engagement in HIV care in 2013

2016 ◽  
Vol 21 (43) ◽  
Author(s):  
Kaja-Triin Laisaar ◽  
Mait Raag ◽  
Irja Lutsar ◽  
Anneli Uusküla
Keyword(s):  
Medical Care ◽  
Universal Access ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Administrative Databases ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
The European Union ◽  
Treatment Cascade ◽  
Living With Hiv

Estonia had the highest rate of newly diagnosed human immunodeficiency virus (HIV) cases in the European Union (24.6/100,000) and an estimated adult HIV prevalence of 1.3% in 2013. HIV medical care, including antiretroviral therapy (ART), is free of charge for people living with HIV (PLHIV). To maximise the health benefits of HIV treatment, universal access should be achieved. Using data from surveillance and administrative databases and the treatment cascade model, we assessed the number of people infected with HIV, diagnosed with HIV, linked to HIV care, retained in HIV care, on ART, and with suppressed viral load (HIV-RNA: < 200 copies/mL). We identified that about one quarter of the 8,628 HIV-positive people estimated to live in Estonia in 2013 had not been diagnosed with HIV, and another quarter, although aware of their HIV-positive serostatus, had not accessed HIV medical care. Although altogether only 12–15% of all PLHIV in Estonia had achieved viral suppression, the main gap in HIV care in Estonia were the 58% of PLHIV who had accessed HIV medical care at least once after diagnosis but were not retained in care in 2013.

scholarly journals Evaluation of the uptake of tuberculosis preventative therapy for people living with HIV in Namibia: a multiple methods analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Clay Roscoe ◽  
Chris Lockhart ◽  
Michael de Klerk ◽  
Andrew Baughman ◽  
Simon Agolory ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Clinical Performance ◽  
Scale Up ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Preventative Therapy ◽  
Variable Screening ◽  
Care Workers ◽  
Isoniazid Preventative Therapy ◽  
Living With Hiv

Abstract Background In 2016, Namibia had ~ 230,000 people living with HIV (PLHIV) and 9154 new tuberculosis (TB) cases, including 3410 (38%) co-infected cases. TB preventative therapy (TPT), consisting of intensive case finding and isoniazid preventative therapy, is critical to reducing TB disease and mortality. Methods Between November 2014 and February 2015, data was abstracted from charts of PLHIV enrolled in HIV treatment. Fifty-five facilities were purposively selected based on patient volume, type and location. Charts were randomly sampled. The primary outcome was to estimate baseline TPT in PLHIV, using nationally weighted proportions. Qualitative surveys were conducted and summarized to evaluate TPT practices and quantify challenges encountered by health care workers (HCW). Results Among 861 PLHIV sampled, 96% were eligible for TPT services, of which 87.1% were screened for TB at least once. For PLHIV eligible for preventative therapy (646/810; 82.6%), 45.4% (294/646) initiated therapy and 45.7% (139/294) of those completed therapy. The proportion of eligible PLHIV completing TB screening, initiating preventative therapy and then completing preventative therapy was 20.7%. Qualitative surveys with 271 HCW identified barriers to TPT implementation including: lack of training (61.3% reported receiving training on TPT); misunderstandings about timing of TPT initiation (46.7% correctly reported TPT should be started with antiretroviral therapy); and variable screening practices and responsibilities (66.1% of HCWs screened for TB at every encounter). Though barriers were evident, 72.2% HCWs surveyed described their clinical performance as very good, often placing responsibility of difficulties on patients and downplaying challenges like staff shortages and medication stock outs. Conclusions In this study, only 1 in 5 eligible PLHIV completed the TPT cascade in Namibia. Lack of training, irregularities with TB screening and timing of TPT, unclear prescribing and recording responsibilities, and a clinical misperception may have contributed to suboptimal programmatic implementation. Addressing these challenges will be critical with continued TPT scale-up.

Clostridium Tetani and Tetanus

2021 ◽  
Author(s):  
Collins Ankunda
Keyword(s):  
Low Income ◽  
Universal Access ◽  
Case Fatality ◽  
High Income ◽  
Neonatal Tetanus ◽  
Low Income Countries ◽  
Immunization Programs ◽  
African Countries ◽  
Clostridium Tetani ◽  
Animal Excreta

Tetanus is acquired through exposure to the environmental spore-forming Gram-positive bacillus Clostridium tetani, which may infect human wounds and cause disease by production of an exotoxin (tetanospasmin). There is no human-to-human transmission. The disease occurs worldwide and it is sporadic in high-income countries with universal access to well-accepted immunization programs. It is more common in agricultural regions and in low-income countries where contact with animal excreta is more likely and immunization programs are inadequate. Neonatal tetanus (NNT) following unclean deliveries and poor postnatal hygiene is still responsible for the majority of tetanus cases and deaths; the majority of NNT occurs in poor Asian and African countries, whereas in high-income countries the disease is extremely rare. Three forms of clinical disease can be distinguished: the most common form is generalized tetanus, whereas local tetanus and cephalic tetanus are rare. Neonatal tetanus (NNT) is a form of generalized tetanus in newborns. The case fatality rate of tetanus is high, 3%–95% depending on age, immune- and immunization-status, form of disease, and availability of proper medical care. The efficacy of tetanus toxoid vaccines was never formally studied, but cases in adequately vaccinated subjects are extremely rare and impact data (e.g. for NNT) convincingly show high vaccine effectiveness. WHO estimates that in 2018, 25,000 newborns died from NNT, an 88% reduction from the situation in 2000.

Tuberculosis treatment outcome in a rural area of Senegal: a decade of experience from 2010 to 2019 by StopTB Italia

2021 ◽  
Author(s):  
Niccolò Riccardi ◽  
Simone Villa ◽  
Andrea Giacomelli ◽  
Mama M Diaw ◽  
Mamoud Ndiaye ◽  
...  
Keyword(s):  
Rural Area ◽  
Low Income ◽  
Rural Areas ◽  
Social Protection ◽  
Treatment Success ◽  
Pulmonary Involvement ◽  
Low Income Countries ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Background: Tuberculosis (TB) unevenly affects individuals across the globe, especially in rural areas of low-income countries. Aim of the study was to assess the impact of social protection to increase TB awareness on treatment outcomes among TB patients in a rural area of Senegal. Materials & methods: The study, conducted in Fimela district (Senegal) from 1 January 2010 to 31 December 2019 and the intervention started from 31 January 2013, includes activities to increase awareness, active case finding, active follow-up and social protection. Results: Overall, 435 subjects – mainly male and young – were included in the analysis. Among TB cases, 94% had pulmonary involvement, 87% had no previous TB history, and 6% resulted positive HIV. Improved outcome was observed once intervention began (from 71 to 91%, p < 0.001); whereas mortality decreased (from 15 to 5%; p < 0.001), especially for those HIV co-infected for whom TB mortality rate dropped from 70 to 29%. Conclusion: After beginning the cooperation program, TB treatment success increased as a result of the decline of mortality, especially in people living with HIV.

scholarly journals Development and Feasibility Testing of an mHealth (Text Message and WeChat) Intervention to Improve the Medication Adherence and Quality of Life of People Living with HIV in China: Pilot Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Yan Guo ◽  
Zhimeng Xu ◽  
Jiaying Qiao ◽  
Y Alicia Hong ◽  
Hanxi Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Low Income ◽  
Low Income Countries ◽  
People Living With Hiv ◽  
Control Groups ◽  
Mhealth Intervention ◽  
Living With Hiv ◽  
And Control

BACKGROUND Most people living with HIV (PLWH) reside in middle- and low-income countries with limited access to health services. Thus, cost-effective interventions that can reach a large number of PLWH are urgently needed. OBJECTIVE The objective of our study was to assess the feasibility and acceptability of an mHealth intervention among PLWH in China. METHODS Based on previous formative research, we designed an mHealth intervention program that included sending weekly reminders to participants via text messages (short message service, SMS) and articles on HIV self-management three times a week via a popular social media app WeChat. A total of 62 PLWH recruited from an HIV outpatient clinic were randomly assigned to intervention or control group. The intervention lasted for 3 months, and all participants were assessed for their medication adherence, presence of depression, quality of life (QoL), and CD4 (cluster of differentiation 4) counts. Upon completing the intervention, we interviewed 31 participants to further assess the feasibility and acceptability of the study. RESULTS At baseline, the intervention and control groups did not differ in terms of demographic characteristics or any of the major outcome measures. About 85% (53/62) of the participants completed the intervention, and they provided valuable feedback on the design and content of the intervention. Participants preferred WeChat as the platform for receiving information and interactive communication for ease of access. Furthermore, they made specific recommendations about building trust, interactive features, and personalized feedback. In the follow-up assessment, the intervention and control groups did not differ in terms of major outcome measures. CONCLUSIONS This pilot study represents one of the first efforts to develop a text messaging (SMS)- and WeChat-based intervention that focused on improving the medication adherence and QoL of PLWH in China. Our data indicates that an mHealth intervention is feasible and acceptable to this population. The data collected through this pilot study will inform the future designs and implementations of mHealth interventions in this vulnerable population. We recommend more innovative mHealth interventions with rigorous designs for the PLWH in middle- and low-income countries. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1800017987; http://www.chictr.org.cn/showprojen.aspx?proj=30448 (Archived by WebCite at http://www.webcitation.org/71zC7Pdzs) REGISTERED REPORT IENTIFIER RR1-10.2196

scholarly journals PROLIFERATION OF HALLYU WAVE AND KOREAN POPULAR CULTURE ACROSS THE WORLD: A SYSTEMATIC LITERATURE REVIEW FROM 2000-2019

2020 ◽  
Vol 11 (10) ◽  
pp. 177-207
Keyword(s):  
Popular Culture ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Low Income ◽  
Research Area ◽  
Internet Technology ◽  
Low Income Countries ◽  
Current Status ◽  
Hollywood Films ◽  
The Pacific

The exponential growth in the popularity of Korean pop cultural products across the globe known as the Hallyu wave has grabbed the attention of people worldwide. At times when the geographic boundaries have become blurred due to the virtual connectivity and advancement in internet technology, South Korean popular culture is developing at an unprecedented rate across the globe. The popularity is such that it has entered the mainstream even competing with the Hollywood films, dramas and music. The field of Hallyu though has attracted many from academia, as it is still a newer research area, not many significant attempts have been made to review the literature in a systematic manner. The major objective of this paper is to acquire a better understanding, and a detailed review of the research regarding Hallyu wave, its allied areas, current status and trends. Systematic Literature Review (SLR) is the method used for this paper. This research has utilized the methods presented by Junior & Filho (2010), Jabbour (2013) and Seuring (2013). The researchers have deployed a systematic literature review approach to collect, analyze and synthesize data regarding the Hallyu wave, addressing a variety of topics using Google Scholar between 2000 and 2019 and selected 100 primary research articles. From the systematic literature review, the results or main gaps from the existing literature have been uncovered. For example, most of the low-income countries do not have extensive research on Hallyu or most of the research on Hallyu is done in the region of East Asia and the Pacific.

scholarly journals COVID-19 and HIV pandemic response: measuring testing, tracing, and treatment outcomes for both pandemics

2020 ◽  
Author(s):  
Reuben Granich ◽  
Julia S Finver ◽  
Somya Gupta
Keyword(s):  
Economic Status ◽  
Hiv Treatment ◽  
High Income ◽  
Lessons Learned ◽  
People Living With Hiv ◽  
Treatment Data ◽  
Hiv Viral Suppression ◽  
Access And Quality ◽  
Living With Hiv ◽  
System Access

AbstractBackgroundAs of May 14th, 2020, the COVID-19 pandemic has caused 4,444,670 confirmed illnesses and claimed over 302,493 deaths worldwide. The experience of well-resourced countries including China, United States, Italy and France, illustrates that COVID-19 threatens to overwhelm even the best-resourced health systems. Interventions have focused on social distancing including isolation and quarantine with some countries effectively using testing and contract tracing. Methods:Data analyses used UNAIDS testing and treatment data or HIV among the 31 countries with the highest HIV burden (85% of global HIV burden). Additional HIV data was sourced directly from official websites. Economic status was determined using World Bank data. COVID-19 data are from the Worldmeters site.ResultsHigher HIV viral suppression in the 26 countries with 2018 GDP per capita of more than USD 20,000 and more than 3,000 people living with HIV was, on average, associated with lower COVID testing and higher COVID-19 death rates. Comparing the high-income countries HIV treatment coverage and COVID testing capacity showed no relation in the rankings. This is likely due to many factors including the phase of the national COVID-19 epidemic, ability to provide tests, and health care system access and quality. Among the high-income countries, there is a weak and negative correlation between COVID tests per case detected and deaths per 1,000 COVID casesConclusionWhile the HIV has many differences, people engaged in the HIV and COVID-19 responses can share lessons learned about how to address the major challenge of testing and treating millions of people to address these ongoing major pandemics.

scholarly journals ‘Management of a spoiled identity’: systematic review of interventions to address self-stigma among people living with and affected by HIV

2019 ◽  
Vol 4 (2) ◽  
pp. e001285 ◽  
Author(s):  
Marija Pantelic ◽  
Janina I Steinert ◽  
Jay Park ◽  
Shaun Mellors ◽  
Fungai Murau
Keyword(s):  
Low Income ◽  
Sex Workers ◽  
Grey Literature ◽  
Scale Up ◽  
Bibliographic Databases ◽  
People Living With Hiv ◽  
Structural Level ◽  
Key Populations ◽  
Global Public Health ◽  
Living With Hiv

BackgroundSelf-stigma, also known as internalised stigma, is a global public health threat because it keeps people from accessing HIV and other health services. By hampering HIV testing, treatment and prevention, self-stigma can compromise the sustainability of health interventions and have serious epidemiological consequences. This review synthesised existing evidence of interventions aiming to reduce self-stigma experienced by people living with HIV and key populations affected by HIV in low-income and middle-income countries.MethodsStudies were identified through bibliographic databases, grey literature sites, study registries, back referencing and contacts with researchers, and synthesised following Cochrane guidelines.ResultsOf 5880 potentially relevant titles, 20 studies were included in the review. Represented in these studies were 9536 people (65% women) from Ethiopia, India, Kenya, Lesotho, Malawi, Nepal, South Africa, Swaziland, Tanzania, Thailand, Uganda and Vietnam. Seventeen of the studies recruited people living with HIV (of which five focused specifically on pregnant women). The remaining three studies focused on young men who have sex with men, female sex workers and men who inject drugs. Studies were clustered into four categories based on the socioecological level of risk or resilience that they targeted: (1) individual level only, (2) individual and relational levels, (3) individual and structural levels and (4) structural level only. Thirteen studies targeting structural risks (with or without individual components) consistently produced significant reductions in self-stigma. The remaining seven studies that did not include a component to address structural risks produced mixed effects.ConclusionStructural interventions such as scale-up of antiretroviral treatment, prevention of medication stockouts, social empowerment and economic strengthening may help substantially reduce self-stigma among individuals. More research is urgently needed to understand how to reduce self-stigma among young people and key populations, as well as how to tackle intersectional self-stigma.

The Bio/Necropolitics of ACTG 076: Lessons from Pregnant Women of Colour Living with HIV for Treatment for Prevention in the Twenty-first Century

Somatechnics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 233-253
Author(s):  
Eli Manning
Keyword(s):  
Hiv Transmission ◽  
Ethical Dilemmas ◽  
Hiv Treatment ◽  
First Century ◽  
Hiv Positive ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Hiv Positive Women ◽  
Aids Clinical Trials ◽  
Living With Hiv

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.

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