Commitment 2: Eliminate new HIV infections among children by 2020 while ensuring that 1.6 million children have access to HIV treatment by 2018

2019 ◽  
pp. 53-65
Author(s):  
Keyword(s):  
Hiv Infections ◽  
Hiv Treatment

scholarly journals The role of contraception in preventing HIV-positive births: global estimates and projections

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jennifer Sherwood ◽  
Elise Lankiewicz ◽  
Beirne Roose-Snyder ◽  
Bergen Cooper ◽  
Austin Jones ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Infections ◽  
Review Literature ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
Treatment Coverage ◽  
Contraception Use ◽  
Unintended Births ◽  
Mother To Child ◽  
Method Mix

Abstract Background Meeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for women, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception in the era of increased HIV treatment coverage and; 2) model the additional HIV benefits of preventing unintended births to WLHIV. Methods Secondary data analysis was conducted using publicly available data from the United Nations Programme on HIV/AIDS (UNAIDS) and Population Division, Demographic Health Surveys, and peer-review literature. National data from 70 countries, that had a UNAIDS estimate for the number of WLHIV nationally, were combined into country-level models. Models estimated the current number of infant HIV infections averted by contraception annually and potentially averted if unintended births to WLHIV were prevented. Estimates take into account pregnancy and live birth rates, contraceptive coverage, contraceptive method mix and failure rates, and HIV treatment coverage during pregnancy to prevent mother to child transmission. Results Contraception use among WLHIV prevents an estimated 43,559 new infant HIV infections annually across 70 countries. Countries with the largest number of infant infections averted by contraception included South Africa (9441), Nigeria (4195), Kenya (3508), Zimbabwe (2586), and India (2145). Preventing unintended births to WLHIV could avert an additional 43,768 new infant infections per year, with the greatest potential gains to be made in South Africa (12,036), Nigeria (2770), Uganda (2552), and the Democratic Republic of the Congo (2324). Conclusions Contraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in sub-Saharan Africa. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide.

scholarly journals SimpactCyan 1.0: An Open-source Simulator for Individual-Based Models in HIV Epidemiology with R and Python Interfaces

2018 ◽  
Author(s):  
Jori Liesenborgs ◽  
Diana M Hendrickx ◽  
Elise Kuylen ◽  
David Niyukuri ◽  
Niel Hens ◽  
...  
Keyword(s):  
Open Source ◽  
Hiv Infections ◽  
Hiv Treatment ◽  
Model Parameters ◽  
Eligibility Criteria ◽  
Hiv Epidemiology ◽  
Treatment And Prevention ◽  
Individual Based Models ◽  
Prevention Programmes ◽  
The Impact

ABSTRACTSimpactCyan is an open-source simulator for individual-based models in HIV epidemiology. Its core algorithm is written in C++ for computational efficiency, while the R and Python interfaces aim to make the tool accessible to the fast-growing community of R and Python users. Transmission, treatment and prevention of HIV infections in dynamic sexual networks are simulated by discrete events. A generic “intervention” event allows model parameters to be changed over time, and can be used to model medical and behavioural HIV prevention programmes. First, we describe a more efficient variant of the modified Next Reaction Method that drives our continuous-time simulator. Next, we outline key built-in features and assumptions of individual-based models formulated in SimpactCyan, and provide code snippets for how to formulate, execute and analyse models in SimpactCyan through its R and Python interfaces. Lastly, we give two examples of applications in HIV epidemiology: the first demonstrates how the software can be used to estimate the impact of progressive changes to the eligibility criteria for HIV treatment on HIV incidence. The second example illustrates the use of SimpactCyan as a data-generating tool for assessing the performance of a phylodynamic inference framework.

scholarly journals Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa

2018 ◽  
Vol 1 ◽  
pp. 3 ◽  
Author(s):  
Renee Heffron ◽  
Kenneth Ngure ◽  
Josephine Odoyo ◽  
Nulu Bulya ◽  
Edna Tindimwebwa ◽  
...  
Keyword(s):  
Hiv Infections ◽  
Hiv Treatment ◽  
Demonstration Project ◽  
Hiv Incidence ◽  
Serodiscordant Couples ◽  
Treatment Services ◽  
Hiv Serodiscordant Couples ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
Hiv Negative

Background: Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk.  Demonstration projects conducted in diverse settings worldwide illustrate practical examples of how PrEP can be delivered. This manuscript presents estimates of effectiveness and patterns of PrEP use within a two-year demonstration project of PrEP for HIV-negative members of heterosexual HIV serodiscordant couples in East Africa. Methods: The PrEP delivery model integrated PrEP into HIV treatment services, prioritizing PrEP use for HIV-negative partners within serodiscordant couples before and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART).  We measured PrEP uptake through pharmacy records and adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results: We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP.  Ninety-seven percent of HIV-negative partners initiated PrEP. Objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected.  Four incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, p<0.0001) in HIV incidence, relative to estimated HIV incidence for the population in the absence of PrEP integrated into HIV treatment services.   Conclusions: PrEP uptake and adherence were high and incident HIV was rare in this PrEP demonstration project for African HIV-negative individuals whose partners were known to be living with HIV.  Delivery of PrEP to HIV-negative partners within HIV serodiscordant couples was feasible and should be prioritized for wide-scale implementation.

Substitution Treatment and HCV / HIV Infection in a Sample of 31 German Prisons for Sentenced Inmates

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Reimer ◽  
H. Stöver ◽  
B. Schulte
Keyword(s):  
Selection Process ◽  
Antiviral Treatment ◽  
Treatment Options ◽  
Hiv Infections ◽  
Hiv Treatment ◽  
Substitution Treatment ◽  
Aggregated Data ◽  
Wide Range ◽  
Immunodeficiency Virus ◽  
Respective Treatment

Injection drug use (IDU) and IDU-related infectious diseases such as hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections are highly prevalent among prisoners worldwide. However, little is known about the prevalence of IDUs and HCV/HIV and the availability of respective treatment options in German prisons. Data, provided by prison physicians of 31 prisons, representing 14,187 inmates, were included in this analysis. The proportion of IDUs among all prisoners was 21.9%. Substitution treatment was available in three out of four prisons (74.2%). Overall, 1,137 substitution treatments were provided annually with a wide range of treatment aims. The prevalence rate was 14.3% for HCV and 1.2% for HIV. Around 5.5% of all HCV-infected prisoners were in antiviral treatment annually, 86.5% of all HIV-positive subjects in antiretroviral HIV treatment.Generally, substitution treatment, HCV and HIV testing and treatment are available. However, due to abstinence-oriented treatment aims substitution treatment is rarely available as maintenance treatment, and HCV/HIV treatment is mainly provided for patients with an existing treatment before imprisonment. The inconsistent data quality necessitate changes in prison related policy are needed, to improve surveillance and to generate aggregated data in German prisons. The selection process in this analysis might lead to overestimating the provision substitution - and antiviral HCV-treatment.

Routine or targeted HIV screening of Indonesian prisoners

2016 ◽  
Vol 12 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Erni Juwita Nelwan ◽  
Ahmad Isa ◽  
Bachti Alisjahbana ◽  
Nurlita Triani ◽  
Iqbal Djamaris ◽  
...  
Keyword(s):  
Drug Use ◽  
Hiv Testing ◽  
Hiv Infections ◽  
Hiv Treatment ◽  
Routine Screening ◽  
Hiv Positive ◽  
Hiv Screening ◽  
Content Type ◽  
Targeted Screening ◽  
Routine Hiv Screening

Purpose – Routine HIV screening of prisoners is generally recommended, but rarely implemented in low-resource settings. Targeted screening can be used as an alternative. Both strategies may provide an opportunity to start HIV treatment but no formal comparisons have been done of these two strategies. The paper aims to discuss these issues. Design/methodology/approach – The authors compared yield and costs of routine and targeted screening in a narcotic prison in Indonesia. Routine HIV screening was done for all incoming prisoners from August 2007-February 2009, after it was switched for budgetary reasons to targeted (“opt-out”) HIV screening of inmates classified as people who inject drugs (PWIDs), and “opt-in” HIV testing for all non-PWIDs. Findings – During routine screening 662 inmates were included. All 115 PWIDs and 93.2 percent of non-PWIDs agreed to be tested, 37.4 percent and 0.4 percent respectively were HIV-positive. During targeted screening (March 2009-October 2010), of 888 inmates who entered prison, 107 reported injecting drug use and were offered HIV testing, of whom 31 (29 percent) chose not to be tested and 25.0 percent of those tested were HIV-positive. Of 781 non-PWIDs, 187 (24 percent) came for testing (opt-in), and 2.1 percent were infected. During targeted screening fewer people admitted drug use (12.0 vs 17.4 percent). Routine screening yielded twice as many HIV-infected subjects (45 vs 23). The estimated cost per detected HIV infection was 338 USD for routine and 263 USD for targeted screening. Originality/value – In a resource limited setting like Indonesia, routine HIV screening in prison is feasible and more effective than targeted screening, which may be stigmatizing. HIV infections that remain unrecognized can fuel ongoing transmission in prison and lead to unnecessary disease progression and deaths.

scholarly journals Challenging the HIV Epidemic in Ontario Through PrEP and HIV Testing

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Steven Winkelman
Keyword(s):  
Hiv Testing ◽  
Hiv Infections ◽  
Hiv Treatment ◽  
Annotated Bibliography ◽  
Hiv Care ◽  
Post Exposure Prophylaxis ◽  
Non Profit ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Priority Populations

The Ontario HIV Treatment Network (OHTN) is a non-profit network which collaborates with health clinics, AIDS service and community organizations, and policy leaders in order to improve the health and wellbeing of people living with and at risk of HIV. I joined the OHTN as a member of the Collective Impact team, with a focus on examining the barriers and facilitators to Pre-Exposure Prophylaxis (PrEP) uptake in Ontario. PrEP is a once-daily pill which is highly effective in preventing HIV infections for HIV-negative people, however usage remains relatively low in Ontario. In this role, I liaised with the Knowledge Synthesis team at OHTN to collect, analyse, and synthesize recent scientific literature on Pre and Post-exposure prophylaxis (PEP) in order to create a comprehensive annotated bibliography on PrEP research. Key findings were drawn from the research to identify potential next steps to increase PrEP use for priority populations in Ontario. Findings from the annotated bibliography were presented to OHTN staff, and have been used to assist in the development of two PrEP study proposals; 1) a cisgender and transgender women-focused PrEP education package and HIV risk screening tool, and 2) a pharmacist-led PrEP delivery pilot. I also worked with the Testing and Clinical Initiatives team at the OHTN, to aid in the implementation and evaluation of two HIV-testing projects: the GetaTest pharmacy-based HIV-testing study, and the GetaKit HIV self-testing pilot program. In this role I drafted health communication materials; analysed survey data and drafted project reports for stakeholders; and provided perspectives on the HIV-care continuum, particularly on PrEP initiation, adherence, and efficacy. My work with the OHTN was important to public health because it sought to expand access to HIV testing and prevention services for priority populations in Ontario, including men who have sex with men, and cis and trans women.

scholarly journals Uptake of HIV testing and counseling among tertiary institution students in the Hohoe Municipality, Ghana

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Evans Agamlor ◽  
Lilian Pencille ◽  
Prosper Lutala ◽  
Derick Akompab Akoku ◽  
Elvis Tarkang
Keyword(s):  
Hiv Testing ◽  
Hiv Infections ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Tertiary Institution ◽  
Chi Square ◽  
Cross Sectional ◽  
Tertiary Institutions ◽  
Stratified Sample ◽  
Hiv Testing And Counselling

HIV Testing and Counselling (HTC) is a critical strategy to reduce the rate of new HIV infections and the key entry point to HIV treatment, care and support services. This study aimed to determine the uptake of HTC among students of tertiary institutions in the Hohoe Municipality of Ghana. This was a quantitative cross-sectional study. A structured questionnaire was used to collect data among a proportionate stratified sample of students from tertiary institutions. Chi-square and Logistic regression analyses were performed using Stata version 12.0 at the 0.05 level of significance. Only 30.6% of the total respondents had ever tested for HIV/AIDS of which, only 22.9% tested less than 6 months before the current study. Students above twenty-four years of age were 3 times more likely to go for HTC than those below 20 years [OR=2.56 (95% CI: 1.07-6.11; p=0.034)]; those in the fourth year of study were 3 times more likely get HTC than those in the first year [OR=3.05 (95%CI: 1.10-8.49; p=0.033)]; and those attending THERESCO, the Midwifery training college and UHAS were more than 2 times more likely to get tested for HIV than those attending FRANCO [OR =2.67 (95% CI: 1.14-6.15; p=0.024)], [OR=2.40 (95% CI: 1.04-5.54; p=0.040)] and [OR=2.63 (95% CI: 1.13-6.13; p=0.026)] respectively. The uptake of HTC among tertiary institution students in Hohoe municipality was considerably low. Policymakers should design programs and interventions that would increase uptake of HTC among tertiary students, with focus on those aged less than 20 years, those at the lower level of study and those in the non-health related institutions.

scholarly journals Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa

2017 ◽  
Vol 1 ◽  
pp. 3 ◽  
Author(s):  
Renee Heffron ◽  
Kenneth Ngure ◽  
Josephine Odoyo ◽  
Nulu Bulya ◽  
Edna Tindimwebwa ◽  
...  
Keyword(s):  
Hiv Infections ◽  
Hiv Treatment ◽  
Demonstration Project ◽  
Open Label ◽  
Serodiscordant Couples ◽  
Treatment Services ◽  
Hiv Serodiscordant Couples ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
Hiv Negative

Introduction: Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV.  Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples of how PrEP can be delivered.  Methods: We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa.  The delivery model integrated PrEP into HIV treatment services, prioritizing PrEP for HIV-negative partners within serodiscordant couples prior to and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART).  We measured adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results: We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP.  Ninety-seven percent (97%) of HIV-negative partners initiated PrEP, and when PrEP was dispensed, objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected.  A total of 4 incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, p<0.0001) in HIV incidence, relative to estimated HIV incidence for the population in the absence of PrEP integrated into HIV treatment services.   Conclusions: PrEP uptake and adherence were high and incident HIV was rare in this PrEP demonstration project for African HIV-negative individuals whose partners were known to be living with HIV.  Delivery of PrEP to HIV-negative partners within HIV serodiscordant couples was feasible and should be prioritized for wide-scale implementation.

scholarly journals HIV incidence among gay men and other men who have sex with men in 2020: where is the epidemic heading?

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 5 ◽  
Author(s):  
Shauna Stahlman ◽  
Carrie Lyons ◽  
Patrick S. Sullivan ◽  
Kenneth H. Mayer ◽  
Sean Hosein ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
Retention In Care ◽  
Hiv Treatment ◽  
Treatment As Prevention ◽  
Structural Level ◽  
Hiv Incidence ◽  
Hiv Risks ◽  
Sex With Men ◽  
Hiv Acquisition

The goal to effectively prevent new HIV infections among gay, bisexual, and other men who have sex with men (MSM) is more challenging now than ever before. Despite declines in the late 1990s and early 2000s, HIV incidence among MSM is now increasing in many low- and high-income settings including the US, with young, adolescent, and racial/ethnic minority MSM being among those at highest risk. Potentiating HIV risks across all settings are individual-, network-, and structural-level factors such as stigma and lack of access to pre-exposure prophylaxis (PrEP) and antiretroviral treatment as prevention. To make a sustained impact on the epidemic, a concerted effort must integrate all evidence-based interventions that will most proximally decrease HIV acquisition and transmission risks, together with structural interventions that will support improved coverage and retention in care. Universal HIV treatment, increased access to HIV testing, and daily oral PrEP have emerged as integral to the prevention of HIV transmission, and such efforts should be immediately expanded for MSM and other populations disproportionately affected by HIV. Respect for human rights and efforts to combat stigma and improve access to prevention services are needed to change the trajectory of the HIV pandemic among MSM.

Development of a Social Network–Based Intervention to Overcome Multilevel Barriers to ART Adherence Among Adolescents in Brazil

2019 ◽  
Vol 31 (2) ◽  
pp. 111-126
Author(s):  
Katie B. Biello ◽  
Beatriz Grinsztejn ◽  
Nilo Martinez Fernandes ◽  
Alberto Edeza ◽  
Luciana Kamel ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Hiv Infections ◽  
Hiv Treatment ◽  
Art Adherence ◽  
Care Providers ◽  
Medication Access ◽  
Key Informant ◽  
Infectious Disease Specialists ◽  
Sex With Men ◽  
Living With Hiv

Brazil's comprehensive HIV treatment program does not specifically address ART adherence challenges for adolescents—a group accounting for the largest number of incident HIV infections in Brazil. We conducted three focus groups with 24 adolescents (age 15–24) living with HIV in Rio de Janeiro, separately for cisgender men who have sex with men, heterosexual-identified cisgender men and women, and transgender women of any sexual orientation, and key informant interviews (n = 7) with infectious disease specialists and HIV/AIDS service organization staff. Content analysis identified socioecological barriers and facilitators to adherence, including individual (e.g., low knowledge, side effects, and substance use), interpersonal (e.g., stigma from partners and health care providers) and structural (e.g., transportation and medication access) barriers. Overlapping and unique barriers emerged by sexual/gender identity. A community-informed, theory-driven ART adherence intervention for adolescents that is organized around identity and leverages social networks has the potential to improve HIV treatment and health outcomes for Brazilian adolescents.

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