Correction: What Is Required to End the AIDS Epidemic as a Public Health Threat by 2030? The Cost and Impact of the Fast-Track Approach

Stover, John; Bollinger, L; Izazola, José Antonio; Loures, Luiz; DeLay, Paul; Ghys, Peter D.

doi:10.1371/journal.pone.0158253

Cited by 14 publications

(5 citation statements)

References 1 publication

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“…In 2016, 36.7 million people were living with HIV (PLHIV), with 1.8 million new HIV infections and one million HIV/AIDS‐related deaths . Despite substantial progress toward the 2020 “90/90/90 targets” current estimates suggest we are already off‐track , with only an estimated 75% [55% to 92%] of PLHIV currently aware of their status . This gap compromises the whole cascade, and also threatens global HIV prevention targets.…”

Section: Introductionmentioning

confidence: 99%

HIV self‐testing: breaking the barriers to uptake of testing among men and adolescents in sub‐Saharan Africa, experiences from STAR demonstration projects in Malawi, Zambia and Zimbabwe

Hatzold

Gudukeya²,

Mutseta³

et al. 2019

J Intern AIDS Soc

145

120

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Introduction Social, structural and systems barriers inhibit uptake of HIV testing. HIV self‐testing ( HIVST ) has shown promising uptake by otherwise underserved priority groups including men, young people and first‐time testers. Here, we use characteristics of HIVST kit recipients to investigate delivery to these priority groups during HIVST scale‐up in three African countries. Methods Kit distributors collected individual‐level age, sex and testing history from all clients. These data were aggregated and analysed by country (Malawi, Zambia and Zimbabwe) for five distribution models: local community‐based distributor ( CBD : door‐to‐door, street and local venues), workplace distribution ( WD ), integration into HIV testing services ( IHTS ), or public health facilities ( IPHF ) and during demand creation for voluntary male medical circumcision ( VMMC ). Used kits were collected and re‐read from CBD and IHTS recipients. Results Between May 2015 and July 2017, 628,705 HIVST kits were distributed in Malawi (172,830), Zambia (190,787) and Zimbabwe (265,091). Community‐based models, the first to be established, accounted for 519,658 (82.7%) of kits distributed, with 275,419 (53.0%) used kits returned. Subsequent model diversification delivered 54,453 (8.7%) test‐kits through IHTS , 23,561 (3.7%) through VMMC , 21,183 (3.4%) through IPHF and 9850 (1.7%) through WD . Men took 294,508 (48.2%) kits, and 263,073 (43.1%) went to young people (16 to 24 years). A higher proportion of male self‐testers (65,577; 22.3%) were first‐time testers than women (54,096; 17.1%) with this apparent in Zimbabwe (16.2% vs. 11.4%), Zambia (25.4% vs. 17.7%) and Malawi (27.9% vs. 25.9%). The highest proportions of first‐time testers were in young (16 to 24 years) and older (>50 years) men (country‐ranges: 18.7% to 35.9% and 13.8% to 26.8% respectively). Most IHTS clients opted for HIVST in preference to standard HTS in each of 12 delivery sites, with those selecting HIVST having lower HIV prevalence, potentially due to self‐selection. Conclusions HIVST delivered at scale using several different models reached a high proportion of men, young people and first‐time testers in Malawi, Zambia and Zimbabwe, some of whom may not have tested otherwise. As men and young people have limited uptake under s...

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Section: Introductionmentioning

confidence: 99%

HIV self‐testing: breaking the barriers to uptake of testing among men and adolescents in sub‐Saharan Africa, experiences from STAR demonstration projects in Malawi, Zambia and Zimbabwe

Hatzold

Gudukeya²,

Mutseta³

et al. 2019

J Intern AIDS Soc

145

120

View full text Add to dashboard Cite

show abstract

“…While UNAIDS has released a report in support of social protection in the context of HIV treatment [ 27 ], the only socioeconomic support mechanism highlighted in the Fast Track plan is cash transfers for girls in areas with low school enrollment [ 5 ]. Funding for social protection through UNAIDS and the President’s Emergency Plan for AIDS Relief (PEPFAR) has reduced over time and is currently principally available through the Orphans and Vulnerable Children (OVC) program and the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) public/private partnership for adolescent girls and young women [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Joint United Nations Programme on HIV/AIDS (UNAIDS) released a Fast Track plan in 2014 with the goal of ending HIV as a public health threat and reducing deaths from HIV by 90% by 2030 [ 4 ]. This plan emphasizes the rapid scaling up of clinical services, primarily through engagement and retention in care and universal ART access, with targets for HIV diagnosis, treatment, and viral suppression of 90-90-90 by 2020 and 95-95-95 by 2030 [ 5 ].…”

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confidence: 99%

Mortality Over Long-term Follow-up for People With HIV Receiving Longitudinal Care and Antiretroviral Therapy in Rural Haiti

Richterman

Léandre

Jerome³

et al. 2020

Open Forum Infectious Diseases

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Introduction Deaths from HIV have fallen dramatically with the increasing availability of fully suppressive antiretroviral therapy (ART), and yet HIV remains the 9th leading cause of death in low-income countries. As more people with HIV enter care and receive ART, the focus will necessarily need to shift from expanding ART to including long-term program effectiveness and outcomes for people with HIV already engaged in care. Methods We evaluated risk factors for mortality among people with HIV on ART receiving longitudinal care in rural Haiti. We assessed baseline characteristics using a household survey and abstracted clinical characteristics from the electronic record. We used multivariable Cox regression models to identify risk factors for mortality. Results There were 464 people included in this study with a median follow up of 69 months (IQR 44-77), during which time 37 (8%) were lost to follow up and 118 (25%) died (median time to death, 29 months [IQR 12-53]). After adjustment, poverty (AHR 1.12 per 10 percentage point increased probability, 95% CI 1.01-1.24) and single marital status (AHR 1.59, 95% CI 1.08-2.36) were associated with increased mortality. Age (AHR 0.78 per ten year increase, 95% CI 0.64-0.94), role function quality of life (AHR 0.75 per quintile increase, 95% CI 0.62-0.90), and CD4 count (AHR 0.66 per 100 cells/uL, 95% CI 0.58-0.75) were associated with decreased mortality. Conclusions Poverty, marital status, and quality of life were associated with mortality. Social protection should be evaluated as a strategy to reduce mortality for people with HIV in concert with increasing access to ART.

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“…Our research team focuses on identifying and understanding the complex and multi-level factors that drive poor engagement along the HIV care continuum among AABL PLWH and, based on this knowledge, creating behavioral interventions to reduce racial/ethnic disparities in engagement [8][9][10][11][12]. Indeed, the larger public health goal of ending the HIV epidemic cannot be reached without increasing rates of sustained HIV viral suppression among PLWH, including AABL PLWH, and effective and e cient behavioral interventions have a vital role to play in this effort [13].…”

Section: Introductionmentioning

confidence: 99%

Exploring intervention components grounded in critical race theory, harm reduction, and self-determination theory: A qualitative study with Black and Latino persons living with HIV in the United States

Cluesman

Gwadz

2022

Preprint

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Background . The persistence of racial/ethnic disparities in the United States in rates of engagement along the HIV care continuum signals the need for novel approaches. We recently described a new integrated conceptual model (ICM) that combines critical race theory, harm reduction, and self-determination theory. This ICM guided the development of six behavioral intervention components tested in optimization trial (Core component, Component A: motivational interviewing sessions, Component B: pre-adherence skill building, Component C: peer mentorship, Component D: focused support groups, Component E: navigation). The present qualitative exploratory study describes participants’ perspectives on the components’ acceptability, feasibility, and impact. Methods . Participants were African American/Black and Latino PLWH poorly engaged in HIV care and with non-suppressed HIV viral load in New York City. From a larger optimization trial (N = 512), we randomly selected 46 participants for in-depth semi-structured interviews. Interviews were audio-recorded and transcribed verbatim, and data were analyzed using directed content analysis. Structured data on components’ acceptability and feasibility were collected. Results . On average, participants were 49 years old (SD = 9) and had lived with HIV for 19 years (SD = 7). Most were male (78%) and African American/Black (76%). Participants reported a constellation of serious mainly social and structural challenges to HIV management including chronic poverty, unstable housing, and stigma. Components were found acceptable (> 70% rated them as quite a bit to very helpful). Feasibility was high: attendance rates for each component was > 80%. For all components, a non-judgmental, pressure-free, and structurally and culturally salient approach was seen as vital and described as lacking in most medical/social service settings. Prominent aspects of components, consistent with the ICM, included establishing trust (core); developing intrinsic motivation and self-reflection (Component A); learning/practicing adherence strategies and habits (Component B); reducing social isolation via peer role models (Component C); reflecting on salient goals and challenges with peers without stigma (Component D); and circumventing structural barriers to HIV management, including related to systemic racism (Component E). Conclusions . The ICM has potential to improve the acceptability and feasibility of interventions and services for AABL-PLWH, key underpinnings of intervention/treatment effectiveness. Future study of the ICM is warranted to address racial/ethnic health disparities.

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Correction: What Is Required to End the AIDS Epidemic as a Public Health Threat by 2030? The Cost and Impact of the Fast-Track Approach

Cited by 14 publications

References 1 publication

HIV self‐testing: breaking the barriers to uptake of testing among men and adolescents in sub‐Saharan Africa, experiences from STAR demonstration projects in Malawi, Zambia and Zimbabwe

HIV self‐testing: breaking the barriers to uptake of testing among men and adolescents in sub‐Saharan Africa, experiences from STAR demonstration projects in Malawi, Zambia and Zimbabwe

Mortality Over Long-term Follow-up for People With HIV Receiving Longitudinal Care and Antiretroviral Therapy in Rural Haiti

Exploring intervention components grounded in critical race theory, harm reduction, and self-determination theory: A qualitative study with Black and Latino persons living with HIV in the United States

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