Epidemiology of HIV, programmatic progress and gaps in last 10 years in Nepal

Paudel, Tarun; Singh, Nalin; Banjara, Megha Raj; Kafle, Sambhu Prasad; Ghimire, Yadu Chandra; Pokharel, Bhesh Raj; Rawal, Bir Bahadur; Badal, Komal; Chaulagain, Madhav; Pendse, Razia; Ghimire, Prakash

doi:10.1016/s2055-6640(20)31099-2

Cited by 14 publications

(10 citation statements)

References 7 publications

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“…40 According to Granich, 21 an increase in the number of people diagnosed and initiated on treatment will normalize the HIV epidemic and also encourage others to seek testing and treatment hence achieving the UNAIDS 90-90-90 target. As suggested by, 41 there is a need to scale up HIV case-detection capacity through creating awareness about HIV, HIV testing and counselling (HTC), reducing stigma and discrimination and also need to expand the ART services so as to achieve the 90-90-90 UNAIDS target. On analyzing the factors that determine viral load suppression among HIV-positive patients that are already on ART treatment and have at least taken one viral load test, the time taken by the HIV-positive patient to start ART treatment from the time of confirmation being HIV positive and a decrease in body weight were found to significantly negatively influence viral load suppression in HIV-positive patients.…”

Section: Percentage (%)mentioning

confidence: 99%

<p>Current Status Towards 90-90-90 UNAIDS Target and Factors Associated with HIV Viral Load Suppression in Kediri City, Indonesia</p>

Ssekalembe¹,

Isfandiari²,

Suprianto³

2020

HIV

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Introduction: In 2016, UN Member States committed to reduce new HIV infections to fewer than 500,000 annually by 2020, a 75% reduction compared with 2010, reduce AIDS-related deaths to fewer than 500,000 globally as a means of ending AIDS by 2030. The UNAIDS 2020 target is to have 90% of the people living with HIV know their status, 90% of the people living with HIV (who know their HIV status as positive) are already on ART treatment, 90% of people on treatment are virally suppressed. The objective of this study is to determine the current status towards the 2020 90-9-90 UNAIDS target and the factors associated with HIV viral load suppression in Kediri city. Methods: The study was a cross-sectional study in Kediri city. The researcher collected secondary data, carried in-depth interviews, then determined the percentage of HIV-positive patients that did a HIV test and received their results as Positive, the percentage of HIVpositive patients that started ART treatment, the percentage of HIV-positive patients that have viral load suppression from the viral load tests done. A simple bivariate logistic and multivariate logistic regression was used to determine the significant factors that determine viral suppression. Results: The progress towards the 90-90-90 UNAIDS target was at 6.4%, 74.9%, 9.9%. The time taken by the HIV-positive patient to start ART treatment from the time of confirmation of HIV positive (AOR= 83.191,) and decrease in body weight of the patient (AOR=29. 636,) were found to significantly influence viral load suppression. Conclusion:There is a need to scale up HIV case-detection capacity through creating awareness about HIV, HIV testing and counselling and expand the ART services so as to achieve the 90-0-90 UNAIDS target. Early initiation to ART treatment (Test and Treat) and encouraging body gaining behaviors are needed to achieve viral load suppression.

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Section: Percentage (%)mentioning

confidence: 99%

<p>Current Status Towards 90-90-90 UNAIDS Target and Factors Associated with HIV Viral Load Suppression in Kediri City, Indonesia</p>

Ssekalembe¹,

Isfandiari²,

Suprianto³

2020

HIV

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“…6 In the current context, integration and scale-up of HIV testing services are required to minimise access related barriers, bring services closer to the communities, provide early detection of HIV cases and link them for treatment, care and support services. 7 In Nepal, STIs diagnosis and treatment services are currently provided through government- and NGO-run sites. In Nepal, based on the available resources, syndromic diagnostic approach and laboratory testing are recommended.…”

Section: Introductionmentioning

confidence: 99%

Availability and readiness to provide sexually transmitted infections and HIV testing and counselling services in Nepal: evidence from comprehensive health facility survey

Acharya¹,

Thapa

Bhattarai

et al. 2020

BMJ Open

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ObjectiveWe assessed the availability and readiness of health facilities to provide sexually transmitted infections (STI) and HIV testing and counselling (HTC) services in Nepal.DesignThis was a cross-sectional study.SettingWe used data from the most recent nationally representative Nepal Health Facility Survey (NHFS) 2015. A total of 963 health facilities were surveyed with 97% response rate.Primary and secondary outcome measuresThe primary outcome of this study was to assess the availability and readiness of health facilities to provide STI and HTC services using the WHO Service Availability and Readiness Assessment (SARA) manual.ResultsNearly three-fourths (73.8%) and less than one-tenth (5.9%) of health facilities reported providing STI and HTC services, respectively. The mean readiness score of STI and HTC services was 26.2% and 68.9%, respectively. The readiness scores varied significantly according to the managing authority (private vs public) for both STI and HTC services. Interestingly, health facilities with external supervision had better service readiness scores for STI services that were almost four points higher than compared with those facilities with no external supervision. Regarding HTC services, service readiness was lower at private hospitals (32.9 points lower) compared to government hospitals. Unlike STI services, the readiness of facilities to provide HTC services was higher (4.8 point higher) at facilities which performed quality assurance.ConclusionThe facility readiness for HTC service is higher than that for STI services. There are persistent gaps in staff, guidelines and medicine and commodities across both services. Government of Nepal should focus on ensuring constant supervision and quality assurance, as these were among the determining factors for facility readiness.

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“…Data from low- and middle- income countries (LMICs) finds that trans women have 37 times greater odds of having HIV than non-trans men and 77.5 times greater odds compared to non-trans women [ 1 ]. Nepal is a country in South Asia with a concentrated HIV epidemic among key populations, including trans women [ 2 ]. A recent behavioral surveillance study found a 8.2% HIV prevalence among men who have sex with men (MSM) and trans women in Nepal [ 3 ], while the general adult population prevalence was 0.15% [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Population-based HIV prevalence, stigma and HIV risk among trans women in Nepal

et al. 2021

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Background Transgender women (trans women) in Nepal are underserved in the HIV response. Data are needed to determine the HIV prevalence disaggregated from other key populations and to identify the particular risks faced by this community. Trans women are marginalized around the world and research is also needed to determine the impact of stigma on HIV risk to inform trans-specific interventions. Methods In 2019, we conducted the first population-based HIV behavioral surveillance study of trans women disaggregated from other key populations using respondent driven sampling (RDS). We estimated the HIV prevalence for trans women, and bivariate and multivariate Poisson binomial regression models were constructed to examine the relationship between HIV risk and stigma. Results Trans women participants (N = 200) had a mean age of 33 years old (SD = 10.96). We found a weighted HIV prevalence of 11.3% (95% CI 6·82% - 18·13). We found that depression and anxiety (aPR 0.81; 95% CI 0.67–0.97; p = 0·02) and current engagement in sex work (aPR 1.31; 95% CI 1.01–1.71; p = 0·046) were significantly associated with greater prevalence of condomless receptive anal intercourse. We found that experienced stigma of ever being verbally abused due to gender identity was significantly associated with lower prevalence of depression and anxiety (aPR 0.42; 95% CI 0.20–0.87; p = 0·002). Feeling unaccepted in Nepali society and believing people thought they were a criminal because of their trans identity was significantly associated greater prevalence of current sex work (aPR 1.36; 95% CI 1.03–1.78; p = 0·03; aPR 1.45; 95% CI 1.03–2.07; p = 0.04). Every measure of experienced stigma assessed was significantly associated with greater prevalence of current engagement in sex work. Conclusions Trans women are highly stigmatized in Nepal, leading to individual and systems factors that impact their risk for HIV. Interventions are needed that support the economic and mental wellbeing of trans women to prevent their heighted risk of HIV from stigma.

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Epidemiology of HIV, programmatic progress and gaps in last 10 years in Nepal

Cited by 14 publications

References 7 publications

<p>Current Status Towards 90-90-90 UNAIDS Target and Factors Associated with HIV Viral Load Suppression in Kediri City, Indonesia</p>

<p>Current Status Towards 90-90-90 UNAIDS Target and Factors Associated with HIV Viral Load Suppression in Kediri City, Indonesia</p>

Availability and readiness to provide sexually transmitted infections and HIV testing and counselling services in Nepal: evidence from comprehensive health facility survey

Population-based HIV prevalence, stigma and HIV risk among trans women in Nepal

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