Expansion and scale-up of HIV care and treatment services in four countries over ten years

Teasdale, Chloe A; Abrams, Elaine J.; Yuengling, Katharine A.; Lamb, Matthew R.; Wang, Chunhui; Vitale, Mirriah; Hawken, Mark; Melaku, Zenebe; Nuwagaba‐Biribonwoha, Harriet; El‐Sadr, Wafaa

doi:10.1371/journal.pone.0231667

Cited by 16 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A limitation of the study is that we can only describe ALHIV enrolled in HIV services who represent only a portion of the population. In addition, loss to follow-up from care is high among adolescents [ 3 , 74 ] and our study was not designed to examine ALHIV who had disengaged from care nor to measure retention or treatment outcomes. While our aim was to describe ALHIV based on mode of transmission, participants were not asked about this directly and information in medical charts was not available.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of adolescents aged 15-19 years living with vertically and horizontally acquired HIV in Nampula, Mozambique

et al. 2021

Self Cite

View full text Add to dashboard Cite

BackgroundAdolescents living with HIV (ALHIV) 15–19 years of age are a growing proportion of all people living with HIV globally and the population includes adolescents with vertically acquired HIV (AVH) and behaviorally acquired HIV (ABH).MethodsWe conducted a survey to measure sociodemographic characteristics, educational status, health history, and antiretroviral therapy (ART) adherence among a convenience sample of ALHIV at three government health facilities in 2019 in Nampula, Mozambique. ALHIV 15–19 years on ART, including females attending antenatal care, were eligible. Routine HIV care data were extracted from medical charts. Classification of ALHIV by mode of transmission was based on medical charts and survey data. ALHIV who initiated ART <15 years or reported no sex were considered AVH; all others ABH. Frequencies were compared by sex, and within sex, by mode of transmission (AVH vs. ABH) using Chi-square, Fishers exact tests and Wilcoxon rank-sum tests.ResultsAmong 208 ALHIV, 143 (69%) were female and median age was 18 years [interquartile range (IQR) 16–19]. Just over half of ALHIV (53%) were in or had completed secondary or higher levels of education; the most common reason for not being in school reported by 36% of females was pregnancy or having a child. Of all ALHIV, 122 (59%) had VL data, 62% of whom were <1000 copies/mL. Almost half (46%) of ALHIV reported missing ARVs ≥ 1 day in the past month (62% of males vs. 39% of females; p = 0.003). Just over half (58%) of ALHIV in relationships had disclosed their HIV status: 13% of males vs. 69% of females (p<0.001). Among sexually active males, 61% reported using a condom at last sex compared to 26% of females (p<0.001). Among female ALHIV, 50 (35%) were AVH and 93 (65%) were ABH, 67% of whom were not in school compared to 16% of ABH, (p<0.001).DiscussionData from our study underscore the high level of deprivation among ALHIV enrolled in HIV care in Mozambique, as well as important disparities by sex and mode of transmission. These data can inform the development of effective interventions for this complex and important population.

show abstract

Section: Discussionmentioning

confidence: 99%

Characteristics of adolescents aged 15-19 years living with vertically and horizontally acquired HIV in Nampula, Mozambique

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Thirty‐nine studies reported on initiation of ART [2,21,23,28,33,34,37,40‐42,44‐47,49‐54,23,55‐62,64,66,67‐75], with 25 (64%) defining numerators and denominators. Thirty‐two were longitudinal, four of mixed design and three were cross‐sectional.…”

Section: Resultsmentioning

confidence: 99%

“…Nineteen studies reported on retention in pre‐ART care [ 2 , 20 , 26 , 27 , 34 , 49 , 50 , 51 , 53 , 54 , 55 , 56 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ], with 12 defining numerators and denominators. Six studies were cross‐sectional and 13 longitudinal.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐nine studies reported on initiation of ART [ 2 , 21 , 23 , 28 , 33 , 34 , 37 , 40 , 41 , 42 , 44 , 45 , 46 , 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ], with 25 (64%) defining numerators and denominators. Thirty‐two were longitudinal, four of mixed design and three were cross‐sectional.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The HIV care cascade in sub‐Saharan Africa: systematic review of published criteria and definitions

et al. 2021

View full text Add to dashboard Cite

Introduction:The HIV care cascade examines the attrition of people living with HIV from diagnosis to the use of antiretroviral therapy (ART) and suppression of viral replication. We reviewed the literature from sub-Saharan Africa to assess the definitions used for the different steps in the HIV care cascade. Methods: We searched PubMed, Embase and CINAHL for articles published from January 2004 to December 2020. Longitudinal and cross-sectional studies were included if they reported on at least one step of the UNAIDS 90-90-90 cascade or two steps of an extended 7-step cascade. A step was clearly defined if authors reported definitions for numerator and denominator, including the description of the eligible population and methods of assessment or measurement. The review protocol has been published and registered in Prospero. Results and discussion: Overall, 3364 articles were screened, and 82 studies from 19 countries met the inclusion criteria. Most studies were from Southern (38 studies, 34 from South Africa) and East Africa (29 studies). Fifty-eight studies (71.6%) were longitudinal, with a median follow-up of three years. The medium number of steps covered out of 7 steps was 3 (interquartile range [IQR] 2 to 4); the median year of publication was 2015 (IQR 2013(IQR to 2019. The number of different definitions for the numerators ranged from four definitions (for step "People living with HIV") to 21 (step "Viral suppression"). For the denominators, it ranged from three definitions ("Diagnosed and aware of HIV status") to 14 ("Viral suppression"). Only 12 studies assessed all three of the 90-90-90 steps. Most studies used longitudinal data, but denominator-denominator or denominator-numerator linkages over several steps were rare. Also, cascade data are lacking for many countries. Our review covers the academic literature but did not consider other data, such as government reports on the HIV care cascade. Also, it did not examine disengagement and reengagement in care. Conclusions: The proportions of patients retained at each step of the HIV care cascade cannot be compared between studies, countries and time periods, nor meta-analysed, due to the many different definitions used for numerators and denominators. There is a need for standardization of methods and definitions.

show abstract

“…Africa hosts 68% of PLHIV worldwide and in 2018, 62% of AIDS related deaths were from this continent (1). Despite this burden, transformative and remarkable progress has been made in the past decades with regards to the expansion of antiretroviral therapy (ART)(2–4). In 2018, there were 23 300 000 PLHIV receiving ART, representing 62% of patients in need of treatment.…”

Section: Introductionmentioning

confidence: 99%

An urgent need for a paradigm shift in HIV testing for older children: A sine qua non condition to achieve an AIDS-free generation

Yumo¹,

Ndenkeh²,

Sieleunou

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Achieving an AIDS-free generation requires effective pediatric testing and treatment services. While pediatric HIV testing has been more focused on children below 18 months through PMTCT, the yield of this approach remains unclear comparatively to testing children above 18 months through routine PITC. This study aimed at bridging this evidence gap and provide knowledge to guide pediatric HIV testing investments. Materials and Methods: Parents visiting or receiving HIV care in three hospitals in Cameroon were invited to test their children for HIV. HIV testing was done using PCR and antibody rapid tests for children < 18 months and those ≥18 months, respectively. We compared HIV case detection and ART initiation between the two subgroups of children and this using Chi-square test at 5% significant level. Results: A total of 4079 children aged 6 weeks-15 years were included in the analysis. Compared to children < 18 months, children group ≥18 months was 4-fold higher among those who enrolled in the study (80.3% vs 19.7%, p<0.001); 3.5-fold higher among those who tested for HIV (77.6% vs 22.4%, p<0.001); 6-fold higher among those who tested HIV+ (85.7% vs 14.3%, p=0.241) and 11-fold higher among those who enrolled on ART (91.7% vs 8.3%, p< 0.028). Conclusions: Our results show that 4 out of 5 children who tested HIV+ and over 90% of ART enrolled cases were children ≥ 18 months. Thus, while rolling out PCR HIV testing technology for neonates and infants, committing adequate and proportionate resources in antibody rapid testing for older children is a sine quo none condition to achieve an AIDS-free generation.

show abstract

Expansion and scale-up of HIV care and treatment services in four countries over ten years

Cited by 16 publications

References 21 publications

Characteristics of adolescents aged 15-19 years living with vertically and horizontally acquired HIV in Nampula, Mozambique

Characteristics of adolescents aged 15-19 years living with vertically and horizontally acquired HIV in Nampula, Mozambique

The HIV care cascade in sub‐Saharan Africa: systematic review of published criteria and definitions

An urgent need for a paradigm shift in HIV testing for older children: A sine qua non condition to achieve an AIDS-free generation

Contact Info

Product

Resources

About